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Filling Medicare Coverage Gaps

Two thirds of Americans will need help to live at home as they age. This help costs on average $50,000 annually (ASPE Research Brief, 2016) and is not covered by Medicare. With over 18% of the U.S. population covered by traditional Medicare plans and thousands more enrolling every day (10,000 per day in the US), understanding the gaps in Medicare coverage and making a plan to fill or manage those gaps is vital for long term financial stability and overall well-being. In addition, many people don’t realize traditional Medicare does not cover dental, vision or, hearing;  and, in most cases, Medicare does not pay for custodial care.

The Senate Democrats’ $3.5 trillion budget plan includes Medicare expansion to cover dental, vision, and hearing, while lowering the cost of prescription drugs for beneficiaries. This proposal, particularly provisions which would lower the cost of prescription drugs, is largely opposed by Senate Republicans, and will most likely be cut back from the initial proposal. While this legislative movement could mean extended coverage for Medicare beneficiaries, long-term care and custodial care coverage is not one of the services up for debate for inclusion in Medicare plans, and comes at a significant cost for aging adults – as well as family caregivers.

The cost of long-term home care is $54,000 on average annually, and this does not fully encompass the cost to families as aging adults need support with daily activities. Family caregivers (who are predominantly women) ages 50 and over often leave the workforce to care for parents or loved ones and these individuals lose over $300,000 in lost income and benefits. With these costs, in addition to Medicare deductibles and copays, having a plan to pay for the long-term care services you will need is necessary to aging on your own terms. While some individuals can afford the cost of care out-of-pocket, many opt for additional insurance plans to help fill coverage gaps. One great coverage option, available with your Aging at Home Association membership, is Home Care Secure, which provides a cash benefit to help you cover the costs of long-term care in the home when you need it.

The first step to managing the costs you will incur as you age is to understand your finances and current insurance coverage. Take advantage of the Aging at Home Association’s Total Well-Being assessment and get comprehensive feedback on the state of your life, health, and money. From here, you can work to improve your well-being in these three areas, and gain a better understanding of the gaps you will experience; what you can or cannot afford out of pocket; and what additional coverage might make sense for you. And, make sure you’re communicating with loved ones and those who may help support you as you age; talk about your goals for aging and how you can best achieve them. Once you feel you have a good understanding of your finances and a plan for long-term care and aging, consider what supplemental insurance you will want to help cover services such as long-term care, dental, vision, and hearing. And, make sure to take advantage of the resources, tools, and discounts available through your Aging at Home Association membership, all designed and provided to make your long-term care and aging goals a reality.