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I'm a national health reporter who covers aging and long-term care. We're exploring a looming problem: middle-income families who aren't wealthy enough for high-end care, but have too many assets to qualify for Medicaid. How are families coping? Would love to hear your stories.

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It isn't a looming problem, it's a current burden which affects not only middle-income families but also many who consider their financial circumstances to be modest at best.

I would guess that most people are surprised, stunned if you prefer, by the cost of care when they are first presented with estimates. That is because very few have ever had reason or pause to reflect on what care comprises.

I will be interested to hear what angle you're expecting to take. You may struggle to find a really credible scapegoat, but the alternative is to present the truth that the skills, time, facilities, equipment and medical input required for anything approaching high quality care over the rising number of years that many of us - us, I stress - can expect to live come at a high cost which the individual is responsible for meeting. Which, as any politician will tell you, will hardly please your audience.

And if not the individual, then who?
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These folks who "can't qualify for Medicaid", are they looking at a chart of numbers or have they bothered to dig deeper and perhaps consult a Medicaid planner or elder care attorney?

Especially in the case of married couples in which only one needs a nursing home, there are ways to qualify.

But yes, healthcare in general and eldercare in particular costs a fortune.
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No, of course you cannot qualify for the taxpayer to pay your costs if you have your own money. So your own money gets spent down. Then, when you have no money you get medicaid and the taxpayer helps to pay your costs. That's how it works. That's how all of this works at the present time.
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Everybody can eventually qualify for Medicaid. What makes it frustrating or aggravating for some is that some of those who have scrimped and saved and managed to accumulate a decent savings portfolio are forced to use that money for care, while others who may have been frivolous with their money and didn't save can go on Medicaid. Those who have saved will still end up going on Medicaid, but after their savings have been depleted.
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Alva; what I am trying to say to this reporter is this:

We've had many folks come here and say "I don't qualify for Medicaid; I looked at the chart". Or, "I have a house; I don't qualify because they'll take my house". Or, "I can't afford to put my husband in a NH because then I'll be out on the street with nothing".

In all three of these very specific situations, getting these folks to a Medicaid planner or lawyer allowed the patient to qualify for Medicaid.

Yes, Medicaid is for the indigent and shouldn't be used to preserve an inheritance for the next generation. But it also shouldn't be overlooked that there are better and worse ways to split assets and income between a couple and the numbers on the chart don't always tell you the whole story.

If a person has a relatively high income but is paying a fortune in medical and pharmacy bills, they may well qualify. If they qualify for opening a Miller Trust (where the "extra money" ends up in Medicaid's pot at the end, that also makes sense.

But most folks don't know about this stuff; I certainly didn't before I came here.
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Yes, agreed Barbara, anybody can qualify (or will eventually qualify) with proper planning, yet we still see posts from people stating they don't qualify. They will, they just have to spend their assets or set up qualified trusts if necessary.
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I think you need to really spend time on this website. It is dedicated to care givers in the trenches. Financial stress is a constant topic here. Either looking for a good deal on adult diapers, thrifty meals to make for dementia/Alzheimer loved ones, and how to pay for professional care giving when it is inevitable that either you die before the person you're caring for because of the physical and mental stress or the person you're caring for has become so complicated in their day to day needs that it is impossible to care for them at all.
For many of us, this is a nighmare. No amount of planning can get anyone ready for what dementia does to a person. There is no "cure". Early testing to detect onset of significant mental decline is basic and pretty much confirms what we've already been dealing with in our loved one.
I don't know how you are defining long term care for an elderly person, is it for someone who has chosen assisted living? Is it someone with COPD? Hospice? Cancer?
"How are families coping?" Oh brother, are you going to read some interesting tales on that too. It ain't pretty, nice or kind some of what has happened in people's families with stuff like this.
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Thanks very much for all of these responses.

We really want to target the group that's been called "the forgotten middle," people older than 65 in the U.S. with incomes between about $25,000 and $75,000, or up to about $95,000 for those older than 80.

It's clear that many, many people don't realize they won't have enough assets to cover the costs of housing and health care when they need it.

We're looking to tell those stories and show the struggles individuals and families are facing.

It has nothing to do with finding a scapegoat; rather, we hope to illuminate
the problem in a way that offers solutions.
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What would be much better is this: when you DO find a solution, post it here so we can finally have an answer to something we've known about for a long time. Most of us can't even afford daily life NOW, before we reach "the forgotten middle" so we're well aware that we won't be able to properly finance our old age, forget about 'high end care'. We realize it, we just can't fix it, especially with the way the economy has been decimated over the past year.
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You're worried about 80+ year olds with incomes of 85K a year? Seriously?
Honestly, they should be able to afford quality care at home at least 8 hours a day 7 days a week with that massive amount of income.
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Universal Health Care is the solution.
Financed by stopping all the tax breaks, loop holes for billionaires. No more HMOs-not the most effective delievery of health care.
There are a lot more solutions to fix this. Basic economics is a good start.
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I see three problems.

First, the people who don’t know what’s available; the ones that believe the horror stories without researching if it’s true or not. For example, the popular “Medicaid will pay for the husband’s care by taking the house and leaving the wife homeless.”

Second, the people who don’t want to loose “their inheritance” to pay for a senior’s care. It’s not their inheritance until someone dies!

Third, when people expect more than they can pay; expecting private rooms, lounges, sunrooms and gardens but “only getting” clean and safe accommodations.

Thats where the conflict comes from. Remove those three and senior care is actually affordable in the United States.
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Never mind basic economics, basic arithmetic dictates that if you are financially productive for only 50-60% of your years of life you will have to be much more productive (and much less given to spending) during those working years than people are currently prepared for or willing to be.

Governments have enough trouble persuading or coercing people into buying retirement pensions, let alone long-term care provision. If you then ask people to pay for insurance for such provision out of working income which is taxed high enough to fund universal healthcare (and social care - that's another can of worms), or to sell their major assets for that matter (hear the squeals of outrage when older people are "forced" to sell the family homes they can't afford to maintain, don't use and aren't enjoying any more), you will be extraordinarily lucky to be re-elected.

Much easier to keep fighting the fires and blaming somebody else for causing them. It's worked fine for the last century, after all.
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