Helping People with Long-Term Health Care Needs:

An Insurance Program to Help People Afford
Long-Term Services and Supports
No one likes to think about getting old, getting sick, or having an accident and needing long-term help with daily activities. But as more of us are living longer—and often living longer with disabilities—more of us will need that kind of help.
Most people who need long-term services prefer to stay at home and receive the care that they need there, rather than having to move into an institution (such as a nursing home). For many, getting help at home can delay—or avert—the need for institutional care. Yet few people have insurance that will help pay for long-term services, in spite of the high cost of that type of care. The average hourly cost for a home health aide is $29, and homemaker services cost $18 an hour.
Health reform includes a voluntary insurance program, Community LIving Assistance Services and Supports (CLASS), that will help people afford the long-term services they need so that they can remain living in the community longer.
The Problem: Necessary Financial Protections That Many Don’t Have
About 70 percent of people over age 65 need some long-term services. But only about 9 percent of all adults have insurance that covers that type of care. There are several reasons for such low insurance rates. Employers don’t typically offer long-term care insurance, so people must buy policies in the individual market. That can be very expensive; benefits can be difficult to compare; and consumer protections for policy holders are often inadequate, which makes people wary of buying such policies. In addition, many people incorrectly believe that Medicare covers long-term services. In fact, Medicare coverage of these kinds of services is quite limited and does not include home- and community-based care.
Without insurance, the cost of long-term services can be financially devastating for the average family. Many eventually exhaust their financial resources and qualify for Medicaid, but that does not always mean that they will have access to the community-based care that many need and want. While Medicaid covers long-term nursing facility care, coverage of community-based care is optional and varies tremendously from state to state. There can be waiting lists; services are often not available statewide; and to qualify for care, there is often a requirement that a person be sick enough to need a nursing home.
From Families USA • April 2010
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