Howard Gleckman, a senior fellow at the Urban Institute and author of “Caring for Our Parents,” recently discussed the complexities of long-term care with Christine Benz. Long-term care encompasses the personal assistance people need to live their best lives, including help with daily activities like managing finances, going to the doctor, eating, or personal hygiene. Currently, about 14 million Americans require substantial long-term care.
Many are older adults living into their 80s and 90s, thanks to medical advancements that allow for longer lifespans. However, living longer also means increased incidences of diseases like Alzheimer’s and other dementias. Despite the common perception, only about 5% of people receiving long-term care live in nursing homes.
Most long-term care is actually provided at home by family members. Other non-nursing home options include assisted living, memory care, and independent senior living, although these settings require considerable financial resources. Traditional Medicare does not cover long-term care.
Some special needs plans, Pace programs, and certain Medicare Advantage plans offer limited long-term care services, but these are very modest.
Navigating long-term care complexities
Generally, people need to look beyond Medicare for comprehensive long-term care solutions.
About half of people over 65 will need some form of long-term care, with men needing it for approximately two years and women for three years on average. Costs can be substantial: nursing homes can exceed $100,000 annually, and assisted living can range from $5,000 to $10,000 per month. Those who want to protect their assets and ensure better long-term care options should consider insurance, particularly if they can afford the premiums and do not qualify for Medicaid.
Planning for long-term care requires a multifaceted approach. Clients depend on the expertise and advice of financial professionals to guide them through the process. Long-Term Care Awareness Month is the best time to dive into long-term care and the senior market for those looking to expand their business and provide critical solutions to those in need.
Everything that is wrong with long-term care services and financing today has its roots in well-intentioned public policy decisions made many years ago that went terribly awry. It started with the addition of Medicaid to the Social Security Act in 1965, which authorized Medicaid to provide long-term care to individuals who could not afford it. To fix America’s long-term care market, policymakers must reverse these flawed policies.
Key reforms include prioritizing the neediest first by not covering the affluent, paying providers market rates to ensure quality care, reducing the number of people covered to focus on high-quality care and home care services, minimizing regulations consistent with safety, and prioritizing the aging and disabled in Medicaid coverage.
