People seek long-term care when they have a serious, ongoing health condition or disability, and the need for long-term care can arise immediately after a heart attack or stroke. In addition, the need for LTC is rising due to people get older, and illness or disability gets worse.
Generally, long-term care refers to the provision of a variety of services to meet a person’s health or personal care needs during a short or long period. Physicians should be aware of the medical reasons people need long-term care services because as a professional you often treat the elderly. The most promising reason is aging as we age, activities of daily living or ADLs which include eating, bathing, dressing, toileting, transferring, and continence are getting harder and harder to perform without assistance. Long-term care can be offered in a nursing home, in a skilled nursing facility, or even at home but it can be very expensive and the need for the assistance required for years. The yearly cost for full nursing home care can be $100,000 or more. Thus, for both family and financial reasons, giving careful thought to these challenges in advance of a long-term care need is wise.
Who Needs Long-Term Care?
It is very difficult to predict the person and time for long-term care, but the following factors are important that increase the risk of needing long-term care.
- Age- The risk generally increases as people get older.
- Gender- Women are at higher risk than men because they often live longer.
- Marital status- Single people are more likely than married people to need care from a paid provider.
- Lifestyle- Poor diet and exercise habits can increase a person’s risk.
- Health and family history- These factors also affect risk.
However, you are always unsure about the need for long-term care hence planning for the possibility of long-term helps you to learn about services in your community and what they cost. In this brief, you will understand various programs that will pay for the long-term.
Medicaid
The purpose of the Medicaid program is to help individuals with low incomes and limited assets get the health coverage they need, so state Medicaid programs set strict income and asset limits when determining whether applicants qualify financially.
Every state in the US has a Medicaid program that provides general health coverage and coverage for nursing home services. These Medicaid programs include individuals who need nursing homes or long-term care also called Institutional Medicaid.
As mentioned earlier the nursing home services include nursing care, personal care, and therapy services. You should note that Medicare covers some skilled nursing facility (SNF) care: up to 100 days per benefit period and If you failed to meet Medicare’s requirements for the SNF benefit or reached Medicare’s limit of covered SNF care, Medicaid may pay for this care.
In other words, you must be poor by defined state standards before the government will assist under the Medicaid program and you will get the assistance in a nursing home.
Insurance coverage
Opting for insurance like Long-term care (LTC) to cover long-term care needs can be a sound part of a financial plan. LTC insurance pays for long-term care services in many settings like at home, in a nursing home, assisted living facility, or adult daycare facility. However, there are many different LTC insurance plans and insurance carriers hence it is important to work with an insurance expert to make sure the plan you select will meet your foreseeable needs. However, In the case of traditional LTC do not have cash value, nor do they have a death benefit.
If a person is eligible for LTC benefits (by becoming unable to perform two of six ADLs) then the traditional policy pays a daily or monthly reimbursement for approved expenses up to the maximum daily/monthly benefit chosen by the insured. You can find the variation between upper and lower limits among carriers but are in the $20 to $300 per day range.
Moreover, there are “Facility-only”, or “facility and in-home care” policies are existing, but elimination periods (deductibles) apply and can range from 0 days to 90 days.
Universal life insurance policies
Purchasing a universal life insurance policy is another way of addressing long-term care needs. This policy must be purchased with an attached rider that can accelerate all or a portion of the death benefit for payment of approved long-term care costs. In this policy, the benefits are received mostly the same way as under a traditional LTC policy.
In conclusion, it is wise to proactively examine options for you and your family members before the need for long-term care arises. If you want to know more about billing for a long term care then you can get in touch with us.
