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Will I Ever Live In A Nursing Home?

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How Much Care Will You Need?

The duration and level of long-term care will vary from person to person and often change over time. Here are some statistics (all are “on average”) you should consider:

  • 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

Distribution and duration of long-term care services

Type of care Average number of years people use this type of care Percent of people who use this type of care (%)
Any Services 3 years 69

At Home

Unpaid care only 1 year 59
Paid care Less than 1 year 42
Any care at home 2 years 65

In Facilities

Nursing facilities 1 year 35
Assisted living Less than 1 year 13
Any care in facilities 1 year 37

Who Pays for Long-Term Care?

The facts may surprise you.

Consumer surveys reveal common misunderstandings about which public programs pay for long-term care services. It is important to clearly understand what is and isn’t covered.


  • Only pays for long-term care if you require skilled services or rehabilitative care:
    • In a nursing home for a maximum of 100 days, however, the average Medicare covered stay is much shorter (22 days).
    • At home if you are also receiving skilled home health or other skilled in-home services. Generally, long-term care services are provided only for a short period of time.
  • Does not pay for non-skilled assistance with Activities of Daily Living (ADL), which make up the majority of long-term care services
  • You will have to pay for long-term care services that are not covered by a public or private insurance program


  • Does pay for the largest share of long-term care services, but to qualify, your income must be below a certain level and you must meet minimum state eligibility requirements
  • Such requirements are based on the amount of assistance you need with ADL
  • Other federal programs such as the Older Americans Act and the Department of Veterans Affairs pay for long-term care services, but only for specific populations and in certain circumstances


Like public programs, private sources of payment have their own rules, eligibility requirements, copayments, and premiums for the services they cover.

Health Insurance:

  • Most employer-sponsored or private health insurance, including health insurance plans, cover only the same kinds of limited services as Medicare
  • If they do cover long-term care, it is typically only for skilled, short-term, medically necessary care

There are an increasing number of private payment options including:


Planning for the eventuality of needing long term care is critical in reducing stress and uncertainty. Meeting with an Elder Law attorney familiar with the rules of Medicaid qualification is a step in the right direction. Contact our office for a no-obligation consultation to see if developing an estate plan with the goal of Medicaid qualification is a right fit for you.

Retiring? You will spend over $130K on Healthcare!

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Retiring Workers Will Need $130,000 Just to Cover Health Care, Study Finds

Retirement-Medical-Bills (1)Today’s 65-year-olds can expect to spend an average of $130,000 on health care after retiring, from premiums to co-payments to eyeglasses, according to new estimates. The average single 65-year-old woman can expect to need $135,000 to spend on health care in retirement, while a man will spend $125,000, according to estimates from Fidelity Investments. (The difference is because the woman is expected to live longer — an additional 22 years, vs. 20 years more for the man.) Every year, Fidelity estimates how much it will cost for today’s average 65-year-olds to cover health care expenses for the rest of their lives if they retire now. For a while, it looked as if health care costs were holding steady, but Fidelity this year says couples need to set aside a record $260,000 for Medicare premiums and all other out-of-pocket medical costs — up 6 percent from last year and 18 percent from 2014.

Prime culprits in accelerating health expenses are prescription drugs, especially high-priced specialty drugs, Fidelity says. And as the economy recovers, retirees are using more health care, driving up costs. Fidelity’s estimates, based on an analysis of Medicare’s claims database and trends in survey data, assume that retirees are eligible for Medicare and try to capture all the costs it doesn’t cover — including premiums, co-payments, and things Medicare doesn’t pay for, such as hearing and vision exams. But the estimates are only averages, and people’s costs can vary widely, according to where they live and how healthy they are.

What are the major expenses for retiring that I must plan for?

As retirement approaches, your life’s expenses don’t go away! They remain and now they must be paid on a fixed income. However, the big bills that I get called about are those possibly catastrophic costs associated with paying for the healthcare of a loved one who must reside inside a medical institution/rehabilitation center/nursing home. Family members are shocked with the reality that their existing health insurance will not cover this expense and that couples are left to finance these expenses out of their life savings.

As noted above, the cost for Medicare insurance is projected to cost a person over $130,000 over the remainder of their lifetime. What if you were to learn that you needed to pay that amount PER YEAR to care for a person in a nursing facility. That would certainly change the landscape of everyone’s financial future.

At Rhode Island Medicaid Planning, we discuss the Medicaid program, the program that if your assets and income are within certain limits will pay for the costs of nursing facilities. We discuss the rules and regulations and allow you to make a decision that works best for you and your loved ones.

Source/more: Bloomberg


Cost of Rhode Island Long-Term Care Services Increase

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The cost to receive long-term care services at home with a health aide has increased in Rhode Island, according to Genworth’s 13th annual Cost of Care Study.

The cost to receive long-term care services at home with a health aide has increased both in Rhode Island and nationally, according to Genworth’s 13th annual Cost of Care Study.

Released Tuesday, the study said long-term care costs across all care settings in Rhode Island, including home care, adult day services, assisted living and nursing facilities, are higher than last year.

“Although home care costs are much less expensive than those in facility-based settings, the costs can add up to as much as $57,200 per year in Rhode Island, which is why it’s imperative for consumers to begin planning now for how they will pay for that care should they need it,” Tom McInerney, president and CEO at Genworth, said in a statement.

He said at least 70 percent of Americans over age 65 will need some form of long-term care services and support during their lives.

In Rhode Island, the median monthly cost of a home health aide is $4,767, a 0.48 percent increase from 2015. That’s also higher than the national median monthly cost of $3,861, which also increased in cost over the year by 1.3 percent.

The cost of adult day services in Rhode Island rose 12.8 percent, for a median monthly cost of $1,625. That compares with the national median monthly cost of $1,473, which fell 1.3 percent over the year.Monthly Cost Chart 2016

Median monthly private nursing home costs also rose in the Ocean State, to $9,581, an 11.5 percent increase, as well as semi-private nursing home costs, which rose to $8,304, a 7.1 percent increase. Annually, the cost for private nursing home care amounts to $114,975, which has increased 2 percent over the last five years. That is also higher than the national cost for private nursing home care at approximately $92,000.

Nationally, the monthly median cost for a private nursing home rose 1.2 percent to $7,698, and semi-private nursing home costs climbed 2.3 percent to $6,844.

Two services that declined over the year in Rhode Island were homemaker services and assisted living, by 2.1 percent and 7.4 percent, respectively, for totals of $4,385 and $4,931 per month. Nationally, those segments increased 2.6 percent to $3,813, and 0.8 percent to $3,628, respectively.

Other report findings:

  • The cost of semi-private nursing home care is 11.72 percent more expensive in the Providence-Warwick-Fall River metropolitan area than the state average at $9,277 per month.
  • The cost of adult day services is 6.65 percent less expensive in the Providence metro area than the state average, at $1,517 per month.
  • Homemaker services costs are 1.1 percent less expensive in the Providence metro area than the state average, at $4,338 per month.

A home health aide will typically help with bathing, dressing, transferring and toileting, but not with catheters or injections. Most agencies also provide homemaker services that typically include assistance with shopping, finances, cooking, errands and transportation. Homemaker services may also be employed for the purpose of providing companionship.

“The annual Cost of Care study is our way of helping Americans fully understand the financial implications of long-term care so that they can plan ahead and, when the time comes, focus on getting the best care without the worry and stress of how they’re going to pay for it,” McInerney said.

The 2016 Cost of Care Survey covers more than 15,000 long-term care providers in 440 regions throughout all 50 states, including all U.S. metropolitan statistical areas.

Source: Providence Business News