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Q & A
Your Retirement Care: What does Medicare cover?
Turn on the television, flip through a magazine, and you will see
advertisements telling you how you should invest money for your
retirement. These advertisements almost always include pictures
of fun and relaxing activities we will all have the time to enjoy
once we are no longer working - from sailing to biking to gardening.
These advertisers know the population statistics. Increased life
expectancy and better medical technology will allow the "Baby
Boom" generation to produce a "senior boom" in the
next 30 years. According to 1998 estimates, in 2030 there will be
nearly 70 million Americans over age 65, a full 20% of the population.
There will also be a substantial increase of the "oldest old",
seniors over age 85. And while these seniors are staying alive longer,
they also are doing so while battling a variety of health ailments.
It is estimated that 50% of people over the age of 85 have Alzheimer's
Disease, to mention just one of the diseases with increased frequency
in older age groups.
How will this aging population pay for their care? It is estimated
that only 7% of seniors have long-term care insurance.
It is important to understand what benefits Medicare covers. Medicare
was not designed to pay for all your health care bills and requires
co-payments and deductibles. Medicare does not provide for long-term
nursing home care or home care. Seniors without long-term care insurance
must pay for their care privately.
Medicare will pay for stays in a skilled nursing facility for up
to 100 days, assuming the patient meets various required criteria.
Medicare will also pay for brief home visits by a Registered Nurse,
Physical Therapist, Occupational Therapist and Speech Therapist,
for limited periods of time. A doctor must approve and order these
home care visits, based on the patient meeting the necessary criteria.
Most seniors need care beyond Medicare's temporary home health
visits and the 100 days in a skilled nursing facility.
Steve Frank, owner of Apple
Home Healthcare, a Chicago Medicare home health agency, says
seniors often require assistance with many of their daily living
activities. "Medicare is a godsend for seniors, but its focus
is upon skilled, intermittent care. An arthritic 90-year-old may
need help to get out of bed and dressed in the morning. While that
basic assistance is absolutely necessary to her quality of life,
it is an ineligible service under Medicare. Her need is supportive
and ongoing, rather than technically skilled and intermittent," says Mr. Frank.
A senior who wishes to remain in their home may secure a home health
care aide. Chicagoland Caregivers, now LivHOME, sends professional caregivers
to senior's homes to allow them to remain independent, while stretching
their care dollars. Part-time and full-time caregivers follow professional
care plans to enable the senior to maintain a healthy, balanced
lifestyle. The caregivers assist with meal planning and preparation,
daily exercises and household duties. By offering seniors a structured
routine with a healthy diet, physical exercise and mental activities,
they are often able to continue to enjoy life in their own home.
Chicagoland Caregivers, now LivHOME, provides a Care Manager to supervise the
caregiver and the care. Both companion caregivers and Certified
Nursing Aides are provided. A C.N.A. is a trained care professional
who performs the hands-on care in nursing homes and hospitals.
The caregivers are completely insured and trained and provide dedicated
care to the individual. Part-time home care of 4 hours per day can
keep the senior on track, while costing a fraction of the price
of a nursing home. Nursing homes in Chicago cost an average of $55,000
per year. Assisted Living Centers in Chicago, which do not provide
private caregivers, have an average cost of $35,000 annually.
Chicagoland Caregivers, now LivHOME, first conducts a Client Assessment Interview
to make sure the senior is appropriate for home care. Then a Care
Plan is created and an appropriate caregiver is assigned. One advantage
of home care is the ability to receive consistent care from one
continuous caregiver. Most nursing home residents must share their
health aide with as many as 10 or more other residents.
As nursing home care does not provide an individual caregiver,
seniors often find they receive better care and are able to better
extend their finances, with a home caregiver.
Long-term care insurance often pays for a home caregiver. Another
option to assist with the cost of home care is a reverse mortgage.
These mortgages allow the senior to receive monthly payments to
use for their health care, while maintaining ownership of their
home.
If a senior does not have any assets or maintains an extremely
low monthly income, Medicaid will provide for care in an authorized
Medicaid nursing facility. Medicaid qualifying income requirements
vary by state.
Visit: www.medicare.gov to learn more about your Medicare coverage.
By Julie Northcutt, President
Chicagoland Caregivers (now LivHOME)
Corp.
For more information on Chicagoland Caregivers', now LivHOME's, senior home care
services, please call 312-633-9955 or email: info@livhome.com
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