The Importance of Planning Your Own Long-Term Care

October 28, 2021
Pamela D. Wilson, Caregiving Expert
Planning your own long-term care gives you choices about care as you age. The truth is, most families don't plan until it's too late because long-term care planning isn't a well-known or frequently discussed subject. On the other hand, some adults believe that needing long-term care will never happen to them.

Regardless of what you know or believe about long term-care, these five tips offer practical information to help you decide the importance of planning your own long-term care.

1. Understanding Medicare, Medicaid, and Supplemental Health Insurance

Most consumers believe that Medicare pays for all care after the age of 65. Families are shocked when they learn differently. Learning the difference between Medicare, Medicaid, and individual health insurance is one of the first steps to becoming more educated about long-term care planning.

Let's begin by defining long-term care. Long-term care services include a wide range of privately paid and government services to help older adults live independently as long as possible. For example, long-term care means receiving care in your home from family members or caregivers, in an assisted living facility, or a nursing home.

Planning your own long-term care means that you understand long-term care costs, the different types of care available, including the services offered by Medicare, Medicaid, and supplemental insurance. Most consumers over the age of 65 receive a Medicare and You handbook offering basic information. Calling 1-800-MEDICARE (800-633-4227) is another way to have questions answered.

After being enrolled in a health plan, calling the customer service number on the back of your supplemental insurance card is the way to learn more about plan benefits. For Medicaid, contact your County Human Services office who can help or direct you to the local agency responsible for Medicaid long-term care programs. Having a level of understanding of health insurance allows you to plan for costs of care that you pay for out of pocket.

2. Care Options and Costs

The next step is to learn about care options and costs to pay for assistance with activities of daily living and advancing health care needs. For example, private home care agencies offer in-home caregivers who provide companionship, meals, light housekeeping, transportation, bathing and hygiene assistance, medication reminding, grocery shopping, errands, and other services. Some care agencies also offer skilled services that include physical, occupational and speech therapy, nursing and other types of medical care.

Adult day centers offer care for aging parents during the day while adult children work or provide respite for the primary caregiver. Independent, assisted living, and memory care communities provide meals, assistance with bathing and dressing, medication management, light housekeeping, transportation, and a menu of other services.

Waiting until after a parent suffers a hip fracture or is diagnosed with dementia usually results in families resorting to crisis-planning mode. Planning your own long-term care—before unexpected events happen—ensures you know the options and who to call to establish care services.

3. Do I Need Long-Term Care Insurance?

Family discussions about long-term care costs can bring up many questions. Should I purchase long-term care insurance for myself or my parents? Are company-sponsored long-term care insurance plans good?

Considering that the average rate for a single day in a nursing home in the United States is $275 per day, $8,365 per month, or $100,380 per year, purchasing a long-term care plan may be a wise decision. Long-term care insurance is available in single plan options or combined programs offering life insurance and long-term care.

Additionally, options exist for shared spousal or individual plans. Coverage options include home modifications, in-home care, day care, assisted living, memory care, and nursing home. It's important to know that long-term care insurance is not guaranteed coverage. Companies may decline coverage if a diagnosis of dementia, Alzheimer's, or other condition exists.
The most favorable rates and coverage options are available when you are young and in good health. Consult a financial advisor or a long-term care insurance agent to learn the details and costs of how long-term care insurance plans work.

4. Initiate Long-Term Care Insurance Claims As Early As Possible

Owning a long-term care insurance policy means that you can use the plan to pay for care instead of paying for services from savings or investments. The qualifications for policy use usually require assistance with two daily living activities or a diagnosis of memory loss.  

Assistance with activities of daily living (ADLs) is the type of help many older adults need to remain safely at home. ADLs include bathing and grooming, continence management or using the toilet, dressing, meal preparation and feeding, ambulation, or transferring.

5. Why Having a Long-Term Care Insurance Plan to Pay for Care Offers Families Peace of Mind

With the flexibility available in long-term care insurance plans today, consumers have various options to pay for and supplement care in the home or care communities. Having a family discussion about care wishes can help identify individual preferences of loved ones for the variety of care that may be beneficial and the preferred care location whether in home or a care community.

For example, as a court-appointed guardian, the agent under medical or financial power of attorney, or a care manager, I arranged and coordinated  services reimbursed by long-term care insurance plans care for my clients that are identified below.  

This list of the benefits of using long-term care insurance and combining benefits with private funds provides options to identify additional care in the home or wherever care recipients reside:
  • Allowing individuals to remain living at home—instead of moving to a care facility—by increasing daily hours of care
  • Delaying nursing home placement for individuals living in assisted living communities who require more support than community staff can offer. In-home caregivers may be hired to help with bathing, meals, socialization, and monitoring daily care needs.
  • Providing additional care and oversight for individuals living in nursing homes who thrive when receiving one-on-one personalized support and interaction.
  • Additionally, long-term care insurance Partnership Plans allow Medicaid recipients to use policy benefits. For example, policy benefits can pay the difference between a typical Medicaid shared room versus a private room not reimbursable by Medicaid in some states.
Planning your own long-term care by learning about all of the options available and the costs of care can help you live the life you want--where you want to live. Many individuals enjoy a better quality of life and live longer and happier when receiving additional care and beneficial services.

Learn how BrightStar Care's independently owned and operated agencies provide in-home care services reimbursable through long-term care insurance policies or by private payments.

About Pamela D. Wilson

PAMELA D WILSON MS, BS/BA, NCG, CSA is a national caregiving expert, author, advocate, and speaker educating family caregivers, older adults, professionals, groups, and corporations. Since 1999, Pamela has been an entrepreneur and business owner providing direct service: in-home care, care management, and legal and financial appointments. In addition, she consults about elder care, care navigation, caregiving services, and caregiver support programs with families, health and care providers, attorneys, and financial planners. 
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