Louis Tenenbaum is one of the leading authorities and thought leaders on aging in place and home modifications. He wrote the visionary white paper, Aging in Place 2.0: Rethinking Solutions to the Home Care Challenge published by the MetLife Mature Market Institute. In 2016 Louis was named a Next Avenue “Influencer in Aging” and won a HIVE (Housing, Innovation, Vision and Economics) award from the building industry.
Does Medicare cover long term care costs as I age, like home modification and caregiving?
The short answer is No.
There is a long persistent idea that Medicare covers long term care. People often think you turn 65 and then you don't have to pay for medical expenses anymore. First, in upper incomes Medicare isn't cheap. It can be $500 per month! Second, if you're lower income, then you pay less and if you're very low income, you can be dual eligible for Medicare and Medicaid.
Medicare covers some of your health care, some of your continuing care related to a specific injury, but it doesn't cover long term care. That's where the issues emerge. This means that people are on the hook for long term care themselves, and end up using savings, often relying on family members as well.
Why doesn’t Medicare cover everything?
The year that social security started for 65, the average age of death was 61. In 1965, when Medicare was introduced, life expectancy was 71 and started to cover at age 65. Now, life expectancy is 79. If you reach 65, most will get to 85, and people start to get really expensive when you get to 79 or so.
Medicare can barely keep up with current costs let alone cover all that's going on, so it ends up in your court to cover the costs of the long period of less health.
Is there anything I can do? What if I can’t afford it and don’t qualify for Medicaid?
You can purchase long-term care insurance or new "hybrid" plans. They are expensive and many can't afford it.
Don’t lose hope! Medicare is experimenting with ways to help, starting with Medicare Advantage programs, which recently came out and are growing. 34% of Medicare recipients have a Medicare advantage plan! These plans are well incentivized to help you stay healthy. Many provide supplemental benefits like Silver Sneakers programs, free gym memberships, glasses, nutrition programs, and more, because it keeps people out of the hospital.
As far as home modification, Medicare Advantage is starting to be allowed to pay for things like structural modification but they are still figuring out exactly how to do it.
What is the best way to reduce out of pocket costs?
The way you can reduce your out of pocket costs is to not fall. Falls change lives, so you want to make sure your home is as safe as possible to keep you from falling.
Once you start to have a fall, you start to do less and become more sedentary, which is one of the key indicators of a fall. Good nutrition, fitness, and good eyesight can help keep you from a fall and keep you healthy so it’s important to keep that up too.
Want to ask Louis a question he can answer in an upcoming blog post? Simply email helllo@meetkoko.com and send us your inquiries!
