The American legal system makes assumptions about married couples. For example, default provisions give a husband or wife the power to make at least some medical decisions for a spouse who is no longer competent to direct his or her own treatment. The surviving spouse usually has first priority to administer a deceased spouse's estate, and will usually inherit most of the estate if the deceased spouse did not sign a will.
None of those automatic protections apply to unmarried couples, regardlesss of the strength or duration of their commitment. Many heterosexual couples chose not to marry for one reason or another, and thereby forgo the protections and benefits of marriage laws. Gay and lesbian couples, of course, are not provided an opportunity to duplicate the marriage relationship except in narrow circumstances.
That makes estate planning much more important for couples who are committed to one another but unmarried - for whatever reason. A sampling of the issues faced by such couples:
Powers of Attorney. Neither partner will have any automatic right to make decisions for the other in the event of a medical catastrophe. In fact, neither partner will have any right to visit the other in the hospital setting, to talk to doctors or even to get status reports.
Living Wills. Without clear instructions (and a health care proxy), each partner runs the risk of leaving family members in charge of their medical decisions. That may be fine for some, but terrifying for others.
Wills and Trusts. Assuming that each paratner wants to share a part of his or her estate with the survivor, it is essential that those provisions be reduced to writing. Relying on the goodwill of family members, or spoken (even clearly spoken) instructions, is simply begging for legal trouble, expense and personal devastation for the survivor.
Partnership agreements. If partners have any desire to protect one another (and, not incidentally, to minimize legal costs and acrimony) in the event that the relationship should end, then a written agreement is a necessity. Simply placing assets in joint names may not be sufficient, and may even be dangerous in ways not experienced by married couples. The partnership agreement may resemble a prenuptial agreement often signed by married couples.
Joint parenting agreement. Family realtionships are much more complicated today than the legal system is prepared to address. Unmarried couples, even same-sex couples, may have adopted one another's children, or jointly adolpted a child not biologically related to either of them. If one partner dies or the couple splits up, parenting and even visitation rights may be difficult to address. A written agreement may help ease the transition.
Source: Elder Law Issues, Volume 12, Issue 51.
Thursday, September 1, 2005
Thursday, August 25, 2005
New Bill Affecting Disposition of Remains
A new bill has passed through both houses of the New York State legislature last week relating to the rights of certain individuals of a decedent to control the disposition of such decedent's remains regardless of whether of a written document exists. The bill creates a priority list of those persons who may have the right to control the disposition of the decedent's remains if no written instrument specifies. In other words, the bill creates a list of people who can carry out their loved ones' burial wishes, whether it be a cemetery burial, cremation, or even donating the body and organs to medical school.
One major part of the bill gives domestic partners the same priority status as surviving spouses. The bill defines domestic partnerships using three categories. First, a domestic partner is anyone who is formally a party in a domestic partnership under the laws of the United States or of any state, local, or foreign jurisdiction. Second, if there is no formal domestic partnership, then the surviving partner must be formally recognized as a beneficiary or covered person under the other partner's employment benefits or health insurance. Lastly, if the partners do not meet either of the previous two requirements, they would have to provide documentation for proof of six months of cohabitation to show dependence or mutual independence on the other partner for support, indicating a mutual intent to be domestic partners.
The proposed order of people who will have the right to control the disposition and the costs associated are (l) the person designated in a will or other written instrument (such as a proxy); (2) the decedent's surviving spouse or domestic partner; (3) any surviving children over 18 years old; (4) either of the decedent's surviving parents; (5) any of the decedent's surviving siblings; (6) a guardian; or (7) a fiduciary of the deceased's estate.
The bill also creates a standard proxy form authorizing the appointment of an agent along with a space with special directions. The proxy is important because although a person can specify her wishes in a will, wills are not generally probated until long after death wheras disposition normally happens within a week after death. Overall, this bill fills an important gap in health law by allowing people to plan ahead to ensure their wishes are carried out at their time of death without any confusion and court proceedings over the very private matter of disposition of their remains.
One major part of the bill gives domestic partners the same priority status as surviving spouses. The bill defines domestic partnerships using three categories. First, a domestic partner is anyone who is formally a party in a domestic partnership under the laws of the United States or of any state, local, or foreign jurisdiction. Second, if there is no formal domestic partnership, then the surviving partner must be formally recognized as a beneficiary or covered person under the other partner's employment benefits or health insurance. Lastly, if the partners do not meet either of the previous two requirements, they would have to provide documentation for proof of six months of cohabitation to show dependence or mutual independence on the other partner for support, indicating a mutual intent to be domestic partners.
The proposed order of people who will have the right to control the disposition and the costs associated are (l) the person designated in a will or other written instrument (such as a proxy); (2) the decedent's surviving spouse or domestic partner; (3) any surviving children over 18 years old; (4) either of the decedent's surviving parents; (5) any of the decedent's surviving siblings; (6) a guardian; or (7) a fiduciary of the deceased's estate.
The bill also creates a standard proxy form authorizing the appointment of an agent along with a space with special directions. The proxy is important because although a person can specify her wishes in a will, wills are not generally probated until long after death wheras disposition normally happens within a week after death. Overall, this bill fills an important gap in health law by allowing people to plan ahead to ensure their wishes are carried out at their time of death without any confusion and court proceedings over the very private matter of disposition of their remains.
Thursday, August 18, 2005
Medicare Part D - Part 2
What happens if I have Medicaid?
If you currently have Medicaid, you will lose your Medicaid prescription drug coverage on January 1, 2006 and will automatically be enrolled in a new plan through Medicare. In October 2005, letters will be mailed out to Medicaid recipients alerting them which plan they will be enrolled in if they do not choose one by December 31, 2005. In order to make sure that your drugs will be covered, you should select a plan that suits your needs.
What about my Medigap plan?
Starting January 1, 2006, any person enrolled in Part D cannot buy or renew Medigap plans H, I, and J. If you have a Medigap H, I, or J plan and want to keep its prescription drug coverage, you cannot enroll in Part D. But, if you choose to later enroll in a Part D plan and lose your Medigap drug coverage, you will be charged a penalty premium. If you want to keep your Medigap plan and enroll in Part D, your Medigap plan will be modified to exclude prescription drug coverage after Part D becomes effective and your premium will be modified accordingly.
Can I supplement my Part D drug coverage at all?
Yes, individuals who enroll in Part D prescription drug coverage can still supplement their coverage from other sources. Supplemental coverage can either offer more comprehensive coverage than Medicare or it may choose to wrap around the Medicaid Part D benefit and help with cost sharing. One option is help through a state pharmacy assistance program (such as EPIC in New York). Employers and unions can also choose to help with supplemental coverage as well.
What about my Medicare discount prescription drug card I have?
The Medicare discount card program will be phased out once the Part D prescription drug benefits begin. The program will be discontinued either when your Part D plan takes effect or at the end of the initial enrollment period on May 15, 2006, whichever comes first.
When and how can I sign up?
There is a six month initial enrollment period starting on November 15, 2005 and continuing until May 15, 2006. If you enroll before or on December 31, 2005, your new plan will start on January 1, 2006 and you will see no lapse in coverage. If you choose to enroll after January 1, 2006, your plan will start on the 1st of the following month. You can currently apply for low income assistance either through Social Security (www.ssa.gov) or through your state Medicaid office. To enroll in a Part D plan, you will apply directly to Medicare (www.cms.gov) but can only apply once the enrollment period begins.
What should I do?
Since Medicare Part D is new, there are still many uncertainties regarding changes in coverage. It is advisable to speak to a knowledgeable Elder Law attorney aware of all the intricacies of Medicare law in order take full advantage of the new Medicare drug coverage.
If you currently have Medicaid, you will lose your Medicaid prescription drug coverage on January 1, 2006 and will automatically be enrolled in a new plan through Medicare. In October 2005, letters will be mailed out to Medicaid recipients alerting them which plan they will be enrolled in if they do not choose one by December 31, 2005. In order to make sure that your drugs will be covered, you should select a plan that suits your needs.
What about my Medigap plan?
Starting January 1, 2006, any person enrolled in Part D cannot buy or renew Medigap plans H, I, and J. If you have a Medigap H, I, or J plan and want to keep its prescription drug coverage, you cannot enroll in Part D. But, if you choose to later enroll in a Part D plan and lose your Medigap drug coverage, you will be charged a penalty premium. If you want to keep your Medigap plan and enroll in Part D, your Medigap plan will be modified to exclude prescription drug coverage after Part D becomes effective and your premium will be modified accordingly.
Can I supplement my Part D drug coverage at all?
Yes, individuals who enroll in Part D prescription drug coverage can still supplement their coverage from other sources. Supplemental coverage can either offer more comprehensive coverage than Medicare or it may choose to wrap around the Medicaid Part D benefit and help with cost sharing. One option is help through a state pharmacy assistance program (such as EPIC in New York). Employers and unions can also choose to help with supplemental coverage as well.
What about my Medicare discount prescription drug card I have?
The Medicare discount card program will be phased out once the Part D prescription drug benefits begin. The program will be discontinued either when your Part D plan takes effect or at the end of the initial enrollment period on May 15, 2006, whichever comes first.
When and how can I sign up?
There is a six month initial enrollment period starting on November 15, 2005 and continuing until May 15, 2006. If you enroll before or on December 31, 2005, your new plan will start on January 1, 2006 and you will see no lapse in coverage. If you choose to enroll after January 1, 2006, your plan will start on the 1st of the following month. You can currently apply for low income assistance either through Social Security (www.ssa.gov) or through your state Medicaid office. To enroll in a Part D plan, you will apply directly to Medicare (www.cms.gov) but can only apply once the enrollment period begins.
What should I do?
Since Medicare Part D is new, there are still many uncertainties regarding changes in coverage. It is advisable to speak to a knowledgeable Elder Law attorney aware of all the intricacies of Medicare law in order take full advantage of the new Medicare drug coverage.
Thursday, August 11, 2005
What is Medicare Part D? - Part 1
What is Medicare Part D?
Starting January 1, 2006, Medicare will begin to offer prescription drug plans to help with paying rising drug costs. To be eligible for Medicare Part D, you must be enrolled in either Medicare Part A or B. It is important that you understand the changes affecting your prescription drug coverage choices. If you currently have Medicaid drug coverage, you will lose it and automatically be enrolled in a new plan through Medicare. You will still have your other Medicaid benefits. There are a number of different prescription drug plans (called “PDPs”) available through Medicare Part D that are offered by private companies. Some plans will offer drugs that other plans do not so it is important to carefully select the right PDP for you to make sure that your medication is included under the plan. Information about specific PDPs will be made available starting in October 2005.
Do I have to have Medicare Part D? And if so, what will it cost me?
No, you do not have to enroll in Part D. It is completely voluntary and you may continue to keep your current prescription drug coverage (either through your employer, union, etc) if you wish. If you later decide to enroll in Part D, however, you may be faced with a late enrollment penalty.
If you decide to enroll in the basic benefit plan, there will be an approximate drug coverage premium of $37 a month. You also have to pay a $250 deductible and then 25% co-insurance for drug costs. If your drugs cost more than $2,250 for the year, you will have to pay 100% of the cost until the cost of covered drugs reaches $5,100 (called a “doughnut hole”). Therefore, beneficiaries will have to pay a total of $3600 of out of pocket costs before Medicare will begin to pay 95% of the formulary drug prices.
Only out of pocket costs for formulary drugs that are paid for by you, a family member, or another person acting on your behalf, or a state pharmacy assistance program count toward your annual out of pocket limit of $3600. Payments by other insurance (such as employer or union plans) do not count. After $5,100 in total expenses, you will receive catastrophic coverage and will only have a 5% coinsurance or a co-payment of $2 for generic drugs or $5 for brand name drugs, whichever is greater.
If you qualify for low income assistance, costs will decrease dramatically. People currently receiving Medicaid, MSP, or SSI will automatically receive low income assistance and will only pay a small co-payment for prescription drugs. Other people will be eligible for low income assistance if their income is less than 150% of the federal poverty level ($14,595/year or $19,485 for a couple) and have limited resources($10,000 or $20,00 for a couple).
What should I think about when selecting a Part D plan?
It is important to realize that all plans are not created equal. Plans are likely to vary not only in the cost but also in the type of drugs offered. PDPs are given flexibility as long as the total value of their plan is the same as the basic benefit. Therefore some plans may have higher co-payments than others while others have lower premiums.
In addition, PDPs have considerable discretion to decide which specific drugs to include on their formularies. Therefore, PDPs do not necessarily have to pay for all the drugs that are covered by Medicare Part D. If you need a drug that is not on your plan’s formulary, you will have to pay full price for the drug. Additionally, payments for non-formulary drugs will not count toward your out of pocket expenses. Each PDP also gets to decide which pharmacies to use. It is possible that a nursing home will no longer be able to receive residents’ drugs from a single pharmacy but will have to deal with a number of pharmacies since residents are likely to have different PDPs.
Plans can vary on a wide array of matters. Some plans might also include options for mail-order drugs. Additionally, plans may place limitations on the number of prescriptions per month or the number of pills allowed per prescription. Each plan may have a different procedure and steps to go through for an appeal to get your medicine because the plans are offered by a multitude of private companies rather than a single entity. Because of all the variations in Medicare Part D plans, it is extremely important to carefully choose and select a plan that meets your needs.
Starting January 1, 2006, Medicare will begin to offer prescription drug plans to help with paying rising drug costs. To be eligible for Medicare Part D, you must be enrolled in either Medicare Part A or B. It is important that you understand the changes affecting your prescription drug coverage choices. If you currently have Medicaid drug coverage, you will lose it and automatically be enrolled in a new plan through Medicare. You will still have your other Medicaid benefits. There are a number of different prescription drug plans (called “PDPs”) available through Medicare Part D that are offered by private companies. Some plans will offer drugs that other plans do not so it is important to carefully select the right PDP for you to make sure that your medication is included under the plan. Information about specific PDPs will be made available starting in October 2005.
Do I have to have Medicare Part D? And if so, what will it cost me?
No, you do not have to enroll in Part D. It is completely voluntary and you may continue to keep your current prescription drug coverage (either through your employer, union, etc) if you wish. If you later decide to enroll in Part D, however, you may be faced with a late enrollment penalty.
If you decide to enroll in the basic benefit plan, there will be an approximate drug coverage premium of $37 a month. You also have to pay a $250 deductible and then 25% co-insurance for drug costs. If your drugs cost more than $2,250 for the year, you will have to pay 100% of the cost until the cost of covered drugs reaches $5,100 (called a “doughnut hole”). Therefore, beneficiaries will have to pay a total of $3600 of out of pocket costs before Medicare will begin to pay 95% of the formulary drug prices.
Only out of pocket costs for formulary drugs that are paid for by you, a family member, or another person acting on your behalf, or a state pharmacy assistance program count toward your annual out of pocket limit of $3600. Payments by other insurance (such as employer or union plans) do not count. After $5,100 in total expenses, you will receive catastrophic coverage and will only have a 5% coinsurance or a co-payment of $2 for generic drugs or $5 for brand name drugs, whichever is greater.
If you qualify for low income assistance, costs will decrease dramatically. People currently receiving Medicaid, MSP, or SSI will automatically receive low income assistance and will only pay a small co-payment for prescription drugs. Other people will be eligible for low income assistance if their income is less than 150% of the federal poverty level ($14,595/year or $19,485 for a couple) and have limited resources($10,000 or $20,00 for a couple).
What should I think about when selecting a Part D plan?
It is important to realize that all plans are not created equal. Plans are likely to vary not only in the cost but also in the type of drugs offered. PDPs are given flexibility as long as the total value of their plan is the same as the basic benefit. Therefore some plans may have higher co-payments than others while others have lower premiums.
In addition, PDPs have considerable discretion to decide which specific drugs to include on their formularies. Therefore, PDPs do not necessarily have to pay for all the drugs that are covered by Medicare Part D. If you need a drug that is not on your plan’s formulary, you will have to pay full price for the drug. Additionally, payments for non-formulary drugs will not count toward your out of pocket expenses. Each PDP also gets to decide which pharmacies to use. It is possible that a nursing home will no longer be able to receive residents’ drugs from a single pharmacy but will have to deal with a number of pharmacies since residents are likely to have different PDPs.
Plans can vary on a wide array of matters. Some plans might also include options for mail-order drugs. Additionally, plans may place limitations on the number of prescriptions per month or the number of pills allowed per prescription. Each plan may have a different procedure and steps to go through for an appeal to get your medicine because the plans are offered by a multitude of private companies rather than a single entity. Because of all the variations in Medicare Part D plans, it is extremely important to carefully choose and select a plan that meets your needs.
Monday, July 25, 2005
Time is Running Out! Seminar Invitation
Medicaid has long served as a safety net for middle class seniors faced with the catastrophic cost of a nursing home. This program is currently under attack and likely to change. Learn how to PLAN NOW before the window closes forever. Don't limit your options and jeopardize everything you've worked a lifetime to acquire.
NOW, more than ever, it's important to learn the answers to these crucial and timely questions:
If I put together a plan right now to protect my assets from a nursing home, will I be grandfathered in?
What will Medicare cover?
If I can't rely on Medicaid in the future to pay for long term care costs, what exactly should I be doing now?
I want to learn from the Terri Schiavo case...Do I need a Health Care Proxy or a Living Will or both?
What exactly is a Living Trust?
If I become incapacitated, how will my finances and medical decisions be handled?
Do I really need a will?
I have a disabled child. How can I protect and provide for that child when I can no longer do it myself?
What is the difference between Revocable and Irrevocable Trusts?
Join Long Island's Elder Law, Special Needs and Estate Planning Firm for the one FREE seminar you can't wait to attend! Discover why planning NOW is more important than ever.
TUESDAY, AUGUST 9TH AT 10:00AM
Presentation and Luncheon
The Islandia Marriott
3635 Express Drive North
Seminar and Lunch are FREE, but reservations are required. Call today to reserve your place...bring a friend. Call 631-234-3030 or email JGrisolia@Davidowlaw.com.
NOW, more than ever, it's important to learn the answers to these crucial and timely questions:
If I put together a plan right now to protect my assets from a nursing home, will I be grandfathered in?
What will Medicare cover?
If I can't rely on Medicaid in the future to pay for long term care costs, what exactly should I be doing now?
I want to learn from the Terri Schiavo case...Do I need a Health Care Proxy or a Living Will or both?
What exactly is a Living Trust?
If I become incapacitated, how will my finances and medical decisions be handled?
Do I really need a will?
I have a disabled child. How can I protect and provide for that child when I can no longer do it myself?
What is the difference between Revocable and Irrevocable Trusts?
Join Long Island's Elder Law, Special Needs and Estate Planning Firm for the one FREE seminar you can't wait to attend! Discover why planning NOW is more important than ever.
TUESDAY, AUGUST 9TH AT 10:00AM
Presentation and Luncheon
The Islandia Marriott
3635 Express Drive North
Seminar and Lunch are FREE, but reservations are required. Call today to reserve your place...bring a friend. Call 631-234-3030 or email JGrisolia@Davidowlaw.com.
Thursday, July 14, 2005
Things to Think About Before You Relocate Your Elderly Parent
Your home is now miles and hours away from your parent. The best thing would be to move Mom or Dad closer…or would it? There are a lot of reasons why it might make sense to relocate an aging parent closer to the rest of the family.
But, before you suggest a move, give it some serious thought. Be sure that this move would really be the best thing for all of you. Once you have made the commitment to relocate, it will be next to impossible to undo.
Following are some important things to think about before you make the decision to relocate an older person:
1. Can my elder get along without me (at least for a while?)
If my elderly parents don’t depend on me for regular assistance now, can the move wait until I have had a chance to learn about local elder resources here?
If I am working long hours, how much will I be able to assist my parent after the move?
Who will select, pack, or sell possessions? Will a house have to be sold?
2. Social Life
Is my elder confident enough to venture out and to make new friends in a strange place? Will he/she be leaving a good network of supportive friends?
If my aging parent is driving on familiar streets now, will he/she be able and safe to do so on unfamiliar territory, where the traffic may be much heavier? Is transportation available, or will I have to be the chauffeur?
3. Important Medical Questions
Does my elder have a long and close relationship with current physicians? Can we find equivalent physicians who will treat an elderly person? Many specialists, in particular, have reduced or closed their Medicare practices.
Will health insurance transfer to this area? HMOs are geographically limited.
Will the climate be a concern?
4. Financial Issues
Is the new cost of living affordable? Social Security and retirement income will not be adjusted if your parent moves to a place with a higher cost of living.
If he/she is currently receiving state benefits or assistance, what will the requirements be to qualify in the new location? Even within the same state, there is often a wait before services resume at a new address.
If a house must be sold, what are the financial (tax and other) consequences?
And, this is the most important question of all…What does the elder think? If he is competent and able to make his own decisions, does he want to relocate? Will you spend hours of effort and anxiety trying to find the “perfect” answer, only to be told to mind your own business?
Source: by Molly Shomer of The Eldercare Team. Please visit Molly’s website at http://www.eldercareteam.com for more elder care articles and important resources for those who are caring for aging adults.”
But, before you suggest a move, give it some serious thought. Be sure that this move would really be the best thing for all of you. Once you have made the commitment to relocate, it will be next to impossible to undo.
Following are some important things to think about before you make the decision to relocate an older person:
1. Can my elder get along without me (at least for a while?)
If my elderly parents don’t depend on me for regular assistance now, can the move wait until I have had a chance to learn about local elder resources here?
If I am working long hours, how much will I be able to assist my parent after the move?
Who will select, pack, or sell possessions? Will a house have to be sold?
2. Social Life
Is my elder confident enough to venture out and to make new friends in a strange place? Will he/she be leaving a good network of supportive friends?
If my aging parent is driving on familiar streets now, will he/she be able and safe to do so on unfamiliar territory, where the traffic may be much heavier? Is transportation available, or will I have to be the chauffeur?
3. Important Medical Questions
Does my elder have a long and close relationship with current physicians? Can we find equivalent physicians who will treat an elderly person? Many specialists, in particular, have reduced or closed their Medicare practices.
Will health insurance transfer to this area? HMOs are geographically limited.
Will the climate be a concern?
4. Financial Issues
Is the new cost of living affordable? Social Security and retirement income will not be adjusted if your parent moves to a place with a higher cost of living.
If he/she is currently receiving state benefits or assistance, what will the requirements be to qualify in the new location? Even within the same state, there is often a wait before services resume at a new address.
If a house must be sold, what are the financial (tax and other) consequences?
And, this is the most important question of all…What does the elder think? If he is competent and able to make his own decisions, does he want to relocate? Will you spend hours of effort and anxiety trying to find the “perfect” answer, only to be told to mind your own business?
Source: by Molly Shomer of The Eldercare Team. Please visit Molly’s website at http://www.eldercareteam.com for more elder care articles and important resources for those who are caring for aging adults.”
Wednesday, July 6, 2005
Facts About Long-Term Care
Each year, consumers spend about $40 billion out-of-pocket for long-term care services.1 This does not include the cost of informally provided care; about two-thirds of persons with long-term care needs receive services from unpaid help only.2 Advance planning can help consumers age in place and make optimal use of available services.
About 13 million Americans report having long-term care needs; in less than 20 years, this number is expected to increase by 70% to 22 million people.3 Five percent of the elderly are in nursing homes - about 1.4 million people.4 Approximately 43% of those turning age 65 can expect to spend some time in a long-term care facility, about half of them will require care for three years or more, and 20% will spend five years or longer in a nursing home.5 One in five people who reach age 65 will spend more than two years in a nursing home.6 Rates of nursing home use are declining, associated with an increase in the use of home health care services and alternative residential care services such as assisted living.7 The fact is, 60% of people who turn age 65 this year will need long-term care as they grow older.8
-----------------------------------------------------------------------------------------------
1 Feder, H.I. Komisar, and M. Niefeld, "Long-Term Care in the United States: An Overview", Health Affairs 19 (2000): 40-56.
2 R. Stone, Long-Term Care for the Elderly with Disabilities. Current Policy Emerging Trends, and Implications for the Twenty-First Century (Washington, D.C.: Millbank Memorial Fund, 2000).
3 Facts on Long-Term Care, 1997 (Washington, D.D.: National Academy on an Aging Society, 1997); available at http://www.agingsociety.org/aging-society/publications/fact/index.html.
4 National Nursing Home Survey 1999 (Hyattsville, MD: National Center for Health Statistics, 2000).
5 M. Donald Wright, "Looking Toward the Future with Long-Term Care Insurance" (Financial Gerontology), Journal of American Society of CLU & CHFC51 (May 1997).
6 P.Kemper and C.M. Murtagh, "Lifetime Use of Nursing Home Care." New England Journal of Medicine (3424): 595-600.
7 National Nursing Home Survey 1999.
8 K.J. Mahoney, L. Connolly, D. Phillips, and T. Hayaski, "Increasing Awareness of Long-Term Care Costs and Options, the Early Experience of the California Partnership for LTC," prepared for the Gerontological Society of America, Coston, MA, 1996.
About 13 million Americans report having long-term care needs; in less than 20 years, this number is expected to increase by 70% to 22 million people.3 Five percent of the elderly are in nursing homes - about 1.4 million people.4 Approximately 43% of those turning age 65 can expect to spend some time in a long-term care facility, about half of them will require care for three years or more, and 20% will spend five years or longer in a nursing home.5 One in five people who reach age 65 will spend more than two years in a nursing home.6 Rates of nursing home use are declining, associated with an increase in the use of home health care services and alternative residential care services such as assisted living.7 The fact is, 60% of people who turn age 65 this year will need long-term care as they grow older.8
-----------------------------------------------------------------------------------------------
1 Feder, H.I. Komisar, and M. Niefeld, "Long-Term Care in the United States: An Overview", Health Affairs 19 (2000): 40-56.
2 R. Stone, Long-Term Care for the Elderly with Disabilities. Current Policy Emerging Trends, and Implications for the Twenty-First Century (Washington, D.C.: Millbank Memorial Fund, 2000).
3 Facts on Long-Term Care, 1997 (Washington, D.D.: National Academy on an Aging Society, 1997); available at http://www.agingsociety.org/aging-society/publications/fact/index.html.
4 National Nursing Home Survey 1999 (Hyattsville, MD: National Center for Health Statistics, 2000).
5 M. Donald Wright, "Looking Toward the Future with Long-Term Care Insurance" (Financial Gerontology), Journal of American Society of CLU & CHFC51 (May 1997).
6 P.Kemper and C.M. Murtagh, "Lifetime Use of Nursing Home Care." New England Journal of Medicine (3424): 595-600.
7 National Nursing Home Survey 1999.
8 K.J. Mahoney, L. Connolly, D. Phillips, and T. Hayaski, "Increasing Awareness of Long-Term Care Costs and Options, the Early Experience of the California Partnership for LTC," prepared for the Gerontological Society of America, Coston, MA, 1996.
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