Longer lives are among the greatest achievements of our modern era. Advances in healthcare and other progress related to human safety have resulted in what the United Nations says is one of the most significant social transformations of the 21st century.
However, with the success of longer lives come problems that catch most of us off-guard. According to a study by the U.S. Department of Health and Human Services, 70% of Americans over the age of 65 will need long-term care services at some point in their lives. Few families are in the position of being able to step-up and take over the care of their elderly loved ones, so they must seek outside help.
Unfortunately, many wait until their loved one is in full-blown crisis to seek long-term care assistance. Making decisions in this way can be fraught with emotion and very expensive. That is why we highly recommend that our clients not wait until their parents are in dire need to begin the long-term care planning process. If you are struggling with finding and paying for the right long-term care option for your parent in Marietta, Georgia, here are some things you need to consider.
Appropriate Level of Care
Long-term care encompasses many different levels of care, so it’s important to match up the facility with the individual needs of your parent. Different types of facilities include skilled nursing facilities, custodial care facilities, and intermediate care facilities. While it’s not always possible to plan ahead for nursing home care, it is a good idea to become familiar with some of the long-term care facilities in your area and select the ones that you and your parent would prefer. When the time comes for long-term care, a Marietta GA elder law attorney can assist you in determining the level of care required for your parent and work with the long-term care facility of your choice.
Paying for Long-term Care
You will also need to think about how to pay for your parent’s long-term care. Facilities can cost anywhere from $5,000 to $10,000 per month, depending on the level of care required. Long-term care insurance policies may help defray some of these costs, but very rarely do those policies cover the entire amount needed. Special benefits are available to veterans through the VA, and Medicare may help pay for a very limited amount of time in a nursing home based on the illness/injury. Medicaid is the most common option to help pay for long-term care, but there are strict eligibility requirements attached to that assistance, and it is very easy to become disqualified from that care if your parent exceeds asset or income limits without the proper planning in place. It is important to speak with a Marietta elder law attorney to review your available options and determine the best course of action to pay for your parent’s long-term care.
Planning ahead for long-term care can make a world of difference in your life and contribute to the comfort of your parent when the time comes. If you would like to start this conversation with a Marietta elder law attorney who has extensive experience helping people find the best long-term care solutions, call our office at 770-425-6060 and schedule a consultation.
Do you have concerns about:
• Running out of money if you (or your spouse) become ill and require significant care
• Having no control over who provides care for you if you need it
• Choosing the type of care you want and where you want to receive it
• Leaving an inheritance to your loved ones, only to have it taken by their creditors
• Your children misusing the property or money you leave to them
• Providing support to a loved one with a disability both during your lifetime and after your passing
• Making sure your wishes about care and your finances are carried out
If you answered YES to any of the questions above, we can help. A long-term care asset protection plan is not a one-size-fits-all set of documents. Each plan is designed based on your concerns, your desires, and your goals.Call our Atlanta elder law attorneys at or email me at email@example.com.
Over recent years, many people have purchased long term care (LTC) insurance to protect themselves against the rising costs of care in their final years. But lately, policy holders have seen their premiums rise and/or benefits decrease. Two of the largest LTC insurance companies, MetLife and Unum, recently appeared before the Florida insurance commissioner to explain why they asked some of their policy holders to pay double what they paid in premiums the previous year.
Unum explained that when it entered this market in the late 1980s, they determined their prices using the best data available about how future experience would develop. But, over the next decades, they discovered their assumptions were very wrong. For example:
- They did not plan on people living so much longer.S. life expectancy increased two full years between 2000 and 2014, from age 77 to 79. According to the U.S. Centers for Disease Control and Prevention (CDC), life expectancy is still on the rise.
- They did not plan on such low interest rates. They had planned on investing the premiums they collected at high interest rates to generate healthy returns, but interest rates have been extremely low since the 2008 recession.
- They did not expect people to hold onto their policies. Insurers expected people would forget about their policies and let them lapse, in which case the premiums they had paid would be forfeited and go into the insurance company’s pockets to pay other claims. But seniors held onto their policies, causing the insurers to pay more claims than planned.
- They did not expect to have to pay claims so long. Diseases like Alzheimer’s and other forms of dementia can last for years, and seniors stayed longer in nursing homes than the insurers had expected.
As a result, some insurers (Allianz, Guardian, MetLife, Prudential and Unum) have stopped offering LTC insurance completely. But they still have to service the people who bought policies and will use them. Insurers plan to reduce the coverage whenever they can, by adjusting the amounts policyholders receive, making them wait longer to receive care and decreasing benefits when they do go into care—and, of course, by increasing premiums. Most of the insurers still have large company-wide surpluses, but seek to make their LTC divisions self-sufficient.
This is not good news for seniors. Those who cannot afford the higher premiums often have to cancel their policies, forfeiting the premiums they have already paid and losing coverage around the time they need it—and then find other ways (bank accounts, home equity) to pay for their care.
Younger seniors will have a difficult time finding acceptable and affordable LTC coverage. Many policies now include a life insurance rider—the money you pay in can be used (for as long as it lasts) to pay for nursing home or other care, or paid as a death benefit to your beneficiary(ies). If you are considering purchasing LTC insurance, be sure to seek sound financial advice first.
“Does mom want to live in a nursing home?”
“What does dad feel contributes to, or takes away from his idea of ‘quality of life’?”
“Do mom and dad have legal documentation in place that ensures someone can act financially on their behalf if they are unable to?”
These are just three of many questions local residents are encouraged to ask their parents and aging loved ones during Sandwich Generation Month, a month-long observance in July of each year that focuses on the legal and financial burdens facing adults who are caring for young kids and their older parents at the same time.
Without knowing the answers to such questions, families could be left battling over long-term care, struggling financially, and not truly honoring their parents’ wishes in the event of a future healthcare crisis.
Far too many families avoid talking about aging and long-term care until it’s too late. Especially from a legal standpoint, if you don’t know your parents’ wishes or the documentation they have in place (or don’t), you could be left with a huge mess on your hands if they become sick or disabled.
This month, it’s advisable for adult children to have 5 specific conversations with their parents as soon as the opportunity presents itself:
- Long-term care preferences – Do mom and dad want to live in a nursing home or would they prefer in-home care if the need presented itself? If they prefer a facility, what amenities and activities are important to them at this point in their life? If they want to live alone in their home, will that suit their personality or will loneliness and depression result? These are questions that if discussed in advance can make the transition into an assisted living facility or a home-health care program much easier on everyone when the time comes.
- Current Legal Documentation – It’s imperative that adult children find out what legal documentation their parents have in place before incapacity occurs. This includes making sure their parents have a financial durable power of attorney, health care directive, and HIPAA documents so someone can easily step in to make financial or medical decisions on their behalf. Otherwise, the family will be forced to petition the court for control over their parents’ affairs if they passed the point of legal capacity.
- Medical Preferences and Wishes – Adult children should find out what type and how much medical care their parents want as they age, or following a debilitating diagnosis such as Alzheimer’s and Dementia. Do they have specific wishes about life support or other end-of-life medical treatments? Who do they want to make such decisions on their behalf? The answers to these questions will help your parents to feel secure knowing their wishes will be carried out during an otherwise emotionally-charged time.
- Current state of financial affairs – To ensure finances are properly managed, adult children should start asking tough questions about their parents’ financial affairs. This includes finding out the location of any safety deposit boxes, bank accounts, investment or brokerage accounts, long-term care insurance, outstanding debts, or other assets unknown to the family. Otherwise, necessary assets needed to cover long-term care or other expenses could go overlooked and unaccounted for. You should also ask your parents how they plan to pay for long-term care. Most expenses are not covered by Medicare or private insurance. Medicaid may be able to help, but you will likely need an attorney to help you create the right kind of trust or utilize other planning strategies in order to meet the income and asset thresholds and protect your assets from being “spent down” while qualifying for benefits.
- Important contacts and information – While their memory is still sharp, adult children should work with aging parents to compile a list of important contacts and information that will be useful to the family. This includes documenting key doctors, professional advisors (e.g. accountant, attorney, financial advisor), and important passwords for online accounts.
While these conversations are certainly not easy to have, families can make the transition into a parent’s senior years easier by planning ahead. Not to mention, mom or dad will appreciate your willingness to make sure their wishes are honored if and when incapacity, sickness or disability occurs.
For more information and help, please download our FREE guide, “Surviving The ‘Sandwiched’ Years: How To Protect Your Parent’s Assets, Honor Their Wishes & Provide Long-Term Care….Without Losing Your Money—Or Your Mind!” by clicking here.
One of the most common issues that Marietta elder law attorneys deal with is how to help clients when it comes to both short-term and long-term care. Folks are living longer than they ever have before due to advances in both health care and technology. Certainly, this is what people have been hoping would happen for generations, but it does bring with it some new challenges. High on that list is the increased need for short-term care (to recover from an illness or injury, for example) and long-term care. What people so often want their East Cobb elder law attorneys to explain is how they can afford it and whether Medicare or Medicaid can help.
The answers to these questions are, of course, fairly complicated; but it’s worthwhile to have at least a little knowledge to get started. In the case of Medicare and Medicaid, you will find that both of them can help when it comes to paying for rehab services, but under different guidelines. This is something that Marietta elder lawyers spend a lot of time researching, and with laws constantly changing, it’s best to confer with someone knowledgeable about the current status of these programs.
If you are over 65, then Medicare might be a reasonable option for you. While similar to health insurance, Medicare is a federal program. Whether you live in Georgia or any other state, you can expect the same benefits and requirements. For example, to qualify, you need to transfer to a rehab facility (or nursing home) only after staying three days and three nights in the hospital; and the move needs to take place within 30 days of the hospital stay.
Basically, Medicare is there to help when an unexpected illness or injury arises so that you can get through it and recover. It’s not a plan for long-term care, rather it’s for those who need skilled care as they’re making their recovery. For that reason, Medicare will only pay for 100 days of care, and the last 80 days require a co-payment from the patient.
Your elder lawyer will tell you, however, that Medicaid is a state-run program. It is in place for those who have a demonstrated financial need. And that need must be pretty significant. In fact, you may have to prove that you have less than $2,000 in assets to qualify, and if you have more, you might have to get creative in how to reallocate it to qualify. Again, and elder law attorney in Marietta, Georgia, may be able to offer advice and suggestions on how to do this appropriately. The good news is that there are some exemptions to this $2,000 worth of assets rule, and you may be able to keep your house and your car while still qualifying.
Getting the most out of Medicaid can be difficult to figure out, so gaining clarification from an East Cobb elder law lawyer is definitely recommended. Social workers and staff at the hospital may also have suggestions and recommendations. This is one of those times when it pays to be prepared in advance, too, so that you know what your options will be and can set things up to work to your utmost advantage should you need to rely on Medicaid.
If you are a caregiver and you want to learn more about Medicare, Medicaid and long term care planning for your elderly loved one, please check out my free guide, “Hope For Caregivers: ABC’s of Long-Term Care and Legal Planning.” You can download it by clicking here.
Genworth, a long-term care insurance provider, has just released the findings of its 2016 survey on the costs of providing long-term care. Not surprisingly, costs have increased since the 2015 survey. In fact, costs have steadily risen over the past 13 years since Genworth began tracking them.*
Long-term care can be provided in a variety of settings, as explained below, and many people use the full range of services as needs increase. Families are often shocked to find out how much long-term care can cost, especially when they learn that Medicare benefits are limited for these services. Unless the person has long-term care insurance, they will likely pay for this care out-of-pocket—from savings, home equity and, often, other family members’ assets. Knowing the kinds of services available, current costs and historical rates of cost increases can help us plan for future costs of long-term care.
Homemaker Services: These include help with “hands off” care such as cooking, cleaning, running errands and providing companionship. The national median hourly rate for 2016 is $20, up 2.56% from 2015—more than the average increase of 2.13% over the last five years.
Home Health Aide Services: This is “hand-on” personal care for which a skilled nurse does not need to be present. A home health aide will typically help with bathing, dressing, transferring and toileting. The national median hourly rate for 2016 is $20 ($3,813 per month, based on 44 hours of care per week), up 1.25% since 2015—slightly less than the average increase of 1.28% over the last five years.
Adult Day Health Care: These community-based facilities provide social and support services in a protective setting for those who are functionally and/or severely cognitively impaired, helping the individuals live more independently in the community and giving relief to caregivers. Most are designed to offer socialization, supervision and structured activities. Some provide personal care, transportation, medical management and meals. The national median daily rate is $68 ($1,473 per month, based on five days per week). This is a decrease of 1.25% from 2015 costs, but the average increase has been 2.53% over the last five years. Government subsidies may be available based on ability to pay.
Assisted Living Facilities: These residential facilities provide personal care, health services, and room and board, but the level of care may not be as extensive as that of a nursing home. Both small group homes and large multi-service facilities qualified as assisted living facilities for purposes of this survey. The national median monthly rate is $3,628, up .78% from 2015, with an average increase of 2.16% over the last five years.
Nursing Home Care: These facilities often have a higher level of supervision and care than assisted living facilities, with personal care assistance, room and board, medication, therapies and rehabilitation, and 24-hour on-site nursing care. The national median daily rate for a semi-private room is $225 ($6,843 per month), up 2.27% since 2015, with an average increase of 3.12% over the last five years. National median daily rate for a private room is $253 ($7,695 per month), up 1.24% since 2015, with an average increase of 3.51% over the last five years.
Are you worried that if you need long-term care, the cost will leave your spouse destitute and leave nothing of your savings to pass on to your children and grandchildren? Let us help you put in place an asset protection strategy that will preserve most, if not all, of your nest egg! Call us, your Marietta Elder Law Attorneys, at 770-425-6060.
* Surveys are conducted by CareScout, a Genworth company. CareScout created the nation’s first quality of care ratings system for certified nursing home and home care providers, and helps families find quality care providers for their long-term care needs. For more information, visit CareScout.com.