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What is Long-Term Care?
Long-term care is a variety of services
that includes medical and non-medical care to people who have a chronic
illness or disability. Long-term care helps meet health or personal needs.
Most long-term care is to assist people with support services such as
activities of daily living like dressing, bathing, and using the bathroom.
Long-term care can be provided at home, in the community, in assisted living
or in nursing homes. It is important to remember that you may need long-term
care at any age.
You may never need long-term care. This year, about seven million men and
women over the age of 65 will need long-term care. By 2005, the number will
increase to nine million. By 2020, 12 million older Americans will need
long-term care. Most will be cared for at home; family and friends are the
sole caregivers for 70 percent of the elderly. A study by the U.S. Department
of Health and Human Services says that people who reach age 65 will likely
have a 40 percent chance of entering a nursing home. About 10 percent of the
people who enter a nursing home will stay there five years or more.
Medicare and Long-Term Care:
Long-term care services can be very expensive. It is important to
think ahead about how you will pay for the care you get. Generally, Medicare doesn’t
pay for long-term care. Medicare pays only for medically necessary skilled nursing
facility or home health care. However, the skilled nursing care and home health aide
services are only covered on a part-time or “intermittent” basis. You must meet
certain conditions for Medicare to pay for these types of care when you get out of
the hospital. Most long-term care is to assist people with support services such as
activities of daily living like dressing, bathing, and using the bathroom. Medicare
doesn’t pay for this type of care called “custodial care.” Custodial care
(non-skilled care) is care that helps you with activities of daily living. It may
also include care that most people do for themselves, for example, diabetes
monitoring. Some Medicare Advantage Plans (formerly Medicare + Choice) may offer limited skilled nursing facility
and home care (skilled care) coverage if the care is medically necessary. You may
have to pay some of the costs. For more information about Medicare Advantage Plans,
look at the Medicare Personal Plan Finder.
Medicaid and Long-Term Care:
Medicaid is a State and Federal Government program that pays for certain health
services and nursing home care for older people with low incomes and limited assets.
In most states, Medicaid also pays for some long-term care services at home and in
the community. Who is eligible and what services are covered vary from state to
state. Most often, eligibility is based on your income and personal resources.
Choosing Long-Term Care:
Choosing long-term care is a very important
decision. Planning for long-term care requires you to think about possible
future health care needs. It is very important to look at all of your choices.
You will have more control over decisions and be able to stay independent. It
is very important to think about long-term care before you may need care or
before a crisis occurs. Even if you plan ahead, making long-term care
decisions can be hard.
To make the best choice, you need to think about: