The GeorgiaCares Lifelong Planning Program

1. The GeorgiaCares Lifelong Planning Program Your Future, Your Choice Presentation Adapted from the Centers for Medicare and Medicaid Services� National Long-Term Care Training Manual

2. What is long-term care help? Activities: * Grocery shopping, laundry, preparing meals, housework, managing medication, transportation * Bathing, dressing, eating, using the toilet, transferring, and continence Locations: * Homes, assisted living facilities, nursing homes, adult daycare facilities, continuing care retirement communities

3. Will I need it? The risk of needing long-term care is 60%. About 43% of people will need nursing home care for some period of time. Nearly one in four people provide long-term care to friends and relatives. Age, marital status, gender, lifestyle, health, and family history may affect your needs.

4. How much will it cost? 2005 Costs: Nursing home care: $69,400 per year ($190/day) Assisted living care: $30,000 per year Part-time home care: $16,000 per yr. What will you pay? In 1999, people and their families paid 28% of long-term care expenses out-of-pocket.

5. Why and how should I plan? Why? More control and choice Better access to home care options Preservation of assets and income Fewer burdens on loved ones How? Think about finances, care options, lifestyle choices and living arrangements, home modification, and legal issues.

6. Can Medicare help? Medicare pays for temporary special care: 1) Post-acute nursing home care 2) Nursing care or specific therapies at home Medicare supplemental insurance pays only for co-pays and deductibles. It does not pay for extended nursing home stays or extra home care visits that are not covered by Medicare.

7. When and how will Medicare pay for nursing home costs? Medicare will pay for limited stays when � Your physician says that daily care is needed. You have been hospitalized for 3+ days for the same condition. You will be in a Medicare-certified facility Medicare pays for an average of 21 days of care in a nursing home. Medicare will pay for days 1-20 at 100% and days 21-100 with a co-pay from you.

8. Will Medicare pay for temporary home health care? 1) You must require skilled PT care (nursing, speech and OT, medical social services), selected medical supplies, or durable medical equipment 2) Your doctor must certify that it is medically necessary, you must be homebound, and care must be provided by a Medicare-certified agency. 3) Medicare will not cover 24-hour care, home-delivered meals, homemaker services, or non-skilled personal care services

9. Can I get help through Medicaid? Eligibility: You must meet requirements based on your income, resources, and health status. Programs vary, and income restrictions have become more stringent for nursing home coverage. Types: Types include nursing home Medicaid, waiver programs (e.g., Community Care Services Program), and SSI Medicaid benefits.

10. Are there disadvantages to using Medicaid? Yes. Funding your long-term care needs through Medicaid: - limits the choices available to you, - reduces your control over your assets, and - may prevent you from getting the best quality of care available.

11. What other public financing is available for long-term care? 1) Home- and Community-Based Programs Exs: home-delivered meals, homemaker services, respite, home modification (in some regions) VA Programs For service-related disabilities and certain eligible veterans and spouses

12. What do I need to know about long-term care insurance? Benefits: Helps protect assets, provides more care choices, reduces or eliminates need for Medicaid, reduces dependence on relatives and friends Drawbacks: May not cover all care costs, may not cover all needed services at right time, has health-related eligibility restrictions, has sizable premiums

13. Is long-term care insurance right for me? How do I decide? You may be a good candidate if � You have $50,000 + in assets to protect You aren�t eligible for Medicaid (or close to eligible) Premiums won�t exceed 7% of your income You�re in reasonably good health You�re in midlife rather than in your upper 70s

14. How should I safely shop for long-term care insurance? - Ask questions and compare. - Understand what�s covered before you buy. - Get the company�s state registration number. - Get the company�s financial rating (Look for �A� ratings.) - Make sure that the company is strong (billions in assets). - Use the free review period to examine the policy. - Study the application at least twice. - Don�t pay in cash.

15. What should I ask the agent? Ask about - The underwriting process and costs - The agency�s recent history of rate increases - Numbers and types of complaints - Your rights regarding claim disputes - Your right to terminate the contract

16. What other options can I use besides insurance? Other financing options: - Reverse mortgages, home sales, leasebacks - Accelerated death benefits, life settlements, viaticals - Single-pay life / LTC policies, LTC annuities - Medicaid Disability & Charitable Remainder Trusts - Use of assets and income, Medicaid estate planning - Continuing Care Retirement Communities

17. How do they work?

18. What do I need to know about reverse mortgages? What it is: A reverse mortgage is a loan against your home. You receive cash for its value without selling it. What you should know: Eligibility age is 62. The lender pays you while you live in your home. You retain ownership, pay taxes, and make repairs. The loan must be repaid if you move, sell, or permanently move out.

19. Is a reverse mortgage for me? What should I look for? Things to consider: - Must be 62+ - Home must be primary residence - No income or credit history required - Little or no outstanding loan balance on mortgage - Can assume no other debts with reverse mortgage - Should attend a free counseling session - Heirs may keep the home if they pay the RM loan

20. Reverse Mortgages: Advantages Potentially available to large numbers of older persons (over 62) Can provide cash that can be used for any purpose including LTC Money is available to people regardless of their insurability and can be obtained relatively quickly Money received is considered a loan, not income, and is tax free Fairly significant consumer protections in place for buyers HUD requires that all applicants receive intensive counseling prior to their closing

21. Reverse Mortgages: Disadvantages Can be relatively expensive ways to borrow smaller amounts of money The home to be mortgaged needs to be in a market where home values are high enough to yield sufficient cash back to make it worth the effort and cost to the older homeowner Many debt-free homes owned by seniors may be in need of extensive repairs or renovation when appraised for purposes of these mortgages Has to be a lender in the community qualified to process Reverse Mortgages

22. Where can I get more information? For more information call: Abby Griffis, LMSW 404-657-8757 amgriffis@dhr.state.ga.us Or the state�s toll-free GeorgiaCares hotline at 1-800-669-8387.