Medicare and Long-Term Care Insurance

Open Enrollment for Medicare is from October 15^th to December 7^th. I’ll be helping people make changes to their plans and ensuring they’re still on the best drug plan – which is more important this year because upcoming changes will soon be announced.  If you’re already enrolled, you don’t have to do anything. Still, you might want to check your coverage and drug plan because, after December 7^th, you cannot make any changes unless you use The Birthday Rule (special for California and some other states).

One area will remain the same regardless of Medicare’s changes: Medicare covers medical services—Part A for hospitalization, Part B for Doctor and Outpatient Services, and Part D for Prescriptions. 

In 2005, when I started offering Long-Term Care Insurance, I approached my parents first.  My father confidently and erroneously told me he wasn’t worried about paying for Long-Term Care services because Medicare would cover it.  It never surprises me how many people talk with certainty about subjects they don’t know well.  I calmly explained to my parents that Medicare does not cover Long-Term Care Services.  If Dad had a stroke, the medical services would be covered by Medicare (likely Parts A & B), and his drugs would be covered by Part D.

Recovering at home, he may have problems with the Activities of Daily Living, which most people encounter within the first hour of waking up:

Getting out of bed;
Walking to the bathroom;
Using the toilet;
Bathing/Brushing Teeth, etc.;
Getting dressed;
Eatingbreakfast.

Medicare will not cover any of these services you might need at home.

That was a sobering realization for my father, and then he rationalized that he and my mother were healthy and likely not needing care.

This level of “magical thinking” is standard.  But 70% of people over the age of 65 need assistance.  The least you can do is make a plan.  Despite my father’s objections, thankfully, they got LTCI.  At age 88, he’s receiving benefits today.

People always tell me they don’t want to be a burden, but that is exactly what happens when there’s no plan in place, and they need help.  Family is the first line of defense.

Recently, someone contacted me about LTCI.  She has a front-row seat watching her mother care for both an aging aunt and her father with liver cancer.  She asked me how LTCI could have helped her mother. I told her that LTCI could have helped coordinate and pay for someone to come to the home to help with shopping, cooking, and all levels of care encompassing the Activities of Daily Living.  With LTCI, her mother’s life would be spent as a companion rather than running herself ragged; she would have more time to herself and money saved.

If you would like to learn more about your LTCI or Medicare options, I’d love to talk with you.

Carly Ebenstein
CJB Insurance Services, Inc.
www.cjbins.com
#0B51667 – CA

#748574 – CO
cjbins.com
510.342.2670