Many of us don’t think about long-term care (LTC) until elderly parents need it or we come face-to-face with our own medical crisis. Myths about long-term care are legion, including “My spouse will take care of me” or “I’m too young to think about it.” Here are eight things you need to know.
LTC costs more in some parts of the country than others. The median cost of long-term care in New York State, for example, was $116,000 per year for a private room and $73,000 for a semi-private room in 2010, but only $52,000 a year in Louisiana. Would you send your loved one to a less expensive area? Not if you want them to live longer. People whose family, friends, and relatives visit them in a long-term care facility live longer and maintain better health than those who have no visitors.
Women are more likely to end up in a nursing home than men. Here’s why: Two out of 3 people 85 and older are women. Women over 65 are more likely to be living alone. Women are more likely than men to get Alzheimer’s disease, and they are more likely to suffer a debilitating stroke. And to make matters worse, many elderly women have no Social Security benefits.
LTC isn’t only for the elderly. The need for LTC can arise at any age. In fact, more than 40 percent of people who need it are under 65. Michael J. Fox was only 30 when he noticed a twitch in his finger that was later diagnosed as Parkinson’s. Christopher Reeve was 43 when he had his tragic accident that left him a quadriplegic.
Health insurance and Medicare don’t pay for LTC. Many people mistakenly believe that if they have private health insurance or Medicare through the federal- and state-funded plan they’re entitled to after age 65, they’ll be covered if they have to spend an extended time in the hospital or move to an assisted living facility or nursing home. The only insurance that pays for LTC is long-term health insurance. The younger and healthier you are when you buy it, the cheaper it is.
Medicaid may pay for LTC–or it may not. Let’s say, to qualify for Medicaid’s LTC coverage, you gave away your assets to your adult kids, or bought annuities believing they would protect your assets, or attempted to hide some of your income. All of these classic “mistakes” can result in little or no LTC coverage. So can applying for Medicaid too soon, assuming a living trust will protect your assets, or taking advice from a Medicaid worker. Please consult a qualified, experienced elder law attorney before entering the Medicaid maze.
It’s not well-advertised, but the VA might have you covered. This is one of the best-kept secrets in long-term care. If you or your spouse, living or deceased, served during a qualifying wartime period and got a discharge other than dishonorable from one of the military services, you may be eligible for a monthly cash benefit from the Veterans Administration that generously covers a wide spectrum of long-term care services.
Long-term care facilities have “lotsa gotchas” in their contracts. Did you know that you can get kicked out of your long-term care facility if you were to land in the hospital for a few weeks–unless you were smart enough to have a “bed reservation benefit” in the contract? It’s imperative that you ask a certified geriatric care manager to find gotchas like these in the contract before you sign.
Running out of money in an LTC facility can cost you your home. If you become impoverished while in a nursing home, your house, your car, even your funeral plot can be taken from you. There are smart and legal ways to protect your assets from being recovered. Again, the best strategy is to find a qualified financial professional who can help you protect your assets.
Harold Lustig is a nationally recognized authority on financial, estate, and long-term care planning for elders and their families, and the author of Naked in the Nursing Home: The Woman’s Guide to Paying for Long-Term Care without Going Broke (Blooming Twig Books, 2011). Learn more at www.nakedinthenursinghome.com.