… that sounds expensive.
free link:
I bet we get mandatory euthanasia for those that refuse to sign up for Medicare Advantage by then.
intercst
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This very concerning article tiptoes around sensitive issues. I will come straight out and say what they are hinting at: much of the increase in dementia cases is driven by the rise in obesity and is especially rapid in poor black women.
Medicare has nothing to do with dementia care since Medicare does not cover long-term care at all. (Medicare only covers skilled nursing care that is needed after release from a hospital but not maintenance care.)
The vast majority of the growing population of demented will be placed into Medicaid-funded nursing homes and “memory care” facilities. Many of the poor, black old women live in southern states that have already cut back on Medicaid. What is going to happen to them? Seriously. (No joking about euthanasia.)
Many of the facilities will be taken over by private equity companies that already own up to 10% of all nursing homes. The ten largest nursing home chains own more than 10% of nursing homes, according to the HHS. Nursing homes that accept Medicare or Medicaid will be required to disclose their owners to the public and federal agencies under a new rule.
Purchases of nursing homes by private equity firms are associated with higher patient mortality rates, fewer caregivers, higher management fees and a decline in patient mobility. the patient mortality rate during a nursing home stay and the subsequent 90 days is 10 percent higher at facilities owned by private equity firms than at skilled nursing facilities overall.
The “memory care” facilities are different from nursing homes, which require a higher level of medical care. But the situation will be the same: companies (especially private equity) will take them over and cut back on services.
Wendy
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Hilarious.
I have an anti aging cream. I will pass for 39 for the next 40 years.
That makes two disturbing things I learned in one sentence.
Nothing good is what will happen. TIG guy cares nothing about them, only about cutting costs and burning things down. Buckle up.
Who did the embalming?
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Want to be even more disturbed?
- Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years
- Women need care longer (3.7 years) than men (2.2 years)
- One-third of today’s 65 year-olds may never need long-term care support, but 20 percent will need it for longer than 5 years.
https://www.nia.nih.gov/health/long-term-care/paying-long-term-care
Wondering how much nursing home care costs? That’s a complex question, as several factors can impact the cost of a nursing home stay, including location, duration of stay, and services required. According to Genworth’s estimates, the median cost of a private room in a nursing home is $330 per day or $10,025 per month in 2024. Semiprivate rooms are more affordable, with a median cost of $294 per day or $8,929 month. That adds up to an annual cost of $107,146 for a semiprivate room or $120,304 for a private room. Nursing home costs will also vary wildly by location. In 2024, monthly median costs for a semiprivate room range from $5,483 in Texas to $19,267 in Alaska.
DH and I have Long-Term Care Insurance (LTCI) which covers in-home care as well as nursing home care. This costs about $3500 per year for both of us. We are covered for up to $250,000 each.
If you expect to live past age 65 you need to be aware of the potentially astronomical cost of long-term care. (Unless you have family who will take care of you and/or plan to be impoverished so Medicaid will pay.)
Wendy
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We are a society that just does not want to take care of each other, aren’t we? Everyone for themselves.
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That’s the reality. Plan for it.
Wendy
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The Sun Tanning of Miami Corporation.
My parents have CNA long term care insurance. It was low cost when they were 55. They held it throughout. Over the last seven years it has inched up but it reasonable.
It will pay half the bills.
Using the averages I expect their bill will top $400k to pick up the second half of the expense.
Dad said to my BIL and I over Christmas he hopes he goes quickly. He means at home but quickly regardless. He will be 86 a few days. Mom right afterwards will be 85. They are in good shape but nothing is very easy.
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I don’t know how long you’ve been paying premiums, but $3500/yr for 20 years is $70,000. If you’d invested that kind of money in the S&P 500 rather than getting rogered by an insurance company, you’d have more than $500,000 and you wouldn’t have an insurance company working overtime to cheat you when you make a claim.
intercst
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I don’t know where to begin with this. For starters perhaps, there is ZERO REASON she could have known she’d go 20 years without having to file a claim. That she would not have had to file a claim, say, 5 years into the policy. Or that a market crash would not have taken her emergency fund at the moment it was needed.
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You’re playing the same odds as the insurance company, but they take their “skim” up-front and then fight you on the claim at the back end. It’s very hard to “win” in a rigged game. That’s why it’s preferable to save for your own LTC and cut the insurers out of the transaction.
intercst
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Sure, but for how long at and what cost? A lot of people die while spending very little time in a nursing home. You need to look at the DISTRIBUTION of expenses over the whole population to judge the risk and cost.
{{ RESULTS
The mean age of decedents was 83.3 (SD 9.0) and the majority were female (59.12%), and White (81.5%). Median and mean length of stay prior to death were 5 months (IQR 1-20) and 13.7 months (SD 18.4), respectively. Fifty-three percent died within 6 months of placement. Large differences in median length of stay were observed by gender (men, 3 months vs. women, 8 months) and net worth (highest quartile, 3 months vs. lowest quartile, 9 months) (all p<.001). These differences persisted after adjustment for age, sex, marital status, net worth, geographic region, and diagnosed chronic conditions (cancer, hypertension, diabetes, lung disease, heart disease, and stroke).
CONCLUSION
Nursing home lengths of stay are brief for the majority of decedents. Lengths of stay varied markedly by factors related to social support. }}
Understand the arithmetic rather than relying on the insurance salesman for information.
You don’t have a 50% risk of spending 5 years in a nursing home.
intercst
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Medicare covers the first 90 days in a nursing home or rehab facility (though if you’re in Medicare Advantage, United Healthcare will try to push you out as quickly as possible) So Medicare is paying 80% of the nursing home costs of a lot of people included in the factoid " Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and supports in their remaining years" who don’t make it past 90 days.
intercst
You can do that for a large group of people. You cannot do that on an individual basis. If for no other reason that the cost of me getting this wrong can be crushing financially. This is why we pool resources in a product called an insurance policy. Yes, the insurance industry takes a lot of skim, and that is bad. Quite possibly a reason why programs like Medicaid and Medicare have so much less skim.
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That is false as it pertains to dementia. You must be first admitted to a hospital for 3 days for Medicare to cover any nursing home care.
Wendy’s point is 100% valid. Medicare does not pay for nursing home care for people with dementia.
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Medicare Part A covers limited short-term skilled nursing care in a nursing home, but not long-term custodial care. Medicare Part A covers skilled nursing care in a nursing home for a limited time if you meet certain conditions. This includes skilled care for an illness or injury. Original Medicare doesn’t cover custodial care if it’s the only care you need. Custodial care helps people with activities of daily living, like bathing, dressing, and eating.
Custodial care is needed for people with dementia who may be physically healthy for many years. Or other people with chronic diseases (such as heart disease) that prevents them from taking care of themselves but don’t require skilled nursing care.
This is a very important distinction. The original subject of this thread is dementia. Custodial care (sometimes called “memory care” facilities) needed for people with dementia are not covered by Medicare.
Wendy
However, the insurance company has much deeper pockets…
DB2
Most policies have a 90-day or a 120-day exclusion period, meaning that they begin coverage after you pay for the first 90/120 days yourself. AND, even policies with a total coverage amount sometimes have a maximum per day amount as well!!! A friend’s dad was in the hospital for a few weeks, then required care at home, so they paid a few hundred a day for the care. Then after about 40-45 days, he was moved to another state to be cared for by a different sibling. Then the 90 days ended, but they would only pay up to $120 a day, so the remainder (the majority) was private pay anyway. And then shortly thereafter he died.
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