News & Resources: Blog

Long-Term Care: What to Know When Planning

Published: October 5, 2021

The need for extra, long-term care for Mom or Dad can sneak up on their children, who may not notice — or choose not to see — signs that their parents are no longer able to manage things on their own. Long-term care involves a combination of services designed to meet a person’s health or personal care needs. As populations continue to age and people worldwide are living longer, the need for long-term care will continue to climb. There are many long-term care options ranging from personal in-home care to assisted living and nursing home facilities. Long-term care is widely forgotten about until the time the need presents itself, and can often leave family members scrambling with both logistics and financing. Being aware of the need for long-term care and planning for it early can help mitigate stress surrounding decisions that need to be made when the time comes.  

Signs that it may be time for Long-term Care

As a family caregiver, when you are under stress it is much more difficult to make good decisions. To preempt a crisis situation it is imperative for children of aging parents to check in often and look for the following signs:

  • Periods of confusion or forgetfulness
  • Hoarding or changes in housekeeping habits
  • Financial troubles — past due notices, bills in the trash, etc.
  • Lack of awareness of time
  • Hygiene issues
  • When daily living goes wrong

The issues described above relate directly to what are referred to as activities of daily living (ADL), a set of activities that determine whether or not an elder is able to remain at home living alone. Difficulty with basic needs is usually a signal that assisted living or nursing care is required. These activities of daily living can be divided into two types: complex tasks (such as shopping, cooking, and managing money) and basic needs (such as bathing, using the bathroom, and dressing appropriately for the weather).

Types Of Care

Because most people want to remain independent and live in their own home, as a caregiver you may want to walk the road of care from the most independent to the least. Take note of the following:

  • Home Care: Staying at home appeals to most people and it is often the least costly option. Approximately 37 million Americans care for a parent or in-law, and 80% of long-term care is provided by families, according to the Family Caregiver Alliance. Family care can be supplemented by a range of third parties, from companions to home health aides to nurses, with cost commensurate. When cost or burgeoning needs make home care no longer workable, it’s time to consider a facility.
  • Assisted Living: Assisted living can mean care in the home or at a designated facility. Assisted living facilities often provide individual apartments and daily meals, with other services available a la carte. Continuing care facilities enable easier transition from one step to the next.
  • Nursing Home: Also called a long-term care facility, these are for people who need around-the-clock help.

Choosing care isn’t just a matter of assessing needs and touring facilities. Finances and legal documents often dictate the options. These steps will help ensure a smoother transition when the need arises:

  • Durable Power of Attorney: This document grants the power to make health care decisions should a person become incapacitated. This is important because an incapacitated person cannot grant such power. Lack of such a document can hold up important transactions, such as a need to sell the house. It’s best to assign durable power of attorney to one person.
  • Living Will: Also called an “Advance Health Care Directive,” this contains instructions specifying what should be done for an individual’s health if that person is no longer able to make decisions.
  • Finances and Insurance: This topic can be uncomfortable, but insights into parents’ cash flow, savings and the particulars of a long-term care insurance policy, if there is one, are key in securing appropriate care.

At Scott Bloom Law, we are a team of advocates who care, always fighting for what is best for our clients and their families. With knowledge, experience, and compassion, we strive to find solutions that make the aging process as emotionally and financially painless as possible. Visit us at scottbloomlaw.com or call 215-364-1111, to talk to find out more.

CLIENT Testimonial

It can be quite confusing to determine which Medicare plan is best for you. There are several types of plans, and each has its own advantages and disadvantages. Understanding some basic features will help you decide how to maximize your healthcare dollars and choices. You should review your choice periodically, especially as elements of the Inflation Reduction Act of 2022 change prescription medication and vaccine policies. Coverage can also change from year to year..

There are three basic types of plans:

  1. Original Medicare
  2. Medicare Advantage
  3. Medigap

Original Medicare

Medicare is a government health insurance plan for people 65 and older. Original Medicare, sometimes called traditional Medicare, comes in several parts. Each part covers different things and has various associated costs. 

Most people do not pay for Part A as it was deducted from their taxes paid while working. It is primarily for hospital visits and nursing care. However, there are many fees associated with being in a hospital that Medicare does not cover, which you still might have to pay out of pocket.

Part B requires monthly premiums, which can be deducted from your social security. You can elect to enroll in part B through Original Medicare. It covers a portion of doctors' visits, durable medical goods, and more. 

Part D covers the cost of many prescription medications. You can add it to Original Medicare or purchase it as part of a Medicare Advantage plan.

Medicare Advantage

Medicare Advantage is offered through private insurance companies that Medicare approves. Most plans include Parts A, B, and D of Original Medicare with some variations from the original. There are a wide variety of Medicare Advantage plans, including Preferred Provider Organizations (PPO) or Health Maintenance Organizations (HMO). PPOs tend to have higher premiums and offer more choices than HMOs. Medicare Advantage HMOs and PPOs often have higher premiums than traditional Medicare because they usually cover more expenses, including prescription drug costs, vision, hearing, and dental.

However, the overall costs, premiums, plus out-of-pocket expenses for Advantage plans can be lower than Original Medicare because the private insurers manage patient care and limit choices. They assemble networks of hospitals and physicians to control their costs and reduce their customer's premiums. They also restrict access to certain providers and increase the cost of care obtained out-of-network.

Traditional Medicare allows people to seek care from any provider participating in Medicare, which includes virtually all hospitals and physicians.

Medigap

Medigap is a co-insurance or supplement to Original Medicare. You can enroll when you first enroll in Part B. It is also available through Medicaid, a union, or a former employer when you qualify for both programs. You can’t have both Medicare Advantage and Medigap plans. Medigap helps cover expenses that Original Medicare does not cover, such as co-pays and deductibles. Due to the enrollment restrictions, you should strongly consider Medigap when you first become eligible.

The Right Choice for You

With all the different plans, parts, choices, and restrictions, it is crucial to consider your priorities for care. Limited access to doctors and hospitals may become important if you need specialized medical care, such as cancer treatment. Before enrolling, consider what specialty hospitals are included in Advantage plans. Likewise, Advantage plans can make it difficult to see a specialist for ongoing and chronic conditions due to limitations in long-term care services. An estate planning lawyer or elder law attorney can help address long-term care planning and the potential to qualify for Medicaid when necessary.

The Kaiser Family Foundation has put together a cost analysis to help you determine when Medicare Advantage would save you money. As you can see, the longer you stay in the hospital, the less advantageous an Advantage plan becomes.

Consumer Reports notes that the JAMA reported that seniors on Advantage plans often get more preventive care than those on traditional Medicare plans. JAMA published a comprehensive paper about how Medicare plan choice affects spending and discovered that Medicare Advantage enrollees usually spend less.

Consumer Reports notes that the JAMA reported that seniors on Advantage plans often get more preventive care than those on traditional Medicare plans. JAMA published a comprehensive paper about how Medicare plan choice affects spending and discovered that Medicare Advantage enrollees usually spend less.

A Guide in Choices after 65

Enrolling in the right Medicare coverage is one of many decisions that will affect your quality of life in your senior years. We are here to help you navigate a wide variety of choices.

If you have questions or would like to discuss your legal matters, please do not hesitate to contact our office at 215-364-1111 to schedule a consultation.

- Medigap, Medicare Advantage, and Traditional Medicare

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CLIENT Testimonial

Our family had the good fortune to find Scott Bloom.  He was invaluable helping us set up our trust. We had an unexpected health crises and realized that we had nothing in place to protect our children.  Scott explained our options and got the necessary paperwork ready for us to hand to our family, accountant and banks. Scott was absolutely the right attorney at the right time for us. We would highly recommend him and his team.
- Tricia B., Hamilton, New Jersey

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