A continuing care retirement community is able to offer progressive levels of care as they become necessary.

In today’s uncertain economic times marked by roller-coaster markets and flat-line wages, leave it to a certain segment of Michigan seniors and retirees who are choosing to live in bigger homes instead of taking a more common route of downsizing during their retirement years.

In fact, according to a recent report by Merrill Lynch and Age Wave, 49% of retirees in their survey chose not to downsize in “their last move.” Moreover, 30% were electing to move into a much larger home. Such choices obviously belong to a retirement sector quite “confident with their investments.”

More importantly, the survey revealed that about 20% selected a larger home not only to accommodate family visits, but also to provide the space for families to live with them in the future—the survey indicates that 16% of the retirees responding actually had a boomerang child living with them.

Accompanying this ongoing trend is the notion that a larger home may actually provide better in-home care options; this, even though larger homes bring higher taxes, maintenance and even association fees.

Still, and while larger homes can make in-home care a more viable option, the increase interest in other choices, such as assisted living and even nursing home options continues unabated.

Staying in the home.

It may not be surprising that around 90% of seniors polled by AARP showed a preference for ‘aging in place, or staying in their home after the age of 65. Often, that might mean customizing rooms by adding ramps, or installing stairlifts, or even moving an upper bedroom to the first floor.

But when health conditions deteriorate for those ‘aging in place,’ seniors can still receive hospice care in their homes during those end-of-life stages—funded by Medicare and Medicaid services.

Is ‘assisted living’ covered by Medicare/Medicaid?

Of course, the home may not be a viable option, because of expense and minor health issues. As such seniors may favor an assisted living facility. Unfortunately, neither Medicare and Medicaid will pick up room-or-board costs.

However, these facilities accept seniors who may be at different ‘tiers’ of medical need, thereby affecting the resident’s monthly charges. Generally, the more ambulatory you are, the cheaper the overall costs.

By law, these facilities can only offer extra care up to a certain level; then, other options may have to be considered. But if you are fortunate to have long-term care insurance, the policy may provide some “in-home” help while you are in an assisted-living setting.

Continuing Care Retirement Facilities (CCRCs)

Generally, these facilities require a one-time ‘entry fee’, and then monthly payments that reflect the range of services and amenities offered. Ideally, as their ability to live independently decreases, seniors are able to receive progressive care at the CCRC—a viable solution to the universal question of how to avoid nursing home costs.

CCRCs are normally set up to  provide  around-the-clock care when needed. Of course, with this level of assistance comes higher monthly costs.

‘Assistance’ from your 401(k).

Congress tried to include long-term care (LTC) for all U.S. citizens in the Affordable Care Act (ACA), but it was axed. Instead, the hope is that the IRS will eventually allow us to use our 401(k) to at least pay for LTC premiums, thereby lessening the agency’s current definition of “hardship” cases.

IRS’s existing hardship withdrawal rules do provide for tax-free withdrawals to cover what is considered to be “significant medical expenses.” But it remains questionable that the hardship rules will change; this, owing to the potential decrease in tax revenues that could result.

To start the conversation about the importance of an overall estate plan, including the need for long-term health coverage, contact us today.

The post How to avoid nursing home costs: CCRCs may provide the progressive care needed. appeared first on Estate Planning Lawyers | Elder Law Attorneys | Brighton | Novi | Livonia Elder Law Attorneys.

As a professional servicing seniors for the past 10 years, I have recognized the importance of clarity of information for both caregivers and seniors to properly discern the services that are needed both immediately and in the future. My analogy has always been that, when you are young parents, you have no clue as the choices, cost and requirement of child care services until you are there frantically calling around searching for the right options that are both safe, convenient and within your budget.
The same holds true for senior care. People rarely plan in advance for the choices that seems so far off into the future. Let me begin by explaining Home Care options.
Although most forms of home care are bundled into that one phrase, there are extreme differences when comparing, medical and non-medical options.
Non-medical home care is basically caregiving paid on an hourly basis to provide general assistance with activities of daily living. These might include assistance with cooking, cleaning, showering or even medication assistance. This type of home care is paid for privately with typically a minimum number of hours per day or week required by the provider.
Medical home care, also referred to as skilled nursing care, includes providing nursing assistance along with physical/occupational and speech therapy if needed. Home Health Care is paid for by either Medicare/Medicaid or a private insurance if the eligibly is met. The criteria includes:

• Doctor’s orders for referral
• The patient is having difficulty leaving the home without assistance (home bound)
• A change in medical status

If the patient meets this criteria, then a nurse will go to the patient’s home to evaluate, treat and educate them to eliminate a relapse or readmission into the hospital.
To better explain medical home health care, here is a complete explanation provided by Medicare.gov establishing what it is and what to expect:

What is home health care?

Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).

Examples of skilled home health services include:

• Wound care for pressure sores or a surgical wound
• Patient and caregiver education
• Intravenous or nutrition therapy
• Injections
• Monitoring serious illness and unstable health status

The goal of home health care is to treat an illness or injury, to regain your independence, and become as self-sufficient as possible.

If you get your Medicare benefits through a Medicare health plan, check with your plan to find out how it gives your Medicare-covered home health benefits.

If you have a Medicare Supplement Insurance (Medigap) policy or other health insurance coverage, tell your doctor or other health care provider so your bills get paid correctly.

If your doctor or referring health care provider decides you need home health care, they should give you a list of agencies that serve your area, but must tell you whether their organization has a financial interest in any agency listed. The decision on what agency to select is the patient or family choice.

What should you expect from home health care?

• Doctor’s orders are needed to start care. Then the home health agency will schedule an appointment and come to your home to talk to you about your needs
• The home health agency staff will also talk to your doctor about your care and keep your doctor updated about your progress.

Examples of what the home health staff should do include:

• Check what you’re eating and drinking.
• Check your blood pressure, temperature, heart rate, and breathing.
• Check that you’re taking your prescription and other drugs and any treatments correctly.
• Ask if you’re having pain.
• Check your safety in the home and teach you how to take care of yourself
• Coordinate your care with Physician

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