As Americans age and the cost of long-term care increases, long-term care has become one of the biggest health insurance uncertainties for people aged 65 and older. Long-term care differs from other types of care because it constitutes care for people with disabilities or chronic illnesses. Long-term care exists to provide services that assist in activities of daily living – assistance that many seniors require as they age and become unable to rely completely on themselves. Yet, Medicare does not cover long-term custodial care at home or in nursing homes.
The fact that Medicare does not pay for custodial care is a fact that many seniors are realizing – often too late. While Medicare does cover payments for acute illnesses and medical treatments, it will not help pay for a person to assist in feeding, bathing, dressing, or other daily activities. Thus, a senior who enters into a nursing home facility must pay an average cost of $70,000 a year without the help of Medicare. It is not until the senior’s funds have dwindled to a few thousand dollars that Medicaid or Medi-Cal kicks in to pay nursing home bills.
Yet, even qualifying for Medi-Cal coverage for long-term care is an extremely complicated process. The rules and necessities for qualifying are so convoluted that one consumer advocacy group uses a 12-page flowchart to help determine whether or not a person qualifies for Medi-Cal to pay for long-term care.
According to the LA Times, about 1,384,000 people in the United States live in nursing homes. A decade ago, approximately 1,456,000 seniors lived in nursing homes. A large part of this decrease is the increase in cost of care and living at nursing home facilities. As a result, millions of seniors who require help continue to live in their communities and are assisted by friends and family members who act as unpaid volunteer caregivers. While it can be comforting to rely on the assistance of family and friends, the increase in community-based caregivers has also given rise to the opportunity for caregiver fraud and abuse.