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HSA 3111 - Week Eleven - Financing Long Term Care 2010

HSA 3111 - Week Eleven - Financing Long Term Care 2010 -...

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LONG TERM CARE Financing Long Term Care
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Financing Long Term Care
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THE NEED FOR LONG-TERM CARE SERVICES IN THIS COUNTRY IS EXPECTED TO INCREASE DRAMATICALLY.
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IN 2011, 77 MILLION PEOPLE WILL TURN 65. IN 2025, MEDICARE BENEFICIARIES IS EXPECTED TO REACH 69.3 MILLION REPRESENTING 20.6% OF THE POPULATION
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OVER THE SAME PERIOD, THOSE OVER AGE 80 WILL COMPRISE THE FASTEST GROWING SEGMENT OF THE POPULATION.
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FOUR OUT OF EVERY TEN PEOPLE TURNING 65 WILL USE A NURSING HOME AT SOME POINT AND MANY WILL NEED HOME CARE.
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EXPENDITURES FOR ELDERLY LIVING IN THE COMMUNITY ARE THREE TIMES THOSE OF THE NONELDERLY.
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AN OBSERVATION BECAUSE NEITHER MEDICARE NOR PRIVATE HEALTH INSURANCE COVERS MOST OF THESE COSTS OF LONG TERM CARE, AND BECAUSE FEW PEOPLE HAVE SUFFICIENT RETIREMENT INCOME OR SAVINGS TO MEET THEM ON THEIR OWN, MANY PEOPLE WHO REQUIRE LONG- TERM CARE ULTIMATELY BECOME DESTITUTE AND TURN TO MEDICAID.
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HOW IS LONG-TERM CARE CURRENTLY FINANCED?
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MEDICAID IS THE LARGEST SINGLE PAYOR FOR NURSING CARE. MEDICARE IS THE LARGEST SINGLE PAYOR FOR HOME AND COMMUNITY- BASED CARE. TOGETHER, THEY PAY FOR 56% OF NURSING AND HOME CARE.
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THE REST IS PAID BY FAMILIES.
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MEDICAID MEDICAID IS THE FEDERAL-STATE PROGRAM OF MEDICAL ASSISTANCE FOR CERTAIN GROUPS OF THE POOR, INCLUDING FAMILIES WITH CHILDREN, THE ELDERLY, AND THE DISABLED.
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ORDINARILY, PEOPLE QUALIFY FOR COVERAGE BY MEETING STRINGENT LIMITS ON INCOME AND ASSETS.
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FOR THE ELDERLY AND DISABLED, THESE LIMITS ARE GENERALLY THOSE APPLICABLE UNDER THE FEDERAL SUPPLEMENTAL SECURITY INCOME (SSI) CASH ASSISTANCE PROGRAM - BUT LIMITS CAN BE HIGHER IN STATES THAT SUPPLEMENT SSI PAYMENTS.
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MOST STATES ALLOW THE “MEDICALLY NEEDY” THOSE WHO LARGE MEDICAL BILLS REDUCE THEIR INCOME TO THE REQUIRED LEVEL TO PARTICIPATE.
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