Start the Year Right: Why January is the Perfect Time to Review Your Long-Term Care Policy on Medicare
What is Long-Term Care and Why Does Medicare Not Cover It?
Long-term care refers to a variety of services designed to meet personal care needs over an extended period. It’s necessary when someone is no longer able to perform routine daily activities like bathing, eating, dressing, and managing medications without assistance.
Medicare, while comprehensive in many ways, typically only covers services related to acute, short-term conditions. It may cover skilled nursing facility care following a hospital stay, but it does not provide coverage for extended stays in a nursing home or in-home assistance for long-term care needs. This is a critical gap because, as we age, our likelihood of needing such care increases.
According to the U.S. Department of Health and Human Services, about 70% of people over the age of 65 will need some form of long-term care in their lifetime. With the number of elderly Americans growing each year, this statistic becomes even more important for Medicare recipients to consider.
Why January is the Ideal Time to Start Thinking About Long-Term Care Insurance
The beginning of the year marks a fresh start, and it’s a great time to take proactive steps toward securing your future. When it comes to long-term care, the earlier you plan, the better. Here’s why January is ideal for reviewing and securing a Long-Term Care policy:
- It’s a Time for New Year’s Resolutions – Many people set health-related resolutions for the year, but it’s equally important to set financial resolutions. Long-term care planning ensures that you won’t face financial stress should the need for assistance arise. Having a solid LTC plan gives you peace of mind and financial security.
- Medicare Open Enrollment has Ended – If you’re thinking about any changes to your healthcare coverage, the Medicare Open Enrollment period has just closed (ending in December). Now that you have a firm understanding of what your Medicare plan covers, you can identify any gaps—such as long-term care—and seek out supplemental policies. Long-Term Care insurance is one such supplement that can make a world of difference.
- You May Qualify for Discounts – Some LTC policies may offer lower premiums if you apply at a younger age or are in good health. By starting the process now, you may be able to lock in a lower rate before your health status changes. The longer you wait, the more expensive the premiums tend to be.
- Rising Costs of Long-Term Care – The costs associated with long-term care continue to climb every year. According to the Genworth Cost of Care Survey, the national average for a semi-private room in a nursing home is over $7,500 per month, and home health care can cost upwards of $4,500 per month for part-time services. Without LTC coverage, these expenses would come out of your pocket, potentially depleting your savings and forcing you to depend on family members or government assistance.
- Helps You Maintain Independence – While Medicare does not cover long-term care, having an LTC policy can give you the resources to receive care in a setting that you prefer, whether that’s at home, in an assisted living facility, or in a nursing home. This allows you to have more control over your care and maintain your independence.
Long-Term Care Insurance helps cover the costs of services like:
- Home Health Care – Support with activities like bathing, dressing, and meal preparation provided at home.
- Assisted Living – Facilities that help individuals who need more care than can be provided at home but do not require a nursing home.
- Nursing Home Care – Coverage for stays in nursing homes, which provide skilled nursing and other medical services.
- Adult Day Care – Services that provide supervision and care during the day for seniors, allowing caregivers to work or take a break.
If you’re ready to secure your future with Long-Term Care coverage, here are some steps to take:
- Assess Your Needs: Understand your health history and the likelihood of needing long-term care. You can estimate the potential costs and figure out what type of care would best suit you.
- Shop Around for Policies: Not all LTC policies are the same, so it’s crucial to compare different options. Some may offer more comprehensive coverage, while others are more basic. Look for plans that cover both in-home care and facility-based care.
- Talk to an Expert: Consult with a financial advisor or insurance agent who specializes in long-term care. They can guide you through the best policies for your individual needs and help you navigate the options available in your area.
- Review Your Current Medicare Plan: Ensure that your current Medicare coverage is adequate for your health needs, and see how a Long-Term Care policy can fill in the gaps.
As you kick off 2025, consider the importance of long-term care insurance as part of your overall healthcare strategy. While Medicare will help with many medical expenses, it’s critical to understand where it falls short—especially when it comes to long-term care. A Long-Term Care policy can protect your financial future, provide the care you need, and allow you to maintain your independence. By planning ahead, you can give yourself and your loved ones peace of mind knowing that you are covered in the years to come.
Start the year off right by giving yourself the gift of security—review your options and consider a Long-Term Care policy today.
Brenda Gilliam
(Your Medicare Advocate and Holiday Cheerleader)
Email: brenda@gilliaminsuranceadvisor.com
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*We do not offer every plan available in your area. Currently, we represent 13 organizations, which offer 131 products in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program to get information on all of your options.