Medical care in the United States can be expensive. And we may need more of it as we get older. Many people assume that they will have adequate healthcare coverage through Medicare once they turn 65 years old. However, Medicare may not cover as much as you think.
Therefore, it is especially important for the elderly and their adult children to understand how to obtain appropriate medical coverage and make sure parents are taken care of. Here’s some background information on Medicare, long-term care, and options children have for making sure their parents receive adequate medical care.
Medicare is a federal government health insurance program for people age 65 and older. Coverage under Medicare includes four programs:
While Medicare Part A provides coverage to most seniors without the need to pay premiums, most people must pay premiums in order to receive coverage under Parts B, C, and D. The Medicare website has a good description of each Part’s benefits and costs which you can review with your parents. The employees at your local social security office can also help your parents obtain medical care.
One thing that’s important to consider is that the cost of Medicare Part B may go up significantly if elderly parents do not initially enroll at age 65. The initial enrollment period for Medicare Part B is seven months long, beginning three months before one’s 65th birthday and ending four months after one’s 65th birthday. If a retired person doesn’t sign up for Part B benefits during this time, the monthly premiums may increase by 10 percent for every year they were eligible for coverage and chose not to enroll. This penalty does not apply to people still working at 65.
For example, if your retired parents waited to enroll in Medicare Part B until they were 75, then their monthly premiums would be double what they would have been had they enrolled at age 65. In addition to the monetary penalty, a limited enrollment period exists as well. Enrollment in Part B outside of the seven-month window at age 65 is limited to January 1 to March 31 of each calendar year at a local social security office.
Your parents may also consider enrolling in a Medicare Advantage Plan. Several plans are available in each state. The plans vary both in cost and in the coverage that they provide. Individuals can view Medigap plan comparisons for their state on the Medicare website. The comparison includes the monthly premiums, annual deductible, summary rating, telephone number, and link to the health plan website.
While Medicare Part A may cover almost all of a patient’s costs if the patient is admitted to the hospital, it will not cover most of their outpatient health care expenses. People typically spend more than hundreds of thousands of dollars on health care over the course of their lifetime, and they incur nearly half of that amount after they turn 65. Therefore, you should plan carefully for the likelihood that your parents will have significant medical expenses during their elderly years, not all of which Medicare will cover.
One of those medical expenses not covered by Medicare (or, in some cases, by private health insurance policies) is long-term care. Long-term care can take many forms, but attempts to help older adults with the basic activities of daily living if aging or infirmity diminishes their capacity. It can be temporary or permanent, in-home or at an assisted living residence or medical facility. Long-term care programs help people suffering from chronic illness, disability, or other health condition stay healthy and active, and have their basic living requirements met.
Because Medicare does not cover long-term care, many elderly people turn to Medicaid to help pay those costs, and the program has become the largest source of long-term care funding.
Medicaid is an assistance program for low- or no-income individuals of all ages, administered by states and local governments within certain federal guidelines. Services differ from state to state, but the federal government mandates coverage for certain services deemed “medically necessary,” including long-term care, nursing facility services, and home healthcare for people eligible for nursing facility services.
Eligibility for Medicaid, however, is limited to people with no financial or property assets, so elderly parents who require long-term medical care but don’t qualify for Medicaid could be paying for that care out-of-pocket.
Stories abound regarding elderly people forced to drain their personal savings or veteran’s benefits, remortgage their homes, and even sell off their personal property to finance long-term care late in life. However, there are long-term care insurance policies that can cover eldercare costs.
Long-term care insurance, or LTC insurance, isn’t for everyone, though. Consider your age, health, and monthly income before purchasing any insurance that purports to cover long-term care, and have an experienced elder law attorney look over any policy you’re considering.
Sometimes ensuring your elderly parents receive the best medical care means having some hard conversations before the need arises. End-of-life care issues are critical for parents and children to address in order to ensure they fulfill an elderly parent’s medical wishes. Here are a few ways to make sure that happens:
Also known as a medical directive, a living will sets out exactly what kind of care a person wants to receive in an emergency or if they become incapacitated. Living wills can cover topics like resuscitation, desired quality of life, and end-of-life treatments, including any life-saving treatments a parent may not want to receive.
No matter how specific, a living will can’t cover every scenario. Therefore, an elderly parent should name a health care agent who is the person who will make medical decisions for them if they are not able. While a durable power of attorney and living will are separate documents, the living will trumps, and the named representative can’t override the living will’s express intent. Rather, the appointed person must make decisions in situations not covered by a living will.
A do not resuscitate order is a written physician’s order contained in a person’s medical record that instructs health care providers to not attempt certain life-saving measures. These decisions can be based on religious grounds or quality of life for the resuscitated person. Elderly parents should document their desires on this issue clearly, to avoid any confusion later.
Caring for elderly parents can be emotionally, financially, and legally complicated. And an experienced elder law attorney should help in drafting or reviewing any contracts, insurance policies, or medical directives to ensure the best preparation and care possible.
This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified elder lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local elder attorney to discuss your specific legal situation.