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Preparing for long-term care

People are living longer and health care is becoming more expensive. To confront this reality, long-term care planning should address options and finances. This care is not restricted to medical care or living in a facility. Long-term care also includes aging in a place where a person can live at home with assistance. Services usually include help with bathing, dressing, using the toilet, care with incontinence, meals and getting around. Other less intensive services include assistance with medications, grocery shopping, housework and handling bills and finances.

Sometimes, people cannot live at home and may need to reside in assisted living facilities or nursing homes, which can be very expensive. A one-bedroom unit at an assisted living facility usually costs $45,000 a year, while a private room in a nursing home is usually $97,000 a year.

An adult foster home, also known as a group adult care home, is a less expensive option for someone who needs assistance for several daily living activities. These are usually contained in residential homes with a small number of older adults.

Medicare will not cover long-term care costs because it is a federal health insurance plan and most long-term costs are not health-related. Medicaid will pay for some long-term expenses for those over 65. But people who have assets over $2,000, excluding their homes and cars, are usually excluded.

Long-term care insurance is another option, but is unavailable for people over 70-years-old. Policies usually have lengthy waiting periods where the insured must pay out-of-pocket costs and coverage caps and other limits.

Veterans may be eligible for the Department of Veterans Affairs' Aid & Attendance pension benefit if they were honorably discharged, served in wartime, are over 65 and have medically-documented need for assistance with daily activities. This also covers their spouses and can be used for long-term care at home, an assisted living facility or a nursing home.

A reverse mortgage may be used if one person must go in an assisted living facility or nursing home and their spouse will continue living at home. This home equity loan will help pay for long-term care expenses for the spouse who moved out.

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