Long-term care: Planning for the future

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By Ron Pollack

It’s nearing tax time, and that’s a good time to think about financial planning. And when you make financial plans, don’t forget to include long-term care needs you or your spouse might have in the future.

Long-term care is expensive, and Medicare does not cover the costs. And there are other reasons to plan ahead, to learn about your options for care before you need help. That way, if you need care suddenly, you and your family won’t have to scramble. Equally important, you won’t end up in a nursing home just because no one knew alternatives were available.

Long-term care isn’t only about nursing homes. There are many options for care and support that can help you stay at home longer or even avoid a nursing home altogether. The “home- and community-based services” that can help you stay at home range from homemaker help, such as help preparing meals, to care provided by health professionals like nurses, and a lot in between: personal attendants can help you with daily activities and adult day services and respite services can give family caregivers a needed rest. You may want training to learn new skills if, for example, you start having vision trouble, or perhaps home modifications can help you get around your house better so you can keep living at home.

What services are available will depend on where you live. Many seniors rely on state programs, like Medicaid, for their care. In states whose Medicaid programs invest more on home- and community-based services, there are generally more of these services available for everyone — even for people who don’t use Medicaid.

The good news is that the Affordable Care Act — the new health care law — includes several new programs that will help people who need long-term care stay at home longer. New programs will give states financial incentives to expand the home- and community-based services they offer. Educational grants will ensure that there is an adequate, and adequately trained, workforce to provide home care as the population ages.

Starting in 2014, the spouse of someone receiving care at home will be protected from having to spend all the couple’s assets in order for their husband or wife to qualify for Medicaid; today, that protection exists only if the person needing care is in a nursing home.

The law also includes a new voluntary federal long-term care insurance program, Community Living Assistance Services and Supports (CLASS), that will help pay for care. CLASS will be available to working adults, regardless of age or health, probably in 2013. To be eligible for benefits, you’ll first need to be enrolled for five years. After that, if you need long-term care, the program will provide an average benefit of at least $50 a day ($18,250 a year), adjusted for inflation.

You can use that money to pay for assistance or other things you need to help you stay in your home. The program pays as long as you need care.

You still need to do your homework — plan your finances and learn what’s available where you live. The Administration on Aging’s ElderCare Locator, at 800-677-1116 or www.eldercare.gov, can help you find services in your community. You can learn more about the new options in the long-term services section of Families USA’s website, at www.familiesusa.org. And you need to keep an eye on what becomes available in your area. Because of health reform, there should be more choices that will help you stay at home.

Ron Pollack is the executive director of Families USA, a national organization for health care consumers. It is nonprofit and nonpartisan, and its mission is to secure high-quality, affordable health coverage and care for all Americans. Online: www.familiesusa.org.