
What a joy it is to be around the staff who, one by one, understands how important autonomy becomes for those of us living in a “retirement setting.”
What a joy it is to be around the staff who, one by one, understands how important autonomy becomes for those of us living in a “retirement setting.”
If you ever need nursing home care, will Medicare pay for it? Well, maybe, but maybe not.
Contrary to what many people believe, their Medicare coverage will not pay for their long-term care needs. And chances are good that you will need some assistance during your lifetime. According to a recent Business Week article, 65% of people over the age of 75 need long-term care and, with an aging population, that number will continue to climb.
Generally, Medicare will pay for care in a skilled nursing community if it is medically necessary and you have met certain conditions that they have set out. Medicare will cover a short-term nursing stay for rehabilitation from an injury or illness, but only following a three-night hospital stay. A rehabilitation stay is covered in full for up to 20 days. After 20 days, if the need for skilled care continues, the resident will be required to pay a co-insurance, which is the amount uncovered by Medicare from days 21 – 100. Many Medicare supplements pay the co-insurance amount.
Medicare does not, however, provide coverage for services in assisted living communities. Assistance with the activities of daily living, such as bathing, dressing, grooming, medication management and using the bathroom are not considered “skilled” services and are not covered under Medicare. Assisted living communities typically only accept private pay and long-term care insurance.
So if Medicare will not pay for your needs, will Medicaid? Once again, the answer is maybe. Medicaid is a joint state and federal government program that pays for long-term care services for older adults with low incomes and limited assets. But, to qualify, you must exhaust all your assets and virtually all of your income. Medicaid recipients must have less than $2,000 in assets. To qualify for long-term care nursing home Medicaid, you must meet “medical necessity,” which basically states that you require 24-hour nursing care supervision. Because the number of applications for Medicaid has increased exponentially over the past few years, states are increasingly making it more difficult to receive Medicaid funding.
According to the U. S. Health Care Financing Administration, about 40% of long-term care bills are paid for by Medicaid and 18% are paid by Medicare. That leaves 42% of all long-term care bills to individuals and families to pay out of their own pocket or to insurers to pay.
Everyday, people of all ages are looking for ways to make a difference in their community and to give back to society. And, increasingly, instead of making monetary donations, people are looking for ways to give of their time. Volunteering in a senior care community is a very enriching and rewarding experience – not just for the seniors, but also for the people who volunteer. Many times, people can shy away from volunteering in nursing homes because they think they do not have anything to offer. But everyone does have something to offer – even if you don’t consider yourself talented.
Mr. and Mrs. Smith knew they needed to start planning for their retirement, but there was never enough time or enough money. At 75, there was no money left, their health was failing and they were afraid to ask their children for help. They waited too long to have the tough conversations, and their options shrunk significantly.
Nearly 37.3 million Americans were 65 years or older in 2006. By 2030, that number will double to 71.5 million people, representing more than 20 percent of the U.S. population, according to the Department of Health and Human Services Administration on Aging. In Texas, nearly 4 million of us will be over 65 years old in 2020, according to a Texas State Data Center projection.
As the president of Morningside Ministries, which includes several senior living communities around San Antonio and the Hill Country, I am acutely aware that too many people in our society simply do not want to deal with issues related to aging. We need to begin to see aging as a positive life progression.
Parents, you can help your children by defining what’s important to you. For example, it’s important for your family to know what your financial capabilities are for long-term care. Family members need to know whether you have the means of caring for yourself or if alternative funding and living arrangements need to be found. Retirement planning is critical to financial stability, and long-term care insurance is an option for people to consider in their 40s and 50s, when the insurance is more affordable and accessible.
Maintaining a positive attitude never hurts as we get older. Studies have shown that positive thoughts can add as much as 7.5 years to your life. And, part of positive thinking is maintaining a strong social circle. People who participate in regular social gatherings and maintain close friendships have a much higher quality of life whether they live to 66 or 106.
Taking proper measures and having these tough conversations before it’s too late, when choices are limited regarding appropriate care, allows everyone peace of mind and the opportunity to enjoy life. With a little preparation, the aging process can be a seamless and beautiful experience.
Alvin Loewenberg, President/CEO, Morningside Ministries