Long-term Care Planning Basics in New York

Long-term care describes the services required to meet an individual’s personal care needs. As approximately 70% of people aged 65 and older require some form of long-term care during their lives, all individuals in this age range should make long-term care planning a priority. While long-term care includes medical care, most of its associated tasks involve assistance with activities of daily living (ADL), such as:

• Bathing
• Dressing
• Medication administration
• Meal preparation
• Grocery shopping
• Transferring and ambulation
• Eating
• Housework

Different types of long-term care services include:

• Home care services – Home care services are typically provided by unpaid caregivers, nurses, home health aides, and therapists.
• Community support services – Examples of community support services include adult day care centers and transportation services.
• Facility-based services – Facility-based services include nursing homes, assisted living facilities, board and care homes, and continuing care retirement communities.

Paying for Long-Term Care in New York

An important issue to consider when planning for long-term care is payment. Determining how to pay for long-term care can be a daunting task, and we recommend consultation with an experienced New York elder law attorney when beginning the planning process. Common long-term care payment options include:

• Medicare – Medicare will pay for skilled services or rehabilitative care in a nursing home for a maximum of 100 days, skilled home health services, and other skilled in-home services. However, Medicare will not pay for non-skilled assistance with activities of daily living, which comprise the majority of required long-term care services, meaning that these expenses have to be paid out of pocket if they aren’t covered by a private or public insurance program.
• Medicaid – Medicaid pays for many long-term care services, but eligibility is based on income. In addition, recipients must also meet state eligibility requirements, such as the amount of ADL assistance one requires.
• Other federal programs – Other federal programs such as those administered by the Department of Veterans Affairs and the Older Americans Act will pay for long-term care services, but such programs only cover certain populations and circumstances.
• Private health insurance – Most private health insurance plans do not provide long-term care coverage, and plans that do provide such coverage tend to be limited to areas similar to that of Medicare.
• Additional private payment options – In addition to the payment methods described above, other payment options include long-term care insurance, reverse mortgages, life insurance options, and annuities.

Please keep in mind that the information above is a general overview of the long-term care planning and payment process, and consultation with a New York elder law attorney is recommended to determine the option most suitable for you. An experienced New York elder law attorney will provide you with detailed legal guidance regarding long-term care based on your unique circumstances. In order to begin the long-term care planning process, please contact us for a free consultation at (518) 462-5601.