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Options for Long Term Care

January 22, 2013 Leave a comment


 When a family member needs some type of long term care due to old age,   disability, or illness, the search for a decent, effective, and yet affordable way of providing that care can get really confusing. It is very common that individual family members would act as informal caregivers at home, but sometimes this set up becomes extremely demanding on the schedules and energy of the home caregivers. There will also be situations where the patient may need proper skilled medical care or close attention from nurses, which are best acquired from a specialized health care facility.




·         Home Care

·         Community-Based Services

·         Supportive housing programs

·         Assisted Living

·         Continuing care retirement communities

·         Nursing Homes



Home Care


Most people would want to grow old and pass away in the comforts of their own home. The elderly, for example, feel more secured when cared for by family members in a familiar environment such as their home. This type of care is called home care, and is given not only by immediate family members, but also by friends, volunteers, and paid professional caregivers.

Community-Based Services

Patients can also seek care assistance from their local communities. Most communities provide support services and facilities for families who may need help in taking care of their elderly or disabled member. These facilities/services include:

·         Adult day care

·         Senior centers

·         Meal programs

·         Transportation

Community-based services for long term care are also very helpful in giving that much needed “break” to family home caregivers.

Supportive Housing Programs

This program offers low-cost housing to the elderly who fall into the low to moderate-income range (less than $46,000 if single or $53,000 if married). The Federal Government together with most states handles these types of housing programs, which may also offer extra help like:

·         Housekeeping

·         Meal preparation

·         Grocery/shopping

·         Laundry

Residents can live in their own apartments and rents are usually a percentage of the occupant’s income.

Assisted Living

Assisted living facilities provide a more home-like setting as compared to, say, a nursing home. Patients who also require close attention or aid can also opt for assisted living since they also have 24-hour supervision and assistance in the area. Other services include:

·         Help with eating

·         Bathing

·         Dressing

·         Toileting

·         Transportation

·         Laundry

·         Housekeeping

Continuing Care Retirement Communities (CCRCs)

CCRCs offer different levels of care depending on what the patient needs. There are usually three levels of care provided, namely:

·         Independent living

·         Assisted living, and

·         Skilled nursing

Residents of these communities usually move from one level to the other based on how they progress with their individual health care requirements. Regardless of their level, residents stay within the community.

Nursing Homes

A stay at a nursing home is most often the best choice for people with chronic ailments and disability who need advanced and immediate care management. Nursing homes basically give care to people who cannot be cared for at home or communities. Care services offered include:


·         Skilled nursing care

·         Rehabilitation services

·         Meal preparation and feeding

·         Physical and social activities like exercises and games

·         Help with daily living

A lot of nursing homes may also provide temporary or periodic care after an injury or hospital stay.

Making Your Decision


Finding and choosing the most appropriate type of long term care for a senior patient, a family member with disability, or a loved one who has a chronic illness can be a long process. Family members will have to weigh the costs and benefits of the services offered at each facility or community against the needs of the patient and their own financial capacity.

Making this decision is hard, but you don’t have to do it alone. Families can also seek the advice and assistance of long term care experts who have years of experience and know-how about the best options for custodial care.

Health care advisors from reputable firms such as in this video: can also help families put together a good long term care plan that will make things easier for them in the future. As a summary, the table below shows a comparison among the different services offered by each long term care type and their cost range.

Different Types of Long Term Care: Services and Cost Range


Home Care

Community Services

Supportive housing programs

Assisted Living



Nursing homes

Help with activities

of daily living

Help with additional


Help with care needs



Range of costs

Low to high

Low to medium

Low to high

Medium to high




This post was contributed by a guest blogger, Indira Pina.  She’s a financial manager, life planner, and LTC expert.  Ms. Pina writes informative articles focusing on planning for senior health and elder care.

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Life Insurance for Long Term Care Planning

June 30, 2012 Leave a comment

Life insurance companies have become more competitive in recent years for policies issued on people over age 70. Good health is still a major consideration for low premiums, but policies have been redesigned to provide more death benefit and less cash value. Some term policies and certain universal life permanent policies are designed to provide a guaranteed death benefit up to age 95 with a guaranteed premium and no cash value at all. This design generally results in more death benefit for each premium dollar. Also, policies designed for couples — second-to-die policies — can provide a significant amount of insurance for a one-time single premium even if one of the partners is in very poor health.

An important concept to consider is that single premium life policies with no cash value and purchased for estate planning purposes, many years in advance of applying for Medicaid, can be a valuable planning tool if the need for Medicaid arises. Medicaid does not apply the death benefit of a life insurance policy to the asset spend down rule. But the cash value of any policy that has more than $1,500 in cash will count towards the asset test and could disqualify a Medicaid applicant. As an example, a person could have $1 million of life insurance with cash value less than $1,500 and it would not prevent that person from receiving Medicaid. However, cash value of more than $1,500 in this example will apply toward the asset test. It is important to know, for long term care planning purposes, that people who apply for Medicaid and then transfer assets to a life insurance policy, while they are going through spend down, could be in violation of their state’s Medicaid transfer rules and such an act may disqualify the applicant.

Life insurance can be used as an alternative for funding the cost of long term care. If someone planning for the eventuality of long term care is concerned about losing assets that would normally be passed on to the children or be needed by a surviving spouse, that person can invest a portion of those assets in life insurance and leverage a death benefit payout — sometimes for up to $3.00 in death benefit for every $1.00 in single premium. The death benefit is also income tax-free. A person creating such an estate can then use remaining assets for long term care needs in the future but still be assured that the children or a surviving spouse will receive an inheritance at death through the life insurance. And, as discussed above, if the money runs out and Medicaid has to start picking up the costs, a single premium life insurance policy with less than $1,500 cash value will not disqualify the applicant owning the policy

Another use for life insurance for the elderly is in paying the cost of final expenses such as funeral and burial. A number of companies will issue policies without any health questions for people who may not have very long to live. Most of these policies will provide little or no death benefit in the first two years after issue and so there is some risk, but most companies will also return the premiums paid if death occurs in the first two years.

Long Term Care Insurance: Don’t Wait Too Long

June 23, 2012 1 comment


When it comes to long term care planning, all can agree that it would be best to have some kind of plan for your parents’ or your own care than to have to scramble at the last minute and spend your entire savings.

A 2005 study led by Peter Kemper projected that people turning age 65 at that time would need long-term care for three years on average, and that more than 1 in 20 would spend $100,000 or more of their own money on long-term care.

More families are turning to long-term care insurance policies to cover the gaps.

You should keep a few things in mind when shopping for long-term care insurance:

Don’t buy too much. The benefit on a long-term care insurance policy is generally structured as a fixed daily amount over a certain period up to a cap. You can typically start the clock on the benefit and begin to access the dollars when you have a “long-term care event,” such as breaking a hip or having a stroke, in which doctors expect you to need help with the tasks of daily living for at least 90 days.

You can get a much more affordable policy by structuring a benefit package that also includes time with a home health aide, at $21 an hour nationally by the same survey, or adult day care. In some cases, just 10 to 15 hours of respite care a week can be enough to allow people to remain in their homes.

Don’t wait too long. You’ll save significantly — not just now but likely over the life of the policy — if you buy a policy when you’re under 60 and healthy.

Consider the “restoration of benefits” rider and the other fine print. A good policy should cover several types of care, from adult day care to nursing home care. You should understand exactly what standards you have to meet to trigger the benefits, and it shouldn’t exclude any pre-existing conditions you have. One additional rider is called “restoration of benefits.” Let’s say you fall down the stairs at 72. You can start spending the benefits today for a home health aide. But once you recover, the “restoration of benefits” rider allows you to stop that clock. If you stay well for six months, the pool of dollars is restored as if nothing ever happened.

Planning for Long-Term Care in Pennsylvania

About nine million people over the age of 65 will need long-term care this year, according to, and that number is expected to rise to 12 million by the year 2020. Fortunately, thanks in part to the increasing demand as the baby boomer generation moves toward retirement, people with long-term care needs have more options today than in years past.

What Is Long-Term Care?

Long-term care is an umbrella term that refers to a wide range of medical and non-medical services for elderly individuals, as well as for those with disabilities or chronic illnesses. In most cases, long-term care helps people meet day-to-day health and personal needs like dressing, eating and bathing.

Long-term care comes in many different forms, including:
-In-home care: People who receive in-home care can continue living at home while getting the help they need from care providers who come and go on a regular basis according to the individual’s needs. Depending on the situation, in-home care may be limited to everyday tasks like bathing and eating, or may include more specialized health care services.
-Assisted living facilities: An assisted living facility is a group housing arrangement that provides on-site services for elderly and disabled individuals. Residents often have their own apartments and live relatively independently with easy access to the care they need.
-Nursing home care: Nursing homes are similar to assisted living facilities in that they provide on-site care to residents, but the level of care provided by nursing homes tends to be far more intensive. Typically, nursing home residents are older individuals who require constant care.

Costs of Long-Term Care

With increased options comes a greater need for careful long term care planning — but, unfortunately, most people are unprepared. According to a survey conducted by Lincoln Financial Group, only 44 percent of Americans have taken steps to plan for their long-term care.

In Pennsylvania, the median cost of in-home care is $19 per hour for homemaker services and $20 per hour for home health aide services, both of which are slightly above the national average. Meanwhile, the median cost of assisted living in Pennsylvania is close to average at $39,015 per year, and the median cost of nursing home care is well above average at $99,280, according to

Legal Help

Although the task of planning and preparing for long-term care may seem overwhelming, there are a wide range of resources and options available to help create a plan that works for your circumstances. To discuss the type of care you want and create a plan for financing it, contact a certified elder lawyer experienced in helping clients plan for their long-term care.

Activities of Daily Living (ADL): What Does it Mean?

Activities of Daily Living (ADL) refers to a variety of routines that a person normally does on a daily basis.

These activities include self-care (such as eating, bathing, dressing, grooming), working, homemaking, and leisure. The ability or inability to perform ADLs can be used as a  measure of ability/disability in many disorders.

(Image source: 

In federally tax-qualified long term care insurance policies,  the ADLs that can trigger the receipt of benefits are limited to eating, bathing, dressing, continence, transferring and toileting. You must need assistance with at least 2 of the 6 ADLs (or have a cognitive impairment) to be eligible to acquire benefits.

Know The Facts: Will Medicare Pay For Your Long Term Care Needs?

Maybe at least once in your life you have wondered if and will Medicare pay for your long term care requirements. This maybe one of the biggest and most popular questions with regards to long term care planning and its processes and more often than not, the public hopes that the answer to this question is in their favor.

Some Americans may have the wrong idea or perception that Medicare can and will cover all their LTC requirements. This is why some of them tend to ignore and not consider buying any LTC policy from a private insurance provider or even those plan options created by the government. They think that through the help of Medicare, they can get and use all their needed LTC services in the future.

Sadly, this inkling may just give them even bigger concerns and problems once they realize that Medicare does not really shoulder and pay for some of the services and facilities that their medical situation might require. So they should not be complacent that the facilities and other services that they would need can be given to them even if they do not own an LTC policy.

So once again, we will try to give helpful and useful answers to the long-time dilemma of the public: Will Medicare pay for your long term care requirements?

Yes, there might be some LTC-related matters and concerns that the Medicare can satisfy and solve but these are really limited and it would be a good idea for the public to inquire first and know every detail of all the things that they have to be aware of about this.

Unlike what many individuals believe, Medicare does not support or shoulder indefinite or a lifetime worth of long term care. It does not lend financial assistance to those who need to be confined in nursing homes and other assisted living or adult day care facilities.

They can lend a hand and pay for a certain portion of the medical expenses incurred due to a short-term illness or injury but once the individual gets well, or if the limit or allotment is already consumed, then the Medicare coverage would be cut.

Who Pays for Long-Term Care?

April 25, 2012 Leave a comment

About 10 million Americans need long-term care. Long-term care refers to the assistance and services provided to people who are limited in their ability or unable to perform basic activities, such as bathing or dressing, because of chronic illness or disabling conditions.

Most people with long-term care needs rely heavily on unpaid help from family and friends. Still, spending for long-term care services is substantial.

In 2002, national spending on long-term care totaled $180 billion, or about 12 percent of total health care (including medical and long-term care) expenditures. Nearly two-thirds of long-term care expenditures are for institutional care.

For individuals with extensive long-term care needs, long-term care services can be costly. In 2002, the average annual cost of nursing home care was $52,000 for a semi-private room and $61,000 for a private room. The average hourly rate for home care provided by a home health aide was $18.5 At this rate, four hours of home care daily would total about $26,000 annually.

Medicaid is the nation’s largest source of financing for long-term care, followed by out-of-pocket payments by the people receiving care and their families. Medicare and private health insurance provide limited coverage for nursing home and home health care. Few people make any long term care planning and have private long-term care insurance, although the number is growing.

Source: Fact Sheet