What are Long term services and supports?

The assistance an individual needs to perform personal functions such as eating, dressing, bathing, going to the toilet, or transferring say from a bed to a chair. These functions are called - activities of daily living (ADLs).

Home aide

Where are these special services received?

  • About 80% in a person's home. It often starts with a Homemaker to prepare meals and provide non medical support. They are sometimes called Companions.
  • When hands on help is needed a Home Health Aide provides this assistance.
  • When medical related assistance is needed an LPN or in some cases an RN would come to your home.

     BTW - home based assistance can range from a few hours every couple days up to around the clock. This help responds to the desire of many to age in place.

Assisted Living Facility (ALF): Individuals have a private residence and receive meals in a common area. A big value of a ALF is socializing, which improves the individuals quality of life. Families report safety is a big factor in moving a loved one to a ALF since they know help is there if they fell or had a sudden illness.

     Note: The monthly rate of some ALF's includes a "basic level" of up to 5 services. Some have a "standard" level with 6 to 9 services. 10 or more services are considered "inclusive". Some also have a secure area with special services for people with cognitive conditions.

Nursing facility: Support for individuals who have more complex needs such as around the clock monitoring.

     Note: An American Association of Long Term Care Insurance study of new long term care claims found 31% started with Home services - 30.5% in Assisted Living - 38.5% in a Nursing home.

OK! How does Long Term Care insurance cover these special services?

  • A health care professional creates a plan of care describing the two or more ADL's a person needs assistance with and submits to the company. Help has to be projected for at least 90 days. Payment begins after the waiting period they selected is completed. It is sent to the person but additional payments can be sent direct to the professional.
  • Not all assistance qualifies. Why? When it is to improve a person's condition it's not custodial! e.g. therapy after being in a hospital for surgery is acute care!

Insightful Findings!

 

What do we know about the need for long term services?

  • Over 80% of us have a relative, or know someone, who is or has.  Some because "parts wore out" and others because of trouble with mental ability.
  • By age 75 - 70% or more of us will need help at some time! People by then have, on average, 2 or 3 chronic conditions and some as many as 10 or 12.
  • By age 85 or older 20% are using support services.

People often think their health will not deteriorate and just die one day! That would be nice however, no one knows whether they will or won't need assistance.

We also know:

  • 88% of people worry about having physical limitations.
  • Advanced medical treatment have increased longevity so females at 65 can expect to live to 86 and males to 84. Longer life however means a much higher chance assistance will be needed and for a long period.
  • A need for help can develop at any age; last for several months, such as following a stroke; or be permanent like the accident Christopher Reeves (Superman) had.

What do long term services and support cost in Connecticut?

  • A Homemaker coming to your home in the Hartford area can be up to $26 an hour.
  • Having a certified home health aide provide assistance say for 4 days a week at six hours can be about $675. This could grow to over $5,500 a month in say 15 years.
  • Adult Day services,  a person goes to a facility during the day so the family caregiver can go to work. This service is up to $85 a day in the Hartford area and on a 5 day a week basis would be about $1,900 a month.
  • Assisted Living Facility rates can be up to $6,600 a month in the Hartford, New London & Norwich area; to $6,900 in the New Haven area; and to $8,000 in the Bridgeport/Stamford area.

The Connecticut Partnership for Long Term Care reports a semi private Nursing home room now costs about $151,000 a year in CT. These costs are next to the highest in the U.S. and have been increasing at an average of 5.5 % since 1988!

 

Yes these services are very expensive but projections tell us they may be three times higher in say 25 to 30 years. Paying directly would use up the hard earned savings nest egg of most people in a few months!

OK! What can be done to offset long term services expenses?

Buying Long Term Care insurance. Taking this action gives you the certainty of a known cost. Ideas to control this cost:

  • Sharing assistance expenses. Determine how much you could pay using your Social Security, other income, or perhaps withdrawing some funds from investments. Knowing this amount will help determine the monthly benefit to select in the plan. Sharing in the cost of assistance means you can own this special kind of insurance at a lower cost.
  • Select a higher monthly benefit - BUT don't include the expensive inflation option.
  • Paying for your plan annually. May be 8% lower than monthly.

Note: The chance your home & auto coverage will be used is significantly lower than for needing long term services! Yet everyone buys home & auto coverage!

Call John C Parker today at 860.739.0005 to talk about not burdening your family. I'll get back to you if not available.

More information on what you and your family will gain is on the Value page.

John C Parker, has achieved professional designations as a Long Term Care Insurance professional and a Registered Health Underwriter. John is licensed to conduct business in CT (644135) and RI (1058420) and does not solicit or sell in other states.

This site shares insights from extensive involvement in professional associations, industry conferences, working with leading Long Term Care Insurance organizations, and individual research. These pages do not advocate a specific company or plan.

 

Insightful advice - no cost to you.

John’s commitment to helping individuals prepare for needing help with day to day activities, in the most economical way, is rooted in parents needing long term services.

Call Now for a Free Consultation [860.739.0005]

 

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