Many older adults and their family members put off discussing future care needs and are left unprepared when a health crisis occurs. It’s not always easy to start the conversation, but planning ahead can provide peace of mind, clarity and more control over important decisions. The earlier you begin planning the more choices you’ll have and the more prepared you and your family members will be if long-term care is needed.
When Should We Start Planning for Future Care?
Ideally, long-term care planning should begin between age 50 and 60 or earlier, depending on your health and personal circumstances. Early planning offers more flexibility in choosing care preferences, like home care versus care in a skilled nursing or assisted living community. Planning ahead also gives you time to evaluate your finances and long-term care funding options and make legal preparations. If long-term care insurance is something you’re considering, premiums will be much more affordable at 55 than 65, and your chances of being denied coverage are lower.
How Will I Pay for Care?
According to a survey conducted by the Federal Long-Term Care Insurance Program, the national average cost for a semi-private room in a skilled nursing community is over $100,000 per year. Care in an assisted living community can cost over $60,000, and hiring a home care aide can cost over $50,000 per year. These costs can vary greatly by state or region, and by rural or urban areas. Most private health insurance policies do not cover long-term care expenses.
It is crucial to understand your options for funding care before you need it. These could include long-term care insurance, government programs, or personal savings or investments.
Is Long-Term Care Insurance Worth the Price?
The answer varies depending on your individual circumstances. If you are between 50 and 60 and in good health, your premiums will be lower than if you are 65 or older or have health concerns. As you age, the odds are also greater that you will be denied for long-term care insurance. A family history of dementia or other serious conditions can also play a role in your decision-making process.
According to an article published by the Insurance Information Institute, your income level and assets are also important factors to consider. Individuals with low income and few assets may qualify for Medicaid, making long-term care insurance less necessary. Those with a very high net worth who expect to have enough funds to pay for long-term care out-of-pocket may also not need long-term care insurance. For individuals in the middle, long-term care insurance might be the most beneficial because they won’t likely qualify for Medicaid but may not have enough funds to cover the cost of care for an extended period of time.
Because everyone’s situation is different, it’s a good idea to meet with a financial advisor to determine if long-term care insurance is right for you.
Does Medicare Cover Long-Term Care?
Many older adults believe that Medicare will cover the cost of long-term care, but that is not the case. Medicare doesn’t cover long-term care whether you are in a skilled nursing community, assisted living community or in your own home. Medicare Part A covers inpatient hospital services and short-term stays in a Medicare-certified skilled nursing facility in specific circumstances, like when you require rehabilitation therapy or nursing care after a hospitalization, surgery, injury or serious illness. A co-pay for Medicare covered stays in a skilled nursing facility begin at day 21. After day 100, you are responsible for all costs of care.
Are There Other Government Programs to Help Fund Long-Term Care?
While Medicare doesn’t cover long-term care, you may be eligible for other government programs that can help you fund long-term care. If you have limited income and assets, Medicaid may cover the cost of some types of long-term care. Eligibility and the types of services covered vary by state, so visit Medicaid.gov to find out if you are eligible in your state.
If you’re a veteran, the VA provides coverage for long-term care for some veterans. You can check with the VA medical center near you, or visit their website focused on geriatrics and extended care to learn what services you may be eligible for. The VA also offers a caregiver support program to promote the health and well-being of family caregivers through education, resources, support and services.
Some states offer additional programs like PACE (the Program of All-Inclusive Care for the Elderly) that provide services to individuals who otherwise would need care in a nursing home. The program helps to cover the costs of medical care, social services and long-term care for some older adults. To find out if your state offers PACE, you can search at PACEFinder.
What Legal and Financial Documents Do I Need to Have in Place?
It is critical to have key healthcare and financial documents in place before a crisis occurs, and to discuss your plans with family members so they understand your wishes ahead of time. Advance healthcare directives outline medical preferences and designate someone to make healthcare decisions for you if you are incapacitated. A durable power of attorney appoints someone to manage financial affairs like investments, bills and other responsibilities if you are unable to do so. Working with an estate planning attorney can ensure that wills, trusts and beneficiary designations reflect your current wishes and provide for future care needs.
Planning Ahead Brings Clarity and Peace of Mind
Planning early for possible long-term care needs helps to ensure that you and your family members are prepared for whatever the future may hold. Having financial, legal and healthcare plans in place helps to ensure that your personal wishes and preferences are honored and your family members are not left stressed and scrambling if a sudden health crisis occurs. Having peace of mind for the future allows you to enjoy living life to the fullest now.
Trust in Trio for Long-Term Care With Heart
At Trio Healthcare, we provide compassionate long-term care and assisted living across Virginia in welcoming communities that feel like home. Residents are treated with the dignity and respect they deserve, while enjoying meaningful opportunities for connection, recreation and engagement. We also offer guidance and support as you navigate the complexities of long-term care planning so you can have confidence and peace of mind. Contact us to learn more or find a Trio Healthcare location near you.