Millions in Dark On Long-Term Health Care

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You don’t drive around thinking you have car insurance if you actually don’t.

But when it comes to long-term care, despite the potentially devastating costs, millions of Americans continue to delude themselves into thinking they have insurance they don’t.

This to us is the most troublesome finding of a new report by AARP on perceptions and realities about long-term care.

The report, based on telephone interviews with more than 1,800 Americans, most of them 45 and older, concludes that a “substantial proportion” apparently believes they have long-term care insurance when they don’t.

“In general, Americans 45-plus do not know what long-term care services cost and do not know about coverage,” said the report, prepared for the senior advocacy group by the research firm GfK NOP Roper Public Affairs & Media.

To avoid misunderstandings, the people interviewed for the survey were told that long-term care means care provided on a regular basis for three months or more for age-related or other chronic conditions.

For example, long-term care may mean that someone comes to your home a few hours each day to help with daily activities or personal care tasks, such as paying bills, shopping, preparing meals or simply getting in and out of bed. It can also mean home visits from a nurse or physical therapist, or living in an assisted living facility or nursing home.

According to the survey, 60 percent of Americans say they are at least “somewhat familiar” with long-term care services, the same percentage as in a similar survey in 2001.

But despite this self-proclaimed familiarity, Americans know precious little about costs and about what insurance covers – in many cases, less what they knew in 2001.

For example, only 8 percent of Americans today, compared with 15 percent in 2001, could come up with an estimate within 20 percent of the average cost of a stay in a nursing home.

That cost is about $6,266 a month, based on AARP calculations using a MetLife Mature Market Institute survey released in September. Almost two-thirds, or 63 percent, thought the cost was lower, and 17 percent admitted they didn’t know.

In addition, just 23 percent could come up with an estimate within 20 percent of the average cost of an assisted living facility, which is about $2,968 a month.

More worrisome, 59 percent mistakenly thought that Medicare covers nursing home stays of three months or more for age-related or chronic conditions, about the same percentage who did in 2001.

The reality: For so-called post-acute institutional care such as in a skilled nursing facility, the Medicare benefit is limited and available only after a patient has been hospitalized at least three days. Even with that benefit, the beneficiary pays $124 a day for days 21-100, and the full cost thereafter.

Also, 52 percent of the people believed that Medicare covers assisted living, compared to 41 percent who did in 2001. In fact, neither Medicare nor any private Medigap policy covers the cost of assisted living in any state.

Possibly because of these misconceptions, 29 percent of the people surveyed said they had long-term care insurance, a figure that does not jibe with estimates that only about 9 percent of Americans 55 and over had it in 2002.

“We suspect that many people are confusing long-term care insurance with other types of coverage, for example disability insurance provided by employers or Medicare,” the report said.

“If this is the case, some Americans may think they have long-term care insurance when they do not.”

Conclusion? “Little has changed since the 2001 survey,” the report said. “Americans 45-plus know less about long-term care than they think – and that they should. Given the high and accelerating costs associated with long-term care and the growth of our older population, it is critical Americans become more informed about the costs, funding sources, coverage options, and state and community resources.”

Send questions to [email protected], [email protected], or c/o Tribune Media Services, 2225 Kenmore Ave., Suite 114, Buffalo, NY 14207.

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