When Health is Lost
by
Book Cover & Preview Text
Introduction
Herman pushed open the glass double doors of the doctor's office, stepped out into the fading colors of dusk, then hesitated by the steps leading to the parking lot. The voice was bouncing through his head like a bad commercial: "I'm sorry, Herman. She has Alzheimer's Disease. You can keep her at home for a few more months, but then she'll need long term care. You'd better budget four or five thousand dollars a month; those places don't come cheap."
His hand gripped the bannister with a slight tremor. "I just retired six months ago. One cruise, then this! We had so many plans. And how can I add four or five thousand dollars a month to our living expenses. We'll be broke in less than five years!"
Herman is not alone. You may face the same horrifying prospect; if not now, someday, and perhaps sooner than you think.
A study by the U.S. Department of Health and Human Services shows that people who reach age 65 face at least a 40% risk of entering a long term care facility. Although 45% of those nursing home stays last three months or less, more than one-third last a year or more; about 10% last five years or longer. In 1997, an estimated seven million people over the age of 65 needed long term care. By 2005, that number will increase to nine million, and by 2012, to 12 million.
Although the estimated national average cost for private patient care is on the order of $4,500 per month, in some parts of the country the costs can be twice that amount. Home care costs less, but is still costly. For an aide three times a week to help with dressing, bathing and preparing meals, the cost may be as much as $1,000 per month. Moreover, if skilled care is needed (like physical therapy), the costs are even greater.
Medicare pays for only 100 days of skilled and intermediate-level long term care, less than 2% of the total costs incurred. Private insurance pays a lesser percentage. The balance of the costs are paid from private savings and the various state-federal Medicaid programs.
Long term care insurance policies are actively marketed and serve this need well. More than 200 forms of coverage are now available. They remain, however, a minor factor compared to the total costs.
In California, Medi-Cal (this state s adaptation of the Medicaid program) is the only public health program that pays for long term care at the custodial level, or at the higher levels of care after the Medicare benefit expires.
Becoming eligible for Medi-Cal can require property transfers that are emotionally difficult for many. It can also lead to a sense of lost dignity. Consequently, Medi-Cal should be used only as a last resort. For many, however, it meets a critical need.
Often, Medi-Cal benefits can be combined with Supplemental Security Income (another state-federal program) to provide attractive benefits for a disabled person living in an assisted living facility (life care or room and board). For so long as assisted living meets the need, a long term care facility may be avoided.
In this book, you are provided with the background information needed in order to make an informed choice. Such critical decision-making must be based on sound information.
Formats
Book Details
About the Book
In the mid-1980s, Congress became aware that many -- almost one out of seven -- worked hard, lived frugally, succeeded in establishing a dignified standard of living as retirement age approached, only to have that independence destroyed by the costs of long term care. To reach out to those left penniless by this blitzkrieg, Congress added several provisions -- optional to the states -- by which to become eligible for long term care under Medicaid without total loss of economic security. These provisions authorize certain transfers and do not count certain resources. The new provisions were added expressly to permit eligibility without spend-down, even permitting avoidance of lien recovery for benefits paid. All levels of government experienced continuing budgetary stress over the 15 year period ending in the late 1990s. During that time, characterization of these broken seniors shifted from "fine Americans, humbled by unfortunate circumstance" to "greedy geezers feeding at the public trough." But Congress has seen fit to leave the eligibility planning rules in place. We must therefore assume that the criticism is for public consumption while the real policy remains one designed to meet these serious social needs.
About the Author
F. Bentley Mooney, Jr. is an av-rated tax attorney, and listed in the Bar Registry of Preeminent Lawyers. (Martindale-Hubbell) With a practice limited to business law, estate planning and probate, he is a frequent speaker on topics within those areas of practice concentration.
Mr. Mooney is also the author of numerous articles and books. Among the latter are Handcuff the Tax Man, Going Bare, The Artful Use of Offshore Tax Havens, Cluster! A Flexible Approach to the Cluster Agency Maze, When Health is Lost: Providing for Long-Term Nursing Home Care, Creating & Preserving Wealth and Preserving Your Wealth.
He receives calls for expert comment from Forbes, Medical Economics, The Los Angeles Business Journal, Wall Street Journal and more than a dozen other publications.