The Qualified Medicare Beneficiary (QMB) Program is one of four types of Medicare Savings Programs. This fall, a new rule will ensure that many more people gain access to this valuable program.
The US Urgently Needs Affordable Long-Term Care
AARP reports that the population of people over 85 years old, who are most likely to require long-term care, will more than triple between 2015 and 2050. Elected leaders must rethink institutional care and its affordability and make improvements while creating innovative long-term care options for those Americans who are aging in place. Recently the Milken Institute 2020 Future of Health Summit looked into the short-term future of long-term care and deemed improvements a most urgent priority for the US healthcare system.
The statistics are that as the nation’s population ages, 70 percent of Americans 65 or more will require long-term care at some point. This statistic represents many seniors who will need affordable care while the private long-term care insurance market has contracted. The Milken Institute Center for Future Aging is partnering with teams through the Financial Innovation Lab to make recommendations to expand options for affordable long-term care for middle-income Americans. Nora Super, senior director of the Milken Institute Center for the Future of Aging and executive director of the Milken Institute Alliance to Improve Dementia Care reports the group study has narrowed many examined solutions into three big ideas including:
- A large-scale Medicare Advantage demonstration project to test the effectiveness of home-based interventions and technology applications as it relates to reducing costs and improving care across the continuum.
- Scaling up and adapting integrated care models to provide low-cost, high-value, flexible services for those enrolled with complex needs.
- Identify the most beneficial and viable options for complementing private and public insurance solutions to expand long-term care coverage for the middle market.
The focus is on Medicare Advantage, which has grown in the past twenty years to allow more flexibility for participants to test new ideas and bring much-needed technologies into the home to prevent extensive stays in the long-term care system. These integrated care programs, according to Super, can bring together the long-term care and healthcare systems; however, the programs have not yet been scaled. Super has said, “Medicaid is the safety net for the nation but there is nothing for middle-class people. Costs are exorbitantly expensive.” Public-private partnerships do not meet the high demand for affordable long-term care as the industry has gone from one hundred private insurers to twelve.
As part of the Milken 2020 Health Summit, David O’Leary, president, and CEO of US Life Insurance Companies and Genworth Financial stated, “This is a problem facing the country, this aging population we’re not prepared for. We can no longer ignore this. This is personal to everyone.” And O’Leary is right. The long-term care industry covers less than ten percent of the people who need it and has an average claim of around 200,000 dollars. The number one reason for a person 65 or older to declare bankruptcy is a healthcare event.
While the healthcare industry professionals and government policymakers attend symposiums and discuss scalable, affordable, long-term care needs, more middle-class Americans fall into a cycle of impoverishment as they confront their immediate individual long-term care needs. Costly institutional care, Medicaid, or unpaid family caregivers seem to be the only solutions currently and are not particularly viable. The Medicaid system is straining to meet long-term care demands for the poor with long waiting lists to become residents at often substandard facilities with infection control deficiencies.
Medicaid planning or long-term care planning with an elder law attorney is one avenue open to middle-class Americans to address long-term care needs without being bankrupted. There may be other options to help protect your life’s earnings as well. Aging Americans must determine how they will be able to handle their statistically likely long-term care needs. Waiting for the healthcare industry and government programs to catch up to your future needs may put you in jeopardy.
We help seniors and their loved ones plan for the possibility of needing long-term care so that their savings and home are not lost to the high cost of the care. If you would like to talk about your particular situation to see how we might be able to help, please don’t hesitate to contact us to schedule a time for your confidential consultation. Please contact our New York office or call us at 607-271-9270.
