Your Options When you are actually faced with the need for long-term care is certainly not the best time to decide what to do about it. Preparation and planning can go a long way towards reducing the physical, mental and financial stress that can often result in a complete breakdown of the family unit. Knowing your options in advance can be a big help. Let's look at some of them. Let Your Family Care For You Your first option would be to let your spouse or other family members take care of you. This is a solution that most people say they would like to avoid because they don’t want to be a burden. But faced with this situation, many families do try, at least at first. Since many diseases can cause you to be unable to take care of yourself, the family may come under a good deal of strain. They usually lack medical skills; there is a lot of emotional turmoil; it’s physically very difficult; often there are conflicts -- grown children, separated by hundreds or thousands of miles fighting among themselves about how, when, and where you should be cared for. This can be especially nasty when one or more family members refuse to take any responsibility for your care. After a short time, those who do provide care may be forced to give up and have to put you into a nursing home. That’s understandable, especially when you consider the burden. The result is that what may have seemed like a sensible solution could turn out to be an impossible dream. Other Insurance You may have individual health insurance or, if you work, group health insurance. These policies are designed to cover your medical and surgical expense: they don’t pay for long-term care. Medicare and Medicare Supplements Many people think that Medicare will pay for their nursing home care. But Medicare pays very little for nursing home expense because most nursing home care is custodial in nature. Custodial care helps in meeting daily living activities like bathing, dressing, feeding. and is not covered by Medicare. The most you can hope for is some limited skilled nursing care benefits for care in a nursing facility after being in the hospital, and perhaps some additional skilled nursing care benefits for care at home. Unfortunately, Medicare Supplements won't pay for custodial care, so you won't receive much help from them either.! Medicaid Medicaid was designed to be a safety net for the poor. While it does pay for some types of long-term care, it is for people with little income and few, if any, assets. For this reason it can be difficult for most Americans to qualify to receive Medicaid benefits. While much has been written about wealthy people going on Medicaid, most have done so only after paying out large sums to someone to help them "transfer" their assets so they can qualify for benefits. In order to put a stop to such practices, The Health Insurance Portability and Accountability Act of 1996 provides severe penalties -- including criminal penalties of up to $25,000 and jail time -- for those who attempt to break the rules in order to be eligible for Medicaid. In addition, the State, at its option, may suspend Medicaid eligibility for up to one year. Also, under the Omnibus Budget Reconciliation Act of 1993 (OBRA ‘93), states must now recover from the estates of beneficiaries any Medicaid long-term care benefits received. Pay For It Yourself (Self-Insure) You may have resources that you could use. But would they be enough? If you do use them -- dollars that are so vital to your income and security -- it could be extremely difficult to replace them. And once you have spent them, those dollars will not be available for your later years. But someone has to pay. And your spouse or your children would be that "someone". Transfer the Risk Finally, and we hope you’ll agree, the most sensible solution would be to transfer the risk to an insurance company. That way you and the insurance company would share the risk. And that’s a reasonable solution because it’s much easier to pay a few hundred dollars each year in premiums for a good LTC policy than pay huge sums of money out over what could be a long period of time. That makes pretty good sense, doesn’t it?
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