By Michael Pessman
This article is reprinted by permission from .
In addition to reminding us of the high cost of long-term care, the COVID pandemic has exposed shortcomings in how we manage the care itself, including the quality of facilities, quantity of beds, scheduling of staff and a lack of commitment to improving the system.
Long-term care reform must be at the top of the federal government’s policy agenda if we as a society are to allow people to age with dignity and well-being. Reform should emphasize expanding coverage and strengthening connections with the broader healthcare and public health systems to create equity. A 2021 report by four leading researchers details this, and other advocates of long-term care reform agree with it.
Every day in the U.S., 10,000 people turn 65 , and the number of older adults will more than double over the next several decades to top 88 million people and represent over 20% of the population by 2050. The government has forecast that more than half of the adults turning 65 today will eventually require long-term assistance with daily activities such as eating, dressing and bathing.
This essential care should not be a personal financial challenge for anyone. At the start of 2022, the Kaiser Family Foundation reported that long-term-care facility residents and staff cared for more than 201,000 COVID-19 patients who died, accounting for at least 23% of all COVID-19 incidents in the U.S.
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Why we need to act now
Considering the recent data from the Centers for Disease Control and Prevention on a national surge in cases, it is necessary to address the importance of affordable long-term-care insurance to pay for the necessary treatment and care.
The national annual median cost of care ranges from more than $108,000 a year for a private room in a nursing home to $20,280 a year for five-days-a-week adult day healthcare services, according to the Genworth Financials’ 2021 Cost of Care Survey .
A semiprivate room costs $7,756 a month, or $93,075 a year. The average length of stay among all nursing home residents is 485 days, according to a February 2019 report from the National Center for Health Statistics.
Families drain their savings
In my experience as a gerontologist at Rush University Medical Center’s Alzheimer’s Disease Center in Chicago, I have spoken to older adults who were worried about the costs involved at the end of their lives. Several families have told me they are taking out reverse mortgages, spending down their savings and tapping retirement accounts to pay for long-term care.
When an individual is part of a married couple, this can be tricky. If they must pay private healthcare for their sick spouse, the healthy spouse often expresses concern about maintaining his or her lifestyle.
Many people I speak with wish to be able to pass their wealth on to their children and not have to worry about paying for skyrocketing long-term care costs. A survey conducted by Genworth in 2021 found that 66% of caregivers used their personal savings or retirement accounts to pay for long-term care for a loved one.
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The Medicare misapprehension
Some Americans reportedly think Medicare covers long-term care. But it only covers up to 100 days of care in a skilled nursing facility for each “ benefit period ,” which begins the day you check into a facility and ends 60 days after you check out.
If someone needs more than 100 days of such care in a benefit period, they will need to pay out of pocket. For patients whose coverage days are running out, they must either pay with private funds or have a Medicaid application pending to avoid being forced out. Nursing homes that do not accept Medicaid are an exception.
For qualifying, lower-income patients, Medicaid pays for skilled nursing care (but not assisted living). Medicaid coverage isn’t available to middle-class older adults with a household income of $17,609 or more for an individual in 2020.
