WHEN MIGHT I NEED LTC?

Long term care provides help when you have a prolonged physical illness, disability, or severe cognitive impairment (such as Alzheimer’s disease) that keeps you from living an independent lifestyle.

These limitations may prevent you from carrying out basic self-care tasks, called Activities of Daily Living (ADLs). ADLs may include things such as bathing, dressing or eating.

Use the following information to better understand your potential needs.

1. Review Options To Pay For Long Term Care

2. Learn The Levels Of Care

3. Types of Long Term Care

4. Review The Costs Of Long Term Care

Review Options To Pay For Long Term Care top

Information is power: the more you know about long-term care, the better decisions you can make about your future.

• Medicare is the federal program providing hospital and medical insurance to people aged 65 or older, and to certain ill or disabled persons. Only in certain conditions are benefits available for home health care.
  
  Generally, Medicare may pay for up to 100 days of care in a skilled nursing facility per benefit period – 100% for the first 20 days (after a three-day hospital stay, if skilled care is needed). Then, from day 21-100, Medicare requires a co-payment. A Medicare supplement insurance policy can help cover the co-payment, but often once Medicare stops paying for care, the supplement payment ends as well.

• Medicaid (in California referred to as Medi-Cal) generally pays for certain health services and nursing home care for those with low incomes and limited resources. Medicaid may also pay for some long-term care services at home and in the community.
  
  Medicaid limits your assets and monthly income before you are eligible for benefits, and restricts transferring assets to qualify for Medicaid. Eligibility and covered services vary by state.

• Long Term Care Insurance helps cover the future expenses of long term care by allowing the purchase of a policy before an individual needs care.

Learn the Levels Of Care top

Long term care can be therapeutic, rehabilitative or personal care delivered at home, in a community-based setting or in a facility. Each level of care differs:

• Custodial Care (Personal Care) is for those needing help with activities of daily living (ADLs), and often involves non-medical personnel. An example would be having a helper come into your house to help with bathing, dressing, or eating and other ADLs.
• Intermediate Care is for those needing occasional nursing and rehabilitative care under the supervision of skilled medical personnel. It is less specialized and less comprehensive than skilled nursing care, but does provide care on an intermittent basis --- the caring for a wound every eight hours, for example.
• Skilled Care is for those with medical conditions requiring care by medical professionals, such as a registered nurse or professional therapist. This higher level of care may include physical therapy or supervising the administration of intravenous medication.

Types of Long Term Care top

There are a number of options when planning for a long term care need:

• Homemaker Services make it possible for people to live in their own homes or to return to their homes by helping them complete household tasks that they can’t manage alone. Homemaker services aides may clean clients’ houses, cook meals or run errands.
• Personal and Home Health Aides help the elderly, disabled, or ill live in their own homes or in residential care facilities instead of nursing homes. Home health aides may provide more extensive personal care than can family or friends.
  
  The two types of home health aide agencies are Medicare-certified and non-Medicare-certified/licensed. Medicare-certified agencies can accept Medicare reimbursements while non-Medicare certified/licensed agencies cannot.
• Adult Day Health Care (ADH) centers can offer a much-needed break to caregivers. These community-based centers care for adults needing assistance or supervision during the day, but who do not need round-the-clock care. The centers may provide health services, therapeutic services and other social activities.
• Assisted Living Facilities (in California referred to as Residential Care Facilities) are living arrangements providing personal care and health services for people who may need assistance with ADLs, but wish to live as independently as possible and do not need the level of care provided by a nursing home. Assisted living is not an alternative to a nursing home, but an intermediate level of long term care.
• Nursing Home Care offers residents a higher level of supervision and care than in an assisted living facility, including personal care, room and board, supervision, medication, therapies and rehabilitation, and skilled nursing care 24 hours a day.

Review the Costs top

Research average costs in your region for homemaker services, home health aides, adult day care, assisted living and nursing home. These average costs can give you a good idea how much money you or your family would need if you or a loved one required long-term care.