Medicare is health insurance for individuals age 65 and over who are entitled to Social Security retirement benefits (or have received Social Security disability benefits for two years.) When Medicare was enacted in 1965, the thinking was that working people would “pay in” during their earning years, so that illness in their later years wouldn’t eat up their life savings.
And yet now, almost 50 years after its enactment, Medicare is not the panacea many had hoped. Why not?
Because Medicare doesn’t cover long term care which is what you need with Alzheimer's or Dementia. Medicare only provides coverage for acute care and skilled care. According to “America’s Long Term Care Crisis,” in July’s Trusts & Estates Magazine, 13% of the population is now over age 65, and 1.8% of these folks (5.7 million) are over 85. More than half of those over 85 need assistance with daily living and assistance is expensive
With home care cost now running $55,000-$75,000/year, and care in a nursing home costing up to $180,000/year, how does the unaffordability of long term care play out in human terms?
My Dad: A Case Study
For two weeks, as I explored renting a house with him, getting an aide and senior living, my 20 year old daughter babysat him. He had difficulty navigating our home and at night he plopped into whatever bed he happened upon. The full reality of his illness hit us and we now knew first hand how tough basic living had become for him.
In my Dad’s case, he couldn’t tend to his daily needs because he couldn’t walk, bathe himself or go to the bathroom on his own. He didn’t so much require “medical” or “skilled” care, but rather “custodial” care. And that’s not covered by Medicare.
Out of options, we felt fortunate to have found a clean safe nursing home where the monthly bill climbed to $12,000/month instead of the $6,000/month in senior living.
An apt analogy is college costs: When I was younger, college cost $5000 a year at a top school. Forty years later it costs $60,000/year. If nursing homes cost $180,000/year now – there is no hope for me – even if I don’t need that “greener pasture” for another 20 years.
I'm holding onto a small ranch house in Florida with three bedrooms and two baths, all on one level, close to the beach and where handicapped accessibility is commonplace. There will be enough room for me, an aide and a visiting child. And the sunshine will feel good, no matter my mental capacity.
And with a little luck, my mortgage will be paid off and it will cost far less than $180,000/year.