What the CLASS Act Means For You
Editor’s Note: This article was originally posted on Caring for Our Parents.
The new health law creates, for the first time, a national, voluntary long-term care insurance system called the Community Living Assistance Services and Supports (CLASS) Act. Participation will be optional, but if you enroll, you'll get a basic cash benefit for life to help pay for personal assistance if you are disabled or very frail and unable to care for yourself. Here is how CLASS will work:
How Will I Enroll?
The insurance probably won't be available until at least 2012. Once policies are on the market, you may be able to sign up through your work. If your employer agrees to offer CLASS, you'll be automatically enrolled starting at age 18 unless you choose to decline coverage. If you do opt-out, you'll still be able to buy in later, although your premiums will be higher.
How Healthcare Reform Impacts Caregivers
Editors Note: This article was cross posted on Brightstar Healthcare's BrightInsights.
A few weeks ago President Obama signed into law a new healthcare reform bill which will expand health insurance coverage for 32 million people who are currently uninsured. This law will be phased in over the next decade but it offers a lot to help family caregivers both in the short term and the long term.
The benefits of the law fall into two categories – provisions which help the care recipient through Medicare and other public programs and those that help the caregiver through expanded health insurance coverage and better consumer protections. The biggest advantages to care recipients come through better coverage under the Medicare prescription drug program and through expanded health insurance options for pre-Medicare retirees.
Family caregivers will see their biggest benefits come from the fact that health insurance will begin to be de-coupled from employment starting in 2014. Many family caregivers face the difficult choice of whether to stay employed and hire professional caregivers to look after their loved ones or to leave their jobs and care for them full time. This decision is made more difficult by the fact that people who leave their jobs risk losing the health insurance benefits that go with them. By providing new health coverage options and subsidies to help pay for them, family caregivers will have one less thing to worry about when making these difficult choices.
Caregiver News Roundup Sunday March 28, 2010
Health Reform Includes a New Long Term Care Program – The new health reform law includes the CLASS Act, a new long term care insurance program administered by the federal government. The program would be available for working adults to purchase and would cover many traditional long term care services plus respite care, transportation, home remodeling and assistive technologies.
What Is in the Health Reform Bill – The new health reform law will make changes to our current system including expanding coverage to 32 million uninsured Americans, providing new consumer protections for the insured and closing the Medicare prescription drug "donut hole."
Memory Can Fade Quickly Even Before Alzheimer’s Disease – Patients with mild cognitive impairment, the stage before Alzheimer’s disease, lose their memory twice as fast as people not suffering any impairment. Once Alzheimer’s sets in, memory loss increases to four times as fast as people not suffering from the disease.
Study Identifies Which Diseases Are Most Likely to Put Seniors in Medicare "Donut Hole" – A new UCLA study has found that seniors suffering from chronic conditions like diabetes and dementia are the ones most likely to hit the Medicare Prescription Drug "Donut Hole."
Rheumatoid Arthritis Is on Rise in American Women – A new study published in the March issue of Arthritis and Rheumatism has found that rheumatoid arthritis is on the rise with American women, especially white women. The study found that the incidence of rheumatoid arthritis in men had leveled off but was continuing to rise by 2.5% per year with women.
The New Healthcare Law: What It Really Means
Editors Note: This article was originally posted on Women’s Voices for Change.
On Sunday, March 21, 2010, the House of Representatives passed major healthcare reform legislation, passing a bill that will be signed within days by President Obama. This is an historic moment that has eluded numerous Presidents, including Harry Truman, Richard Nixon and Bill Clinton. The legislation will provide health care coverage for an additional 32 million Americans who are currently uninsured, and provide important consumer protections for all Americans.
The struggle to pass healthcare reform has been difficult, at times nasty, and filled with misinformation. Now that it will be law, what exactly does it mean for the average person, and how will it affect our lives?
Women. This bill will help women both in terms of coverage and affordability of health insurance. Currently 19 percent of women are uninsured, for a variety of reasons. A smaller number of women receive health insurance coverage through their employers than men do, with 38 percent of women being insured through their jobs compared to 50 percent of men. Additionally, a larger number of women receive dependent coverage through their spouses’ employers, with 24 percent being covered this way compared to 13 percent of men. Another 6 percent of women receive coverage in the individual insurance market. By providing greatly expanding health care coverage, the number of women who are uninsured should drop dramatically.
Additionally, the bill will help lower the cost of insurance for many women, since insurers now can charge women of childbearing age higher premiums than men in many states. The bill eliminates this discriminatory practice by instituting community rating, a practice in which everyone is charged the same amount, including individuals and small businesses.
Children. Kids already benefit from the Children’s Health Insurance Program, but this bill provides additional benefits—the most important being the elimination of pre-existing condition restrictions for children, and allowing them to remain on their parents’ health insurance to age 26.
Uninsured. The bill provides much broader coverage by expanding health insurance to cover 32 million of the 46 million people who are currently uninsured. It achieves this through a combination of mandates to employers and individuals and expansion of government health insurance programs.
Who’s Left Out. It’s expected that approximately 14 million people will not qualify for coverage under the bill.
2010: What Goes Into Effect This Year
The bill is structured so that parts of the legislation will phase into law starting in 2010 and continue to phase in until 2020. There are many benefits that go into effect this year.
Elimination of Pre-existing Conditions for Children. The bill immediately eliminates the ability of insurers to deny coverage to children on the basis of a pre-existing condition. For adults, the ban on pre-existing conditions goes into effect in 2014. High-risk insurance pools (below) will be available to help them gain coverage in the meantime.
Temporary High-Risk Insurance Pools. The bill creates high-risk health insurance pools for people who have pre-existing conditions and have been denied coverage due to those conditions. To qualify, they have to have been uninsured for at least six months. Monthly costs will be based on those for general health insurance population. Perhaps most important: the monthly fees will not be able to vary more than 4-to-1 based on age. Out-of-pocket costs are capped at $5,950 for an individual and $11,900 for a family. The pools sunset in 2014, when the pre-existing condition ban goes into effect and Health Insurance Exchanges (see below) come online.
Changes to the Medicare Drug Benefit. The bill provides a $250 “bonus” to all who have enrolled in a Medicare Prescription drug program in 2010. It also begins closing the Medicare Prescription Drug “doughnut hole” in 2011.
Coverage of Adult Dependents Up to Age 26. The bill requires that insurers permit dependents to remain on health insurance policies up to age 26, regardless of whether or not they are full-time students. Most insurers currently cover dependents not in school only up to age 19 and those in school up to age 23.
Prohibition from Insurance Rescissions. Insurance rescission is a practice in which insurers retroactively cancel an insurance policy, usually due to an unreported pre-existing condition. The new bill makes this practice illegal.
Tax Credit for Small Businesses to Pay for Insurance. The bill includes $40 billion in tax credits to help small businesses pay for health insurance for their workers. The credits are available to employers with fewer than 50 workers and will cover 35 percent of health insurance premiums in 2010. This figure will rise to 50 percent of premiums in 2014.
Prohibiting Lifetime Benefit Caps. The bill will prohibit lifetime caps on health insurance benefits.
Years to Come: What Gets Phased-In
The bulk of the new benefits and subsidies for health insurance will begin in 2014. The lead time is necessary to accumulate funds to pay for the cost of the new coverage.
Health Insurance Exchanges. These state-based marketplaces start operation in 2014 and are based on the Massachusetts Health Connector system, in which individuals and small businesses are able to purchase health insurance. The goal is to provide individuals and small businesses with transparency in benefits and pricing so they can compare health insurance and purchase the coverage that best fits their needs.
Employer Mandate. Starting in 2014, businesses employing 50 or more people will be required to provide insurance coverage to their employees or pay a $2,000 per worker penalty.
Individual Mandate. Almost all Americans will be required to get insurance coverage or face fines—a system similar to the one that’s already in place in Massachusetts. The fines start small at $95 in 2014, but rise rapidly to $695 in 2016. Low-income individuals are exempted from the mandate but most of them will be eligible for coverage through Medicaid or other subsidies.
Health Insurance Subsidies. In order to help families afford the mandatory insurance premiums, starting in 2014 subsidies will be available on a sliding scale, up to a level of $88,000 per year for a family of four. The amount of the subsidies will also be on a sliding scale, meaning that people with lower incomes will receive larger benefits.
Long Term Care. The bill includes the CLASS Act, which provides a public, voluntary long term care program that working people can purchase. The program would cover home care, respite care, home modifications, transportation, and assistive technologies.
The Bottom Line: How’s It Paid For
The legislation is expected to cost $940 billion over ten years. It’s expected to reduce the federal deficit by approximately $143 billion during this time by slowing the rate of healthcare-cost inflation.
The new healthcare measures are paid for through cost savings in Medicare and other government health programs, estimated at approximately $500 billion over ten years. The cost savings in Medicare are achieved by bringing payments for Medicare Advantage plans in line with the cost of providing care, and by reducing the rate of estimated growth in the program.
Additionally, some new taxes are being instituted. Approximately $100 billion will be raised by fees on prescription drugs, health insurance premiums, and an excise tax on medical devices. The bill also raises the Medicare tax from 1.45% to 2.35% for individuals earning more than $200,000 and families earning more than $250,000 per year.
Finally, starting in 2018, an excise tax of 40% will be applied to “Cadillac” health plans: those costing more than $10,200 per year for an individual and $27,200 for a family. These are health plans for wealthier individuals, since the average cost for family coverage is about $12,000 per year.
While health insurance reform has passed and will be signed by the President within days, the Senate still needs to act on a bill to fix some of the problems in the bill enacted into law. That’s expected to take place this week.
It is unlikely that work on health reform is done. The lesson of other social insurance programs is that they always remain works-in-progress. Social Security and Medicare have been modified and expanded a great deal since they were first enacted. You can expect similar developments to occur with healthcare reform as it moves forward.
Study Finds Working Caregivers Are More Likely to Have Health Issues
Being a caregiver is an incredibly stressful experience and a new study by the MetLife Mature Market Institute has some startling conclusions about its impact. The report examined employees serving as caregivers and found that they are more likely to suffer from health problems like diabetes, high blood pressure and depression than their co-workers.
Some of the key findings in the study include:
- Caregivers have health costs which are 8% higher than people who are not caregivers and cost employers $13.4 billion a year.
- Employees serving as caregivers were more likely to report poor health than their co-workers. For example, 17% of female employees ages 50 and older who were caregivers reported fair or poor health compared to 9% of non-caregivers.
- Employed caregivers find it difficult to take care of their own health care needs and are less likely to get preventive care such as mammograms, annual physicals and preventive health screenings.
Healthcare Reform Helps Pay for Long Term Care
Assistance to help people pay for the costs of long term care has been included in both the House and Senate healthcare reform packages. This bill, known as the CLASS Act, establishes a voluntary, affordable government long term care insurance program.
The coverage is designed to keep people in their own houses and out of institutions like nursing homes whenever possible. Some of the services covered under the CLASS Act include home care, respite care, home modifications, transportation, and assistive technologies.
The premiums will work in a similar manner to life insurance and will vary based on age at the time of purchase. They are expected to increase periodically with age.
In order to qualify for benefits, an individual is required to be 18 years old or older and have paid monthly premiums for at least 5 years. In order to receive coverage, a person must:
- Be unable to perform two or more activities of daily living (ADL) e.g. eating, bathing, dressing, transferring.
- Have a cognitive disability that requires supervision or hands-on assistance such as Alzheimer’s disease, multiple sclerosis or traumatic brain injury.
Caregiver News Roundup Sunday January 3, 2010
Senate Passes Healthcare Reform Bill – The US Senate passed a healthcare reform bill on Christmas Eve. The House of Representatives passed a bill in November. The two bills will be merged and a final vote is expected by late January.
Alzheimer’s May Lessen the Risk of Getting Cancer – A new study found that people who are suffering from Alzheimer’s are 69 percent less likely to get cancer than people not suffering from the disease.
Nursing Shortage Is A Concern for Baby Boomers – The US is expected to face a nursing shortage just as the baby boom generation begins to retire. By 2025, the US will be facing a shortfall of 260,000 nurses.
Healthcare Will Need to Change as the Nation Ages – A report from the Institute of Medicine says US is not prepared for the coming boom of senior citizens. A major concern is a lack of medical professionals, such as geriatricians, to treat aging conditions.
Caregiver News Roundup Sunday December 20, 2009
Caregiver News Roundup Sunday December 13, 2009
The Impact Caregiving Had on Me
Editors Note: This is the third of a 3 part series on my caregiving experience. It is being cross posted at Caregiving.com and LosingourParents.com.
Being a caregiver has been a life changing experience and a fulfilling one in so many ways. It strengthened the bond between my father and me. It opened my eyes to the confusing and antiquated world of long term care. It gave me an understanding of how difficult it is to watch someone you love deteriorate before your eyes.
Since my father’s death, I have gone from caring for him to being the father of a beautiful, healthy 19 month old daughter, Avery. Being a father made me realize how many sacrifices my parents made for me when I was growing up. I am so grateful I was able to help my father enrich his life during his last years and like to think I repaid him for a few of the sacrifices he made for me.
After my experience as a caregiver was over, I was determined to help others by sharing the lessons I learned and bringing long term care into the 21st century. I have worked in healthcare for almost 25 years but was shocked at how difficult it was to navigate the world of long term care.
It was difficult to find qualified and compatible home healthcare aides for my father. There was no information about the quality of services or reviews from customers about their experiences. We went through numerous aides as we struggled to find the right one for my father.
One of the most frustrating parts about being a caregiver was keeping track of my father’s appointments, especially as his Parkinson’s progressed. He had home care visits, doctor’s appointments and medication dosages every 3-4 hours. There was no centralized place to track all this information.
Obtaining specialty medical supplies like bathroom bars, bed liners and walkers was difficult. Many of these items were not available at the local pharmacy and had to be order via catalogs or the Internet.
I created eCare Diary to make life easier for caregivers. It was developed out of my personal experiences and has grown through the input of other caregivers. eCare Diary is the first centralized website that offers free tools, information and community to address many of the issues I faced. These include an appointment and medication management tool, a search engine of care facilities, a shopping portal and supportive blog communities for caregivers.
One of the major goals of eCare Diary is to be an interactive community where the needs and suggestions of caregivers can be integrated into the site. We have been so gratified by the feedback and suggestions we are getting from visitors. We plan to release eCare Diary 2.0 shortly and this will include a number of additions recommended by users.
Starting a new business has been exciting and scary. I worked for a startup during the dot-com boom but I have spent most of my life working in large organizations. eCare Diary does not currently have investment money so we are operating on a tight budget. It is difficult and takes a lot of hard work, but it has also forced us to be creative. We have found social media to be an excellent way to connect with caregivers and to publicize what we are doing. It was through Facebook that we connected with Denise Brown and learned of the terrific work she is doing here at Caregiving.com.
The most rewarding part of the launch has been the new people we are meeting. Since launching the site in September we have connected with many caregivers locally and online. We have found that many of them have the same thirst for information and feeling of isolation that I had. They are fortunate that there are resources available today that did not exist when I was caring for my father.
A Message From the Founders: What We’re Thankful For
For this Thanksgiving holiday, we have so much to be thankful for.
We thank all of you, the community of eCare Diary caregivers, visitors and partners, who’ve helped make the site a success in such a short period of time. Our mission was to create a centralized place where caregivers could find help, information, and the support they need. John and I developed this site based on our own personal frustrations as caregivers with the hope that future caregivers would never have to go through what we did.
I am thrilled to report that in only 10 weeks since eCare Diary went live, the number of visitors and registered users more than exceeded our expectations. Response to the site has been amazing! We are overwhelmed by the emails offering thanks, support and terrific new ideas.
We are thankful for our experiences as caregivers. It wasn’t a role we expected or wanted. No one wants to watch their parents suffer through long term disease. However, while those were very difficult, sad times, that experience gave us a hard and fast education on long term care. We were exposed to information, resources and communities that lead to the creation of this site.
We are thankful for the loved ones in our lives more than ever. When you’ve suffered loss and death, you appreciate the people in your life in a whole new way. Around the holidays, John thinks about his parents a lot wishing that they were alive to have met our daughter, Avery. Their absence makes me more thankful than ever that my parents are still alive, and I appreciate them more profoundly.
We are thankful for our daughter Avery who just turned 19 months old. She has opened our hearts in ways we never expected. Giving birth to her reminded us of the preciousness and volatility of human life, interestingly similar to what we observe as caregivers.
We are thankful that eCare Diary is becoming a family affair. John’s sister, Polly Whitehorn, recently joined us as Director of Special Events and Outreach. Formerly of the Arthritis Foundation, Polly’s experience and networking has been invaluable in getting the word out about eCare Diary. Susan’s brother, Kevin Kim, has also joined eCare Diary as Web Designer. We are so fortunate to have his talent for developing clean, consumer-friendly designs; he is in the process of redesigning the site for eCare Diary 2.0 coming soon!
We are thankful for many new friends we’ve made and partnerships we’ve formed. Their generosity and assistance have helped propel eCare Diary. We thank and acknowledge them below.
We wish you a very Happy and Healthy Thanksgiving!
Bill Walters, CEO of ALTHA (a hospital trade association), for featuring a 2 page story on eCare Diary in ALTHA’S quarterly newsletter
Denise Brown, creator of Caregiving.com (blog for caregivers), for inviting John to write a 3-part series on his caregiving experiences with his father
Howard Gleckman, author of Caring for Our Parents, for his long term care expertise
Margery Pabst, author of Enrich Your Caregiving Journey, for her caregiving expertise and articles
MarketWatch.com for inviting John to write “Obamacare: Why it’s Different This Time”
Chris Lombardi, of WomensVoicesForChange.org, for publishing my article “Sex in the Workplace: A Caregiver’s Story”
Jason Alba, Founder of JibberJobber.com (a relationship management website for professionals and entrepreneurs), for his advice, constant support, and plugs
Katherine Lewis, of CurrentMom.com (a blog for tech mom entrepreneurs), for publishing my story, “Becoming An Accidental Entrepreneur”
Karla Lightfoot and Stella Grizont, of LadiesWhoLaunch.com (women entrepreneurs website), for promoting the site and connecting me to an amazing community of female entrepreneurs
Jean Levin, founder of Caring From a Distance, for her advice, thoughts and insights.
Facebook Fans & Friends, your thumbs up and support encourage us all the time!
Caregiving in America Today—A True Story
Editor’s Note: eCare Diary is pleased to announce that Michael Chien, co-founder of Head to Toe Care LLC, is a guest blogger today. Head To Toe Care is a free website offering practical tips for home based caregiving. Medical professionals give step-by-step instructions, symptom management, and medical provider interaction tips.
My friend is a registered nurse experienced in hospice and palliative care. This is her story. Her father is a retired Air Force colonel—he served as a commander in three wars and assumed the responsibility to care for his troops. He still has this responsibility.
Last Saturday evening, she received a frantic call from her father that one of his “troops” needed assistance. They rushed over to the condo of his friend, a retired officer and doctor. He had been discharged from the hospital after a 7 day stay which included ICU care. He was discharged to his “home” which is a condo in the independent living section of a life care community. He had been “home” for about 4 hours when another friend happened to stop by for a visit. He found the doctor in a chair, in the living room, with no ability to care for himself, or call for help. There were no sheets on his bed and no clean towels or washcloths. There was nothing to eat or drink within his reach, and no possible way for him to get to the bathroom. Recognizing that the needs of the doctor were far beyond his abilities, the friend managed to place the doctor on the sheet less bed and telephoned my father for help.
When they arrived, what they found was heart wrenching. Not only was the hospital gown saturated with urine and feces, there was evidence of old as well as new urine and feces through out the small condo. It took them two hours to see to his basic needs of bathing, nutrition, making the bed, positioning him comfortably and cleaning the condo as best we could. The colonel is a smart and capable man. He had insight to know that he could not have cared for his friend alone. With her directions, he was able to learn and participate in simple care giving for his friend.
Sadly, this story is not unique. This scenario is happening all the time. People are being sent home from various health care facilities (hospitals, rehab centers, etc.) While care needs are evident, there is little if any communication to achieve a seamless transition between the needs of the patient from the outpatient setting to the inpatient setting, and then back to the “home” setting. With “real” discharge planning—this situation could have been avoided. A paid caregiver could have been hired as there were no family members available because the family lived out of state. When there are no funds to pay for a hired caregiver, than it is up to family members and friends to see to caregiving needs. However, the family needs to be instructed on how to provide care.
This type of caregiving information is vital for families and friends. This will ensure that those who need care can maintain their dignity and get the care that they deserve.
Three Toughest Challenges I Faced As A Caregiver
Editors Note: In honor of National Family Caregivers Month I will be doing a 3 part series on my caregiving experience. It will be cross posted at Caregiving.com and LosingourParents.com.
Becoming a caregiver is an unplanned experience since we never know when or where it will occur. It creates many challenges in terms of day to day care and the emotional needs of the patient and caregiver. When I was caring for my father who suffered from Parkinson’s disease I faced many challenges and will discuss the three toughest ones.
Allowing My Father to Be Independent While Convincing Him He Needed Help
Parkinson’s is a degenerative disease so when my father was initially diagnosed the medications addressed many of the symptoms permitting him to live independently. However, as the disease started to take its toll on his body and the medications were less effective, it became harder and harder for him to live without help. He started to fall, had trouble making meals for himself, dressing himself and bathing himself.
Caregiver News Roundup Sunday November 15, 2009
Medicare Prescription Drug Enrollment Begins - The annual enrollment period for the Medicare Prescription Drug program starts November 15 and ends December 31. Seniors are encouraged to shop around for the coverage that best fits their needs.
Caregiver Crunch Coming – The aging of the baby boomers, fewer family members and the increasing number of children not living near their parents is going to create a shortage of family caregivers in the near future.
New Law Prohibits Genetic Discrimination – A new law will prohibit employers from requesting genetic tests or considering genetic history in hiring, firings or promotions. The law also prevents health insurers from requiring genetic tests as a condition of coverage or to set premiums.
Lupus Drug Submitted to FDA for Approval – Experimental Lupus drug Benlysta has completed its first round of testing and is headed to the FDA for approval. If approved, the medicine could be available by late 2010.
Gene Mutation Is Linked to Parkinson’s Disease – A study in Natural Genetics has found that mutations of the alpha-synuclein gene and microtubule associated protein tau increase the risk of getting Parkinson’s disease.
Caregiver News for Sunday November 8, 2009
Healthcare Reform Passes House of Representatives – A bill to reform the US healthcare system passed the House of Representatives by a vote of 220-215. The bill includes a requirement that all people have health insurance, eliminates denial of coverage for pre-existing conditions, and provides a new regulatory structure for the health insurance industry.
Flu Facts for Patients for Dementia – The Alzheimer Foundation issued a list of tips for patients with dementia and the flu. One of the most important things is to look out for both Swine Flu and regular flu since both viruses will also be of concern this winter.
More Evidence That Alzheimer’s Is Hereditary – A Dutch study has found that about 60% of the risk on contracting the disease is based on genetics. A gene called apolipoprotein E is believed to be the cause. People with a variant called APOE e4 are more likely to develop Alzheimer’s than those without it.
Discovery of New Protein Offers Hope for Parkinson’s Patients – Scientists at Iowa State University have discovered the presence of protein kinase-C, a dopamine killer. In people suffering from Parkinson's Disease the brain cells producing dopamine die. It is hoped that knowing what causes these cells to die will lead to a cure.
It’s National Family Caregivers Month – President Obama has declared November Family Caregivers Month to recognize the extraordinary work of this group of people
Caregiver News Roundup Sunday November 1, 2009
Geriatric Care Managers: What They Are and How They Help
Today I attended a conference for professional geriatric care managers (GCMs) in New York City. I had an idea of who they are and what they do, but admittedly, wasn’t one hundred percent clear. Interestingly, I learned today that many people don’t know who they are or that their service even exists. Today I got my education and would like to share it with you.
Who & What
GCMs are professionals who conduct in-depth assessments of elderly clients to identify solutions and suggest a customized care plan. Their knowledge, experience and network can help families navigate the complex system of eldercare. They can assist with a wide range of topics:
Financing care (long term care insurance, Medicare, Medicaid)
Placement in care facilities (such as adult daycare, nursing homes, assisted living facilities)
Finding home care agencies
Home living space and design
GCMs can also serve as a third party when families are having trouble discussing care planning amongst themselves. They can guide the conversation and even help families through conflicts.
Healthcare Reform – What’s In It; What’s Not
Healthcare reform is winding its way through Congress and is on the verge of being voted on by the full House of Representatives and Senate. This is an historic event because in the 61 years since President Harry Truman first proposed universal healthcare coverage in 1948, no bill has ever come close to being voted on.
This is a good time to review what’s in the bills, what may be in them, and what’s not in them.
What’s In Healthcare Reform – here are the 6 key items:
- Guaranteed Healthcare Coverage for Everyone – All the bills would provide health insurance to the 46 million Americans who are currently uninsured. It is accomplished through a mandate that individuals purchase insurance and that employers provide it or pay a penalty.
Long Term Care Remains a Forgotten Stepchild in Health Reform
Earlier in the summer I wrote about President Obama’s support of the late Senator Ted Kennedy’s long term care insurance bill as part of health reform. While this proposal is an improvement over current programs, it does not provide the comprehensive solution families need to pay for the cost of long term care.
Caring for an elderly or infirm relative is both time consuming and expensive. According the Department of Health and Human Services, the US spends over $200 billion per year on long term care services. To give you an idea of what this means to a person receiving care, it costs between $18 and $29 per hour for home health care services and an average of $209 per day for a nursing home.
Medicare provides only limited coverage for long term care so the US has a piece meal system to cover these services. The most common ways to pay for care are:
- Long Term Care Insurance – About 10 million Americans have purchased these policies. While they help cover the cost of care, they generally cover less than 50% of the expense of long term care.
- Medicaid – This program that pays for long term care for people who are poor. Many people divest themselves of their assets to become eligible for Medicaid coverage. The rules vary by state. To learn more about each state’s requirements visit the Financing Care page of eCareDiary.com.
Obama Supports Long Term Care Coverage in Health Reform
As a caregiver and founder of eCareDiary.com, I am very excited that President Obama has decided to support a long term care benefit in Health Reform. Based on my past experience in Heath Reform, long term care has rarely come to the forefront of the healthcare discussion, so this is a welcome development.
Senator Ted Kennedy has proposed a federal long term care insurance program which is included in the Health Reform bill. The Kennedy proposal would create an affordable long term care insurance policy that working individuals could purchase for as little as $65 per month. This is a low premium considering an average long term care insurance policy for a 55 year old will cost over $100 month and will increase to over $300 for a senior citizen. (For more information, here is the link to the bill)
The long term care insurance program would provide a benefit of $50 per day for home care and nursing home services. While this is a modest amount, it will help many people stay in their homes when they become debilitated with long term illnesses.
Determining That Your Loved One Needs Long Term Care
One of the toughest conversations a caregiver has to hold is telling a loved one they need help caring for themselves. I faced this discussion about 4 years with my father who was suffering from Parkinson’s disease at the time.
The process of determining the long term care needs of your loved one, breaking the news to them that they need help and setting up the services should be deliberate and done with care. It is important that you provide the care recipient with the help they need without breaking their spirit. I have outlined some tips to help you deal with this difficult process.
- Can the Patient Perform Activities of Daily Living (ADLs)? – Activities of Daily Living are the self care actions we perform for ourselves everyday and include bathing, dressing, undressing, cooking, eating, walking, using the toilet and getting in and out of a chair or bed. If you notice that your loved one has a problem performing one or more of these ADLs then he or she needs some form of long term care.
- Begin the Conversation Early– Chances are you will need to have multiple conversations with your loved one before they will agree to receive long term care so begin the conversation as soon as you notice they are having problems. Remember the person you are setting up care for has been caring for themselves for most of their life so the idea of receiving long term care is going to be frustrating, frightening and humiliating. It is important to be sensitive to their needs and feelings as you discuss the situation.