RUNNING HEAD: Long Term Care 1

Long-term Care

Jassmine Bradley

University of Mary
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Long term care (LTC) services can be used by anyone of any age, disability, or

chronic illness; however, the elderly are the primary population in LTC facilities. With an

increase in life expectancy and increase in chronic illnesses, the number of people

needing LTC is expected to triple in the next thirty years (Yesaliz, 2013).

LTC involves a variety of services designated to meet a person’s health care

needs over a period of time. Defined by the U.S Department of Health (2017), LTC

services help people live independently when they can no longer perform everyday

activities on their own.

Nursing homes, home health care, assisted living and hospice care all focus on

treatment of chronic illnesses and disabilities. Although LTC facilities are meant for all

who need its services, the risk for need is increased with age. Other risk factors in the

elderly population include those who are single, poor lifestyle and exercise habits, and

women. Women are at higher risk mainly because of a longer life expectancy

(nia.nih.gov, 2017). The need for LTC has increased over the years; with a rise in

chronic illnesses due to the longer living baby boomer generation, the need for these

facilities is high.

Although the need for LTC is high, the cost of it may be out of reach for some.

According to the U.S. Department of Health (2017), in 2016 the national average for a

private room in a nursing home is $7,698 per month and $6,844 for a semi private room.

In an assisted living environment, services are more affordable at $3,628 per month.

For those who have more independency may pay for a home health aide for $20.50 per

hour, or spend $68 a day for an adult day care center. These prices may be affordable
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for healthier and wealthier beings; however, those in low-income demographics aren’t

able to afford it without LTC insurance.

LTC insurance is designed to cover long term services in a variety of settings.

Cost is based on: age, maximum amount policy will pay per day, and maximum number

of days per policy, but if you are in poor health you may not qualify for LTC insurance

(U.S. Department of Health and Human Services, 2017). LTC insurance premiums

average about $2,700 a year (Stark, 2018), which puts coverage out of reach for many

Americans. While LTC services in less expensive, Medicare does not pay for it, in fact,

100% of non-covered services is paid out-of-pocket (Medicare.gov). Medicare will only

pay for medical care provided in addition to LTC. For example, if a nursing home

resident suffers a heart attack, Medicare will pay for the treatment necessary for the

heart attack despite the fact that Medicare is not paying the monthly nursing home bill.

Medicare will also pay for physical therapy, occupational therapy, or other medical care

received in a skilled nursing facility, provided the patient meets certain criteria

(Medicareresources.org).

The technological advances in health care have aided in efficient treatments and

better health. Education and access to care have given Americans the luxury of a longer

and independent life. Unfortunately, a longer life is prone to chronic illnesses and

disabilities in some people. By 2020, more than 12 million elderly Americans are

expected to need LTC (Yesaliz, 2013). Those with low incomes may qualify for

Medicaid, a government assistance insurance program. Medicaid does cover LTC for

those who have exhausted their resources, however not everyone meet the

requirements for it. There needs to be better, more affordable options. For those who
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have low-income and don’t qualify for Medicaid, this a burdening issue. With high

insurance premiums and certain qualifications to receive government assistance, the

population of low income/poor health elderly Americans will go without necessary

services. More affordable options need to be set in place to ensure the growing

population of elderly Americans is covered.

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References

Long-term care definition. (2019, April 19). Retrieved from

https://www.medicareresources.org/glossary/long-term-care/

Stark, E. (2018, March 01). 5 Facts You Should Know About Long-Term Care

Insurance. Retrieved from https://www.aarp.org/caregiving/financial-legal/info-

2018/long-term-care-insurance-fd.html

U.S. Department of Health and Human Services. (2017, May 1). What Is Long-Term

Care? Retrieved from https://www.nia.nih.gov/health/what-long-term-care

U.S. Department of Health and Human Services. (2017, October 10). What is Long-term

Care Insurance? Retrieved from https://longtermcare.acl.gov/costs-how-to-

pay/what-is-long-term-care-insurance/

US Government Site for Medicare. (n.d.). Long Term Care Coverage. Retrieved from

https://www.medicare.gov/coverage/long-term-care

Yesalis, C., Politzer, R. M., & Holt, H. D. (2013). Fundamentals of U.S. Health Care:

Principles and Perspectives. Clifton Park, NY: Delmar, Cengage Learning.