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Second Wind: Even Peter Pan needs health care

Each of us has an Inner Peter Pan, someone within who imagines old age is what happens to other people. This is a pleasant form of denial and as long as blue jeans come in the giant sizes known as “comfort”, we can go along with Peter. But denial has its dangers and one of them is the failure to imagine that one day we may need help, which is where long-term care comes in.

Long-term care means getting aid when it comes to bathing, dressing, cooking, eating, getting around and doing the things needed to keep us out of harm’s way. Now, maybe our children will help us someday and there are community services available, but there is definitely one entity that does not want to be financially involved in our long-term care – the state of California.

The state of California runs Medicaid, the joint federal and state health insurance program for low-income people, and it’s Medicaid that pays for long-term nursing home care for those who can’t afford it or those who run out of money while paying about $70,000 a year out-of-pocket for nursing home care. With reason, California anticipates it will not be able to finance the rush to nursing homes when Boomers grow old, infirm and begin playing the Stones over the PA system at Sunset Manor.



So what are the states doing about a possible glut of geezers draining their treasuries with nursing home care? California and about 15 other states so far are partnering with insurance companies to encourage citizens to buy long-term care insurance which will presumably cover any long-term services we need and keep us out of the publicly-financed LTC arena.

California as insurance pitchman




What’s wrong with this picture? Maybe too early to tell, but here are a few things to think about if you received one of the 6 million letters California sent out pitching the idea of long-care care insurance. According to the Kaiser Family Foundation, an excellent source of information about health care issues, long-term care insurance policies are “unaffordable to the majority of low to middle income seniors” and not available to people who already have long-term care needs. So that leaves many of us out of this particular solution. (Go to http://www.kff.org for more information about long-term care insurance, what it covers, what it doesn’t and how Medicare and Medicaid fit into the picture.)

Another thing to think about, even if you can afford the policy, are the pitfalls associated with the long-term care insurance industry. According to Consumer Reports, some insurance companies may not still be in existence when the time comes to pay for your care. Another concern: The coverage may be insufficient. Say you buy a policy that will pay $180 dollars a day for your care now. In maybe 10 years that same benefit could cost $300, but, unless you buy a policy with adequate inflation protection, you will be stuck for a large part of your bill. (More at http://www.consumerreports.org.)

Still another drawback: premiums can rise so steeply over time they become unaffordable. People may have to drop their policies. Still another: it may be the insurance company’s doctor who is the one deciding if you have gone downhill enough to deserve a payout. And one more: some policies can be tricky about the locations they will cover. Will they cover home care, day care, assisted living and/or nursing homes?

So buyer beware, even if it is the state of California that is urging you to consider a LTC policy. Check out the state’s website on this issue: http://www.dhs.ca.gov/cpltc/.

Words to the wise

There are many alternative ways of obtaining help if you need it. Family, friends, community services such as Meals on Wheels, public transportation, adult day care, home modifications and home health aides. For more home-based and community alternatives, google: National Clearing House for Long-Term Care Information. Also, people who enjoy greatly increased value on their homes may be financially eligible for life care communities with three levels of care – independent, assisted and nursing – post-menopause to the grave.

Now my Inner Peter Pan said I should just relax into my over-sized jeans and pretend I can fly around forever, but today, my Inner Geezer told me to write this column for you. And yes, I may look older than last year, but you – just fabulous, darling – not a day over (you fill in the blank.)

Mel Walsh is a gerontologist and certifiable geezer. Her book of advice for older women, Hot Granny, is available at The Bookseller in Grass Valley and online at Amazon and Barnes & Noble.


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