By Frank Samson
As I advise people on care options for their family members, most are surprised to learn about various nuances of insurance coverage as well as the various long term care options available.
See if you can answer these True or False statements.
1) T or F – There are approximately 25 licensed assisted living locations in Sonoma County.
2) T or F – Insurance coverage for Homecare is limited only to medically necessary skilled care.
3) T or F – Fewer than 15 percent of the elderly needing care live in nursing homes.
4) T or F – Most of our parents prefer to stay at home and it is the best place for them.
5) T or F – Medicare does not pay for long-term care.
6) T or F – The leading cause of death among seniors (65 years +) are falls.
7) T or F – In order to be eligible for Medi-Cal, you must exhaust your financial assets and have very limited income.
8. T or F – Less than ten percent of personal care costs in the U.S. are paid by private long-term care insurance.
9) T or F – Long-term care insurance are not for those who are financially secure.
10) T or F – The highest percentage change for cause of death is Alzheimer’s disease.
ANSWERS:
1. False. There are nearly 200 assisted living locations (Residential Care Facilities for the Elderly) in Sonoma County. Options range from small, family Residential Care Homes to larger, full-service communities with hundreds of residents.
2. False. Though non-medical homecare is not covered by health insurance, some is covered by long-term care insurance. Non-medical or personal assistance may be help eating, bathing, or going to the bathroom. It may be a ride to the doctor or the grocery store, or help balancing a checkbook or cooking dinner.
3. True. Most of us get this care at home or in the home of an adult child or relative, not in a nursing home. In fact, nearly 80 percent of the frail elderly and the disabled live at home.
4. False. Of course each situation is different, but living at home can be lonely and often dangerous. If your mom or dad needs lots of help, there are several options which also may be less expensive than staying at home in a potentially unsafe environment.
5. True. Neither will Medicare Supplement insurance. These programs will pay only for limited nursing home or home health care, and only after a patient is discharged from the hospital.
6. True. In 2006, there were 16,650 fall-related deaths or 37% of all deaths among the elderly. In 2007, 3,134,935 seniors experienced an injury. Most seniors were injured by a fall: 1,927,766 seniors or about 62% of all senior injuries.
7. False. The misconception is you have to spend all your money to qualify for Medi-Cal. This isn’t always true. You may be able to protect your assets by utilizing different legal trusts such as special needs trust, irrevocable trust or a revocable living trust. However, once qualified for Medi-Cal, there are limited long-term care options.
8. True. More than 80 percent of Americans have health insurance, usually through their jobs or from Medicare. Yet only seven percent of us have long-term care coverage. That is the real crisis of the uninsured.
9. False. Long-term care insurance is extremely important for those at any income level. On average, Assisted Living costs are $40,000 per year and Nursing Homes average $82,000 per year. A Long-term insurance option is part of the new Health Reform Plan called The CLASS Act which will offer only minimum coverage, but it’s a start.
10. True. Between 2000-2006, Alzheimer’s disease had a 47.1% increase as cause of death. All other major causes of death decreased – Heart disease (-11.5%), Breast cancer (-0.6%), Prostate cancer (-14.3%), Stroke (-18.1%).
Frank M. Samson is Founder of Senior Care Authority based in Sonoma and also hosts “The Aging Boomers” on KSVY every Monday at 2pm beginning May 3rd. The company provides free assistance to families in helping them find In-Home Care, Independent and Assisted Living for their loved ones. He can be reached at 707.939.8744 or e-mailed at frank@seniorcareauthority.com. The company website is http://www.seniorcareauthority.com.
