Planning For An Uncertain Future And Long-Term Health Care

By Jan Howard

  Attorney Barbara Reynolds, of Cramer & Anderson LLP in New Milford, presented the legal perspective of securing future needs in “Planning for Your Long Term Care Needs” at Ashlar of Newtown’s Lunch and Learn program on Tuesday, October 10, at Lockwood Lodge.

Ms Reynolds, one of a select group of elder care attorneys in the state, discussed wills, living wills, durable power of attorney, and health care directives as well as long-term care options and medical insurance options.

“We are living longer,” Ms Reynolds said, noting that women aged 65 have a life expectancy today of 19 years and men aged 65 have a life expectancy of 15 years.

“The number one issue is how will I take care of my long-term care needs,” she said. “How do you make plans for an unknown future?”

“The earlier you plan, the better to protect assets and receive the proper care you need,” she said.

 Ms Reynolds advised program attendees to be informed as to their present circumstances. Know what is available to you now to prepare for long-term care needs, she said.

Investigate possible future needs for housing, such as assisted living and nursing homes, and look at care options and their cost. There may be flat rates or you might pay rent and pay extra for needed care services. Find out how the assistance is provided and how it is paid for.

Know what you can expect in financial matters, such as future income and income from investments. Investigate the possible need for long-term care insurance.

Long-Term Care Insurance

“For some, long-term care insurance should be part of their planning,” she said. “It is a complex consumer product.” Several factors affect what long-term care insurance costs, such as the amount and type of care needed and where it is received, which makes it difficult to buy, she said.

A booklet entitled A Shopper’s Guide to Long-Term Care Insurance is available from the National Association of Insurance Commissioners, 120 West 12th Street, Suite 1100, Kansas City, MO 64105-1925. It addresses federally tax-qualified long-term care insurance policies as well as those that are non tax-qualified.

People seeking long-term care insurance need to know what the policy will pay for and how much coverage is needed per day. They need to check the ratings for the insurance company, compare policies, and evaluate their assets and income to see what to buy, Ms Reynolds said.

“Go to people who have spent time learning about long-term care insurance. Don’t buy it through phone or mail solicitations. It may not be right for you,” she said.

Legal Documents

People investigating their long-term needs need to make legal choices, to have documents in place to help  them stay in charge of their affairs, such as a durable power of attorney, a living will, and will.

A durable power of attorney is a document in which someone is designated to handle your affairs (primarily financial) if you are unable to do so. “A durable power of attorney gives that person the right to act on your behalf, such as handling finances and paying bills,” she said. “It is valid upon signing and delivery. A safeguard is to tell the person where it is and keep it in a safe, fireproof location.”

Choose someone trustworthy, she said.

She does not recommend getting a copy of a durable power of attorney from a stationery store or downloading one from the Internet. “It may not be properly executed for you,” she said.

“It’s an inexpensive document but very important,” Ms Reynolds said. “It lasts even if you become incompetent.”

Usually a spouse is designated on a power of attorney, but an alternate should also be named, she said.

 A living will states your preferences about medical care in the event of a terminal illness. “It is a three-part document,” Ms Reynolds said. “The living will states you are not to be kept alive through artificial means if in a permanent vegetative state.”

For health-care decisions, a person should be designated to act on your behalf in making medical decisions if you are unable to do so. Again, a spouse is usually named, but an alternate should also be named. “The health care agent should feel comfortable about what your wishes are.”

The living will should also name a conservator, someone to handle things for you, if you do not have a durable power of attorney.

A will should be renewed as a result of changes in lifestyle, such as when you retire, when children no longer need a designated guardian, or if your assets change, Ms Reynolds said.

“Wills cover only assets in your name alone. If they are held jointly, they pass to the joint owner,” she said. Assets from annuities, insurance policies, and 401Ks go to the beneficiaries, she noted.

Medicare And Medicaid

“Medicare only pays a little bit of nursing home care,” Ms Reynolds said. It will pay nursing home stays for 20 days if it follows three days of inpatient hospital care and skilled nursing care or skilled rehabilitation services are needed on a daily basis. It co-pays the next 80 days if these qualifications continue.

“At the most you get 100 days in a nursing home, and you must meet the Medicare definition of skilled nursing or skilled rehabilitation.”

To pay for nursing home care privately will cost on an average of $235 to $245 a day, she said, or $85,000 plus per year.

 Medicaid, or Title 19, is based on need and covers long-term care in a nursing home from the time you qualify, she said. “Everyone gets Medicare, but not everyone gets Medicaid. Medicaid is administered by each state and is different in each state.”

To qualify for Medicaid, single individuals can have a total of $1,600 in assets. Assets have to be spent or gifted down to meet the income qualifications. If married, a house is excluded as long as one person is living at home. A married couple can have assets up to $84,000.

For more information, contact an elder care attorney. A pamphlet, Questions and Answers When Looking for an Elder Law Attorney, can be obtained from the National Academy of Elder Law Attorneys, Inc., 1604 North Country Club Road, Tucson, AZ 85716-3102.

This community program is part of a free seminar series for mature adults about living and aging well sponsored by Ashlar of Newtown. To learn more about upcoming programs, please contact Hilda DeLucia at 203/364-3127.