1. Funding Alternatives for Long Term Care

2. Costs of Long Term Care Home Care $0 - $500 per day Adult Day Care $50 per day and up Facility Care $3,000 - $12,000 per month

3. Funding Alternatives I. Major Medical Insurance II. Medicare Skilled Nursing Facility – Part A Home Care – Part A or B III. Medicaid IV. Family & Personal Resources V. Long Term Care Insurance VI. Other

4. Funding Alternatives Major Medical Insurance Must meet Medicare standards Maximum of 120 days Must be skilled care Skilled nursing Physical therapy Rehabilitative

5. Funding Alternative Medicare Skilled Nursing Facility Maximum of 100 days –0 to 20 daysno copay –21-100copay $128.00 per day Must be skilled care Required daily Skilled nursing Physical or speech therapy Three days of hospitalization reqd prior Must enter facility for same reason as hospitalization Must enter within short time (usually 30 days) Must be rehabilitative

6. Funding Alternative Medicare Home Health Care Part A –Maximum of 100 visits –Skilled and under care of physician –Agency participates with Medicare –Patient is confined to home Part B –Skilled but may be for chronic conditions –Not directly related to hospital stay –Part time and intermittent from participating agency

7. Funding Alternative Medicaid WelfareImpoverishment is necessary –You cannot have assets or income of significant value Nursing Home Onlyvery few ALF –It is less expensive for Medicaid to provide care in a facility than to provide home care Medicaid Planning –Loss of choice and independence

8. Funding Alternative Family & Personal Resources Cost –$6,000 - $7,000 per month for facility –$150 for home care session –If family chooses to do it: Toll on the Family –Money meant for college educations –Loss of privacy –Emotional cost to caregiver and to other family members Is it best for the patient? –Isolation –Quality of care

9. Funding Alternative Long Term Care Insurance Qualified vs Nonqualified plans –Opinion –Less chance of rate increases –Less chance of fraud Tax Advantages Fully deductible to business for employees Tax deductible subject to age/premium restrictions Benefits received tax free Cost The younger you are, the less expensive in the short term and the long term The healthier you are, the less expensive If you live with someone of your same generation - discounts

10. Funding Alternative Other Reverse Mortgage Annuities Viatical Settlement Combination of life insurance & LTC Accelerated benefits of life insurance Rental of home for income Partnership Plan

11. Non-funded Alternatives Meals on Wheels Interfaith Ministries Churches Project Dana Catholic Charities Salvation Army