Home
In this issue
April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review

Alzheimer's care can be less devastating

By Kimberly Lankford





Know what private and government insurance programs may pay


One in eight individuals 65 and older suffers from Alzheimer's disease -- a sobering statistic for the growing number of baby boomers crossing that age threshold. And the costs can be an "overwhelming financial burden," says Carol Steinberg, executive vice-president of the Alzheimer's Foundation of America.

Private and government insurance programs may cover some costs. Here's a primer on your options:

MEDICARE
Many people are shocked to discover that Medicare does not cover the long-term custodial care that Alzheimer's patients need. Custodial care is the non-medical care associated with activities of daily living, such as bathing and dressing.

Medicare does cover limited care in a nursing facility or at home. For home care, the patient must require skilled-nursing care or physical or occupational therapy to help with the recovery from an illness or injury -- not to help an Alzheimer's patient with daily-living activities.

"One of the most difficult situations is when a loved one needs personal or custodial home care, but Medicare will only cover that if there is some type of skilled-care need," says Frederic Riccardi, director of programs and outreach for the Medicare Rights Center, an advocacy group.

At-home services in most cases can be provided for fewer than seven days each week or less than eight hours each day over a period of 21 days or less. Limited custodial care could be provided during these visits -- perhaps if an Alzheimer's patient treated by a registered nurse for a broken hip needs help bathing. Medicare pays the cost of a skilled-nursing facility, but only to provide continuing treatment following a hospital stay of at least three days. Skilled care in a facility is limited to 100 days.


While Medicare offers little by way of custodial care, it does provide diagnostic and medical treatment that Alzheimer's patients need. The new annual wellness physical exam, which is free and part of the health care law, includes testing for cognitive impairment.

"This is a critical, yet hardly known, provision," Steinberg says. Medicare also covers visits to a geriatric assessment clinic.

Alzheimer's patients and their families need to carefully choose a Medicare Part D prescription-drug plan or private Medicare Advantage plan. Alzheimer's medications are generally covered under Part D, but plans vary regarding co-payments. Use the Medicare Plan Finder to compare the total costs of your drugs under each policy. The Alzheimer's Association offers a guide about coverage for common Alzheimer's drugs.

If you choose an Advantage plan, make sure your neurologist and other physicians you see often are covered as in-network providers. Otherwise, you'll pay higher out-of-pocket costs. You can compare Advantage plans by using the Plan Finder.

LONG-TERM-CARE INSURANCE
These policies provide coverage for the custodial care that Alzheimer's patients usually need. Benefits typically kick in if the patient needs help with at least two activities of daily living, or if a doctor provides evidence of cognitive impairment.

Because most people with Alzheimer's receive care in their own homes, look carefully at the policy's home-care requirements. Typically, a patient must wait 60 or 90 days before benefits begin. But policies differ on when the clock starts ticking, which could be a big headache for caregivers.


FREE SUBSCRIPTION TO INFLUENTIAL NEWSLETTER

Every weekday JewishWorldReview.com publishes what many in the media and Washington consider "must-reading". HUNDREDS of columnists and cartoonists regularly appear. Sign up for the daily update. It's free. Just click here.


For example, some policies start the 60-day waiting period on the day the doctor certifies the cognitive impairment -- and benefits kick in 60 days later. But other policies count only the days a patient receives care from a qualified caregiver during the waiting period. If the caregiver visits two days a week, the policy only counts those two visits toward the 60-day waiting period -- and benefits won't kick in for 30 weeks. In the meantime, the family has to pick up the tab for the caregiver.

Before you hire a caregiver, check the policy's fine print on the type of caregiver the company will cover. Some policies pay for any caregiver who is not a family member, while others only pay for licensed caregivers who work for an agency. Some families who hire an unlicensed caregiver later discover that the caregiver doesn't qualify under the policy.

Don't expect a policy to pick up round-the-clock home care. Daily coverage is based on the daily benefit. A policy with a $200 daily benefit, for example, will likely cover the cost of eight to 10 hours of a home health aide. If a family caregiver can't fill in the gap, a nursing home may be a better option.

You can't use more than your daily benefit in a day, but you can stretch your daily benefit over longer periods. Say you choose a benefit period of three years, at $200 a day. If you only use $100 a day, your coverage can last for six years. Some policies cover adult day care, which can cost a lot less than daily caregivers.

"Many adult day services specialize in care for those with Alzheimer's disease and similar disorders," says Kathy O'Brien, senior gerontologist with the MetLife Mature Market Institute.

MEDICAID
This program, whose costs are shared by federal and state governments, is the primary payer of long-term-care services for the elderly. Unlike Medicare, it provides custodial care for Alzheimer's patients. Custodial care typically is provided in Medicaid-eligible nursing homes, but many states' Medicaid programs now pay for home care and sometimes adult day care or care in assisted-living facilities, says O'Brien.

The downside: You need to be virtually impoverished to qualify. Many people end up qualifying after spending their retirement savings on care. While state laws differ, generally you can't have more than $2,000 in countable assets, including investments. A spouse who lives at home can generally keep about $113,000. You're allowed to keep your home, car and assets in certain kinds of trusts. (Visit www.medicaid.gov to find eligibility requirements in your state.)

To protect more of your assets, you can buy a state-approved long-term-care policy that is "partnership" eligible. The policy would allow you to qualify for Medicaid without having to spend almost all of your money first. For example, if you buy a partnership policy that covers $200,000 of care, you would pay out of pocket until you have $200,000 left and still qualify for Medicaid. Go to the National Clearinghouse for Long Term Care Information to see if your state allows these policies.

DISABILITY BENEFITS
Individuals who develop Alzheimer's while they're still working may be eligible for some coverage from disability insurance, either through an employer or an individual policy.

"Their cognitive impairment can quickly reach a point where they can no longer maintain gainful employment," says Beth Kallmyer, a vice-president of the Alzheimer's Association. Most policies tend to end benefits at age 65, but rules vary by policy so it's worth checking.

The benefits triggers will depend on the policy's definition of disability. Some policies will make a partial payout if a newly diagnosed worker needs to cut back to part-time and will pay more if the worker needs to leave the job, says Barry Lundquist, president of the Council for Disability Awareness.

Sign up for the daily JWR update. It's free. Just click here.

Interested in a private Judaic studies instructor — for free? Let us know by clicking here.

Comment by clicking here.

Kimberly Lankford is a Contributing Editor at Kiplinger's Personal Finance.



All contents copyright 2013 The Kiplinger Washington Editors, Inc. Distributed by Tribune Media Services. All rights reserved.

Quantcast