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Long term health care: Plan ahead
Paying for long term care
Long term care can be expensive. There are multiple sources that provide funds to pay for long term care. Options include:
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Long term care insurance. You pay an annual premium for long term care insurance. In exchange, when you or a loved one needs care, the insurance provider pays a daily rate to the long term care facility. Daily rates differ, depending on the insurance policy. If long term care is needed immediately, it may not be possible to get long term care insurance. However, if you or your loved one is currently healthy but likely would need long term care in the future, you might want to consider this option.
Before you purchase a policy, make sure it covers pre-existing conditions you disclose when you buy the policy, and covers conditions that could arise later in life, such as dementia. Also check whether you can reduce your coverage later if the premiums become too expensive.
- Medicaid. Medicaid is a joint state-federal program for people who meet certain income requirements. Medicaid usually covers nursing home care only after an illness or injury. Whether Medicaid covers assisted living or a continuing-care retirement community depends on what state you live in. Medicaid coverage differs in each state, with some states covering home care services.
- Medicare. This federal program is for people over age 65 and those with disabilities. Although Medicare doesn't cover assisted living, it covers home care services in some cases. Medicare covers nursing home care for up to 100 days, but only if you have recently been in the hospital for at least three days.
Other options that may carry a risk or charge fees include reverse mortgages, annuities or setting up a trust fund for long term care. Deciding how to make payments for these options can be difficult. Discuss your options with your lawyer, accountant, a social worker or your local agency on aging. Also talk to your doctor, who may recommend community resources.
Discussing long term care with a loved one or parents
The idea of leaving home or receiving in-home help for everyday activities can be distressing. That's why it's important for you to include your loved one as much as possible in the selection of a long term care service. Try these tips for talking about long term care:
- Plan ahead. Waiting until a loved one needs a long term care facility isn't the best time to bring up the subject. If a loved one becomes ill or injured, it may be difficult for him or her to participate in the selection of the facility.
- Take opportunities to talk. Your loved one might mention a problem around the house that you can relate to his or her need for long term care. For example, if your aunt mentions a problem turning on the faucet, you could ask whether she could use help with managing bathing and other personal care.
- Listen to your loved one's or parent's concerns. Let them know you understand their concerns. Point out the benefits of long term care services. Remind your parents that their safety is your primary concern.
- Listen to your loved one's or parent's preferences. Include your loved one or parents in the decision-making process. Find out what kind of facility they would prefer, but also recognize their ability to make decisions on their own. You might encounter some resistance from your loved one or parents, but stay positive. Keep in mind that if your loved one or parents are mentally competent, they have the right to decide whether they need long term care services or a long term care facility.
- Involve others. If your loved one doesn't respond well to your efforts to talk, involve someone else that can be trusted, such as clergy, a doctor or an attorney.
You may feel anxious about leaving home to live in a long term care facility. Involving family and friends in the decision-making process might help you feel better about your choices for long term care.
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