Your spouse suffers a stroke or you fall while cleaning and fracture your wrist and pelvis – what happens next? Some amount of long-term care services will likely be required.
Long-term care includes all the medical and non-medical services to cope with a chronic illness or disability when an individual can no longer provide all necessary self care (i.e. bathing, dressing and use of the bathroom to name a few). These services may include an extended period in assisted living, retrofitting a home to accommodate a wheelchair or in-home services to relearn to walk after a stroke.
Not simply old age
While it is most common to need this type of care in your 80s, you need to start planning for it much sooner. Roughly, 40 percent of those receiving long-term care services are 18 to 64.
Colorado State University extension estimates that as of 2013, the median annual cost of an assisted living home was $42,240. Costs for a year in a semi-private room at a nursing facility average $77,380, but can go much higher.
Long-term care frequently falls to family members, who provide 80 percent of care at home. This takes its toll on the healthy spouse. Caring for an ailing spouse in retirement is one thing, but if you are still working it may require a reduction in hours, loss of tenure and a corresponding decrease in planned retirement savings.
How do you pay for it all?
If you are over the age of 65, you need to know that Medicare only covers short-term costs following a hospital stay. It pays nothing after 100 days.
What will your insurance policies or Medicaid cover? Short-term and long-term disability policies through an employer may help. It may still be difficult to know how to file a proper claim and denials of coverage are unfortunately very common. Medicaid only pays for costs when income and assets are below a minimal cap.
Putting it all together
An elder law attorney can review your existing mix of insurance policies and estate plan documents to uncover whether there are any gaps. When a loved one unexpectedly needs long-term care, a lawyer can assist you to construct the best possible plan based on your individual situation.