Archive for June, 2010
Recently I gave the keynote address for the Annual Meeting of the Visiting Nurse Association of Long Island, Inc. I titled the presentation, “Long-term Care: The Middle Class Dilemma.” The dilemma for the middle class is having too much to qualify for Medicaid and other government benefits but too little to pay for care without spending down a lifetime of savings. Many think that as they get older Medicare will pay for all medical costs. This is a sorry fable. Medicare does not pay for the custodial care that long-term care requires.
Long-term care insurance is a good investment for those who purchase it early enough to make the insurance affordable. The problem for many is that the insurance becomes too expensive to purchase as the individual gets older or some pre-exisiting medical problem makes the individual uninsurable. So again it is a middle class dilemma. Recent legislative initiatives have tried to address the dilemma on the federal and state levels but none go far enough in finding a solution for the hard working middle class. Medicaid, a program originally envisioned as the medical safety net for poor people, is often the only option available for extended payments for long-term care needs. Medicaid eligibility often requires impoverishment.
It is the fear of losing a lifetime of savings if long-term care is required which sends many to seek the advice of an Elder Law attorney. Medicaid rules are complicated, often penalty periods are imposed, but generally the sooner one starts planning the better the result.
So how did this keynote address end after I had explained the difficulties of financing long-term care? I advised those present that there was one sure fire solution to the dilemma. Live a long and healthy life, enjoying everything along the way. Good advice for everyone!