Long term care means different things to different families. It can involve a little extra help around the house, or it can mean full time nursing support. Many people are not aware of how many options actually exist, or how to pay for them. Here is a general overview to help you start thinking through the choices, long before a decision becomes urgent.
The range of care settings
Long term care is not a single thing. It covers a spectrum of services depending on how much help a person needs and where they want to receive it.
Home care can be provided by family, friends, or paid aides, and can range from light help with errands to skilled nursing care. Hospice services for those with a terminal illness can also be provided at home.
Community based services, such as adult day programs, senior centers, meal delivery, and local transportation, can support someone living at home while giving family caregivers a break.
Supportive housing programs offer affordable housing for older adults with modest incomes, often with help available for meals or light housekeeping, while residents keep their own apartment.
Assisted living provides round the clock supervision in a home-like setting, with help for things like bathing, dressing, medication reminders, and meals, along with social activities.
Continuing care retirement communities offer a continuum, moving between independent living, assisted living, and skilled nursing as needs change over time.
Nursing homes provide skilled nursing care, rehabilitation, and supervision for those who cannot safely be cared for at home. Many also offer short term or respite stays.
Figuring out what kind of help is actually needed
It helps to separate needs into two categories: help with daily activities and health care needs.
Daily activities can include shopping, meal preparation, laundry, home upkeep, bill paying, bathing, dressing, grooming, and remembering medications.
Health care needs might include physical, speech, or occupational therapy, wound care, oxygen, pain management, memory care, or nursing services ordered by a physician.
Needs tend to change over time, so it is worth revisiting this question periodically rather than assuming today's situation will stay the same.
How long term care is typically paid for
Long term care can be costly, and many people are surprised to learn that standard health coverage does not routinely pay for extended custodial care.
Medicare generally does not cover ongoing help with daily activities. It may cover limited skilled nursing care following a hospital stay, and some home health services when specific conditions are met.
Medicaid is a joint federal and state program that can help cover long term care costs for people with limited income and assets. Rules about eligibility vary and are set at the state level, so it is worth checking current New York requirements directly.
Private long term care insurance is one option some people consider, ideally while still relatively young and in good health, since availability and pricing depend on health status at the time of application. Policies differ widely in what they cover, so reviewing the details of any policy carefully matters.
Many families also rely on personal savings, other assets, or existing life insurance to help cover costs, sometimes before becoming eligible for Medicaid over time.
Your State Health Insurance Program and the national Medicare resources can provide free general counseling about Medicare, Medicaid, and related coverage questions.
Evaluating the quality of care and facilities
Whether you are considering home care or a nursing home, a little research goes a long way.
For home care, check whether agencies are licensed in New York, whether they are certified to work with Medicare, and whether they hold any accreditation from recognized healthcare organizations. Ask for references and ask about staff training and supervision.
For nursing homes, inspection reports are generally available for review, and facilities participating in Medicare or Medicaid are visited periodically by trained inspectors. Speaking with the administrator about any noted issues, and how they were addressed, can be informative.
Local long term care ombudsman programs and consumer affairs offices can offer additional background, including information about past complaints and how they were resolved.
This is general background information, not legal, tax, or financial advice. Rules, programs, and coverage details change over time, so confirm current details with the relevant agency or a qualified professional before making decisions.
Planning for long term care involves a lot of moving parts, and everyone's situation looks a little different. The team at Flynn Insurance Agency in Kings Park is glad to sit down with you, walk through your questions, and help you think about how long term care coverage might fit into your overall plan.
This article is general information, not legal, tax or financial advice. Coverage depends on the terms, conditions and exclusions of each policy. Talk with a licensed agent about your situation.
