Published in Pawtucket Times on December 31, 2001

Are you a savvy shopper for services that you might one day need to purchase?

Many Americans are especially savvy when they purchase cars, electronic equipment or clothing.  But most are not when it comes to their knowledge of purchasing needed long-term care services, says a report recently released by AARP.

More than half (60 percent) of aging baby boomers age 45 plus say they are at least “somewhat familiar” with long-term care services currently available. However, they are woefully uninformed about the costs of, and funding sources for, long-term care services.

Yet with the graying of America’s population, the need for these services is expected to increase in the upcoming years. According to the 2000 U.S. Census Bureau projections, today’s 65 or older population numbers are expected to double to about 70 million in 2030, and the 85 and older population will also nearly double to about 8.5 million.  Those 85 years and older will be in the greatest need for nursing facility care.

“With the onset of the aging demographic revolution, essential that the general public not only learn about the long-term care options but understand their costs, and begin planning for their future care requirements,” said AARP CEO Bill Novelli. “Unfortunately, most of us pay little attention to the cost of such care until we or our loved ones needed it.  AARP sees  our role as informing and assisting people to make good choices.”

The AARP telephone survey asked a random sample of 1,800 Americans ages 45 and older questions  designed to measure their knowledge and understanding of the continuum of long-term care services, ranging from in-home care, assisted living to nursing home care.  In addition, to the national survey, five state-specific surveys were conducted with a random sample of 400 people age 45 and over in California, Florida, New Mexico, Washington and Wisconsin.

The survey findings suggested that aging baby boomers and seniors are generally not familiar or knowledgeable about the costs of long-term care services.  Only 15 percent could identify the cost of nursing  home care within plus or minus 20 percent of the national average of cost (about $ 4,654 per month).  Even 24 percent of those participating in the survey admitted that they did not even know the cost. And that’s not all – 51 percent estimated the cost too l ow.  So much for those savvy shoppers.

As for assisted-living facilities, one in four (27 percent) were able to come within a plus or minus 20 percent of the estimated median cost of care in an assisted-living facility while 38 percent said they did not know the national estimated median cost for assisted living per month, ranging from $ 2,000 and 2,500.

Meanwhile, survey participants continued to reveal their lack of knowledge by being generally unaware of how much an in-home visit from a skilled  nurse or aide costs.  The average Medicare reimbursement is $ 109 per a skilled nurse visit and $ 64 for a home visit by an aide.  The survey findings reported that they gave a wide range of answers, with no real consensus.  Thirty three percent even admitted they did not know the cost.

So, what about the aging baby boomers knowledge of long-term care insurance, one viable option to pay for the cost of long-term care services? About 31 percent said they have insurance that covers the cost of long-term care, when they probably didn’t.  Maybe it’s time for people to read the very small print in their insurance policies.  The Washington, D.C.-based Health Insurance Association of America estimates that only about 6 percent of Americas purchased such insurance.

Additionally, the survey respondents who said that they had insurance coverage for long-term care services were more likely to say they feel better prepared to meet the financial challenges of paying for care than those who say they do not have coverage (7 percent versus 39 percent).  This finding suggests that people who say that they long term care coverage when they do not may have a false sense of financial preparedness.

According to the new study, there is also a discrepancy between what people think Medicare and Medigap cover and what they actually cover.  More than half (55 percent), including those who say they are “very familiar” with long term care (58 percent), believe Medicare covers long-term nursing home stays.  And nearly a quarter say they would rely on Medicare to pay for such stays.  This is not the case.  Medicare does not cover long-term care nursing home stays.

The survey noted that 41 percent thought Medicare also covered assisted living care and more than 34 percent know whether it does or does not.  Medicare does not pay for assisted living.  And 57 percent correctly said that Medicare covers the cost of in-home visits from a skilled nurse. However, many respondents did not understand the difference between a home visit from a skilled nurse and a home visit by a home health aide.

More than half (52 percent) thought Medicare covers aide visits. In fact, Medicare covers only home health aide services for care that is medically necessary, not custodial care.

Kathleen S. Connell, AARP State Director, notes that this research study highlights the big gap between consumers understanding of long-term care services and its associated costs.  She adds that the findings reveal a great deal of confusion as to what long term care services are covered by Medicare and Medicaid.

“Aging baby boomers are now facing decisions regarding the purchase of long-term care services for their older parents. They will also be forced to deal with their need for services as they age and as longevity increases,” Connell says. “Consumers need to be come better informed about what Medicare and Medicaid pays for available long term care options for services that are actual costs of care.  They need to investigate different long term care insurance options, too,” she urges.

In Rhode Island there is a general recognition in agencies assisting seniors of the need for educating consumers and putting information into the hands of people who need it, Connell notes, adding that information specialists are available in local senior centers to assist in this effort.

Don’t wait until a sudden health crisis forces you to shop around for long-term care services.  Start today Become a savvy shopper by increasing your knowledge and understanding of different long-term care service options and  their associated costs.  Learn more about government financing programs, specifically Medicare and Medicaid, and private senior financing with long-term care insurance and Medigap policies.