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  • Writer's pictureKaren McPhail, RN, MSN

Paying for Care: A Growing Challenge!

One of the biggest challenges for many of my clients is how to plan properly for the future, preserve assets, and pay for care when needed.

Often times people did not have the means to purchase a long term care policy or have not been able to save sufficiently for retirement along the way. In addition, in some cases people have not had proper guidance and exhaust funds without realizing the legal mechanisms for preserving them.

In all cases there are three general scenarios for paying for long term care:

Long-Term Care Insurance: Although expensive the older policies are worth their weight in gold as they have less restrictions and some have no life time maximum unlike the more limited current plans! Those debating the purchase at this time should get guidance from their financial advisor as they are costly and may not be worthwhile. However, for those who want to preserve assets they may be worth considering.

Entitlement Programs: Medicaid, Auxillary Grants, Veterans benefits, Medicare, and state programs.

I am always shocked by the number of people that have misinformation about Medicare. Medicare, does not cover chronic or convalescent care needs aside from limited and very specific rehabilitative coverage. Medicare does not cover long term care, skilled nursing, memory care, or assisted living. A lack of understand is often times what puts seniors at a disadvantage and leads to problems!

If one has limited resources and requires care Medicaid can be explored. Always seek guidance from an elder care attorney for planning purposes as this process as it can be very convoluted and one missed submission date can have catastrophic financial consequences. Medicaid income requirements / qualification and other information is online and can be accessed easily.

Veterans benefits / Aid and Attendance should always be explored. Basic qualifications are online and easy to access.

Private Pay: Most individuals are in a situation where they require care and need to privately pay for services. Many people seek out care in assisted living or memory care facilities, while some remain at home to age in place. No matter what the scenario is proper and careful planning needs to be done! Planning out funds is essential with a trusted financial manager. Many people just do not realize how much care actually costs and how fast their funds are being depleted. And, unfortunately very few assisted living and memory care environments have easy access to subsidies or auxiliary grant rooms if funds are exhausted. Many people are shocked when they have to move a loved one to another facility as their current one does not participate in the grant program, has a long wait list, or does not offer them a bed for their family member- which is sadly always at the discretion of the facility. The choice then becomes skilled nursing under medicaid which may not be needed care wise and provides less quality of life. Sometimes people with a reverse mortgage think that they can take funds and use them for facility care not realizing that you need to remain in the home as a part of the reverse mortgage and that funds cannot in fact be used. This process can be frustrating, difficult to navigate and often times individuals choose facilities poorly and their choice significantly limits their future options.

Again, understanding and navigating this process can be more than confusing! Seek guidance early to prevent serious issues and financial complications. Always have an elder care attorney, a trusted financial manager to guide you through the process!

A care manager can also assist in linking one to resources, appropriate facilities, and assist in understanding strategies and programs that are essential and will decrease stress and set you on a path for success...

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