What are Long term services and supports?

The assistance an individual needs so they may 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) in a Long Term Care insurance plan.

Home aide

Where are these special services and support received?

  • About 80% in a person's home. The assistance may start with a Homemaker who prepares meals and provides non medical support. Homemakers are sometimes called Companions.
  • When a person needs hands on help it would be provided by a Home Health Aide.
  • When medical related assistance is needed an LPN or in some cases an RN would come to your home.

     BTW - assistance in a home can range from a few hours every couple days up to around the clock. These services respond to the desire of many to age in place.

Assisted Living Facility (ALF): Individuals have a private room and receive meals in a common area. Family's report a big value of a ALF is socializing, which improves the individuals quality of life. Safety is also a big factor in moving a loved one to a ALF since family members know help is there if they fell or had a sudden illness.

     Note: Services vary from one ALF to another. Some offer a "basic level" of up to 5 services in their monthly rate. Facilities with 6 to 9 services have a "standard" level. 10 or more services are considered "inclusive". Some ALFs 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% were for Home services - 30.5% for Assisted Living - 38.5% in a Nursing home.

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

  • To qualify for benefits 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 for assistance received is sent to the person after their selected waiting period is completed. Additional payments can be sent direct to the professional.
  • Not all assistance qualifies. Why? When it is to improve a person's condition, such as therapy after being in a hospital for surgery, it's considered acute not custodial and would not qualify!

Insightful Findings!

 

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

  • People all around us are receiving them! Over 80% of us have a relative, or know someone, who is or has received assistance.  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.
  • Today's advanced medical treatment and prescriptions have increased longevity so an average 65 year old female can expect to live to 86 and a male to 84. Longer life however means a much higher chance assistance will be needed and be for a long period.
  • A need for help can develop tomorrow or 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 six hours 4 times a week can be about $675. This could grow to over $5,500 a month in just 15 years.
  • Adult Day services,  where a person goes to a facility during the day, so the family caregiver can go to work costs up to $85 a day in the Hartford area. On a 5 day a week basis its 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.

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

 

Yes these services are very expensive today 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 not face expensive long term services?

Buy Long Term Care insurance. Taking this action gives you the certainty of having a known cost. The key things to think about 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 how much of a 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 of using your home & auto coverage is significantly lower than for needing long term services! Yet everyone buys home & auto coverage and don't use!

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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