Transcript Planning for your future, or for a loved one

Long Term Care
Planning For The Future
What You Need to Know
Goals for Learning
Increase knowledge of the different types
of long term care
 Increase understanding of factors to
consider in choosing long term care
options
 Increase understanding of how to pay for
long term care options
 Increase knowledge of local resources
and services
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What Is Long Term Care?
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The provision of care and services, prompted
by either chronic illness, injury, frailty or
dementia.
Support for activities of daily living and
nursing care as needed.
A need for these services for many months,
years, or the rest of your life.
What are Activities of Daily
Living?
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EATING/FEEDING
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BATHING/DRESSING
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MOBILITY/TRANSFERS
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TOILETING/CONTINENCE
CARE
What are Instrumental Activities of
Daily Living?
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SHOPPING
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HANDLING FINANCES
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CLEANING/LAUNDRY
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USING TRANSPORTATION
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PREPARING MEALS
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TAKING MEDICATIONS
Case Examples
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Louise
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Bella Vista Assisted
Living for 5 years
Exhausting finances
Ruth
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Living alone, children live
out of town
Difficulty managing
alone; confused
You Or Someone You Know Will Need
Long Term Care Services
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Women who reach the age of 65 are likely to
live 19 additional years, for males—16
additional years.
8.5 million people over the age of 70 have
limitations with their ADLs or IADLs
The longer you live, the greater your chances
of needing long term care services.
How Likely Are You To Spend Time In A
Nursing Home?
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1 in 3 persons who live to age 65 will spend
one to three months in a nursing home.
One in 4 will spend one year or more.
The average length of stay is 19 months.
Women are more likely to need nursing
home care (they live longer).
Caregivers
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Family Caregivers provide 80 to 90% of
all long term care
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Trends that impact family care giving:
 Fewer
children
 People live to be much older
 Families live far apart
Long Term Care Continuum
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Support Services for
persons living at home
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Residential Options
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Simple services to
very complex services
to meet personal and
medical needs
1. Some Of The Support Services For
Individuals Living At Home Are:
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Adult Day Services
Home Delivered Meals
Homemaker
Medications
Management
Personal Care
Assistance
Personal Emergency
Response System
1-888-456-5664
 Information
about Services is
available from the:
Area Agency on Aging of Western
Michigan
In-Home Services Are Available From
Many Programs
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FIA Home Help
Program
Veteran’s Assistance
Care Management
MI-Choice Waiver
Hospice
2.Residential Options
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Informal Options
Assisted Living
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Licensed
Unlicensed
Adult Foster Care
Home for the Aged
Nursing Home
Continuing Care
Retirement
Communities
1-800-782-2918
 For
Information about residential
options call:
Citizens for Better Care
You’ll need to Know
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Assisted living is not a legal designation
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Licensing—benefits
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State inspection reports and other quality of
care information
When Is It Time To Move?
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When more help or a move is needed
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Caregiver burnout
Increased care needs
Health and or Safety
Quality of Life
Exhausted financial resources
Things To Consider
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Physician’s recommendation
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Type of assistance needed now/future
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Available residential openings and services
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Financial resources
How To Choose
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Get a list from Citizens for Better Care (CBC)
Ask others about their experiences
Involve the care receiver in the search and decision
if possible
Call and visit potential LTC residences
Use check lists and other notes to document your
search
Use state inspection reports and quality indicators
How Much Does A Nursing Home
Cost?
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The average cost for nursing home care is currently
$60,000 a year.
The average stay in a nursing home is 19
months….$95,000
Single individuals who move into a nursing home will
spend themselves into poverty after only 13 weeks.
50% of those persons who move into a nursing
home, with a spouse at home, with deplete their
resources within the first year.
How Much Does In-Home Care or
Assisted Living* Cost?
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Very limited home care can average $15,000
per year.
Full time home care could cost $130,000 to
$185,000 annually.
Assisted Living currently ranges from
$20,000 to $60,000 per year.
*remember this is a marketing term
Who Pays?
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Over 90% of care in the
home and assisted
living is paid for with
private resources.
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Over 50% of nursing
home care comes from
public funds.
Resources
Next we will go through more detail about these payment sources:
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Private Pay
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Savings
Family Contributions
Long term care insurance
Reverse Mortgages
Older American Act and Kent County Senior Millage
Medicare and supplemental insurance
Medicaid
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FIA Adult Home Help
MI Choice Waiver
Nursing Home
Private Sources
1.Private Pay – Income/Savings, Life Insurance
2.Reverse Mortgage, Home Equity
3. Long Term Care Insurance
 age 65, approximate cost is $2,400 a year.
 Some planners recommend that you not
spend more than 7% of your income on LTC
insurance.
Long Term Care Insurance
Benefits to Consider
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Daily benefit (how much)
Benefit period (length of time you receive benefits -1 year, 2
years, lifetime)?
Elimination period (deductible) time before begin collecting
benefits
Inflation protection
No prior hospitalization required
Coverage not limited to skilled nursing home
Waiver of premium (does payment continue after you begin
receiving services)
Home health care
Eligibility and Government Sources
4.Older American Act and Kent County Senior
Millage
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Priority to those most in need
List of services available from the Area Agency
on Aging Of Western Michigan
Some cost share
Eligibility and Government Sources
5. Medicare and Supplemental Insurance
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Eligibility = Prior Hospital Stay
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Skilled Service
Maximum 100 days in skilled nursing home with a $105
required daily co-pay
Services covered
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Nursing, Physical Therapy, Occupational Therapy,
Speech Therapy
Eligibility and Government Sources
5.Continued: Medicare Supplemental Insurance
There are 10 standardized Medicare
supplemental insurance policies.
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8 cover skilled nursing facility daily co-pay
4 cover limited at-home help if the beneficiary is
receiving Medicare covered home health services
None cover basic long term nursing home care
Eligibility and Government Sources
6. Medicaid LTC- Categorical Eligibility and
Financial Eligibility
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Income
Assets Countable and Non countable
(exempt)
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Single $2,000
Married both in nursing home $4,000
Married, one person in a nursing home or in the MI Choice
Waiver program up to $92,000
Eligibility and Government Sources
Assets Declaration
An Assets declaration is filed to protect assets
for the community spouse.
Eligibility and Government Sources
Exempt Assets
One homestead, one car, household goods
and personal effects, burial space
Eligibility and Government Sources
Transfer of Assets--Divestment
Before giving away or selling any
assets below fair market value
consult an attorney or financial
planner who is an expert in Medicaid
law
Who Pays For In Home Care?
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Private Pay
FIA Home Help
Older American Act
Kent County Senior Millage
MI Choice Waiver
Limited long term care
insurance
Limited-short time Medicare
Veterans
Who Pays For Residential (non nursing
home) Assisted Living Care ?
 Private
Pay
 Limited
SSI
Who Pays Nursing Home Care?
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9.6% nursing home care (rehab) is paid by
Medicare
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23.5 % of nursing home care is paid with
private dollars
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67% of nursing home care is paid by
Medicaid
Hope For The Future
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More control and
more flexibility
Payment not based
on where you live,
thereby allowing
consumers more
choice
Hand Outs and Additional Resources