Print

Email story

Comment

Email editor

Cost of extended care a shock

By STEPHEN NOHLGREN
Published December 14, 2006

ADVERTISEMENT [Times file photo] Rev. Cedric Cuthbert chats with 96-year-old parishioner Arether Burroughs in June while visiting her at the Heritage Park Health and Rehabilitation Center in Dade City.

Ruth Stewart got a whopping surprise when her husband, Richard, moved into a nursing home last year: a bill for more than $6,000 a month.

For decades, her husband, a former sales representative for General Motors, carefully deducted money from his paycheck so insurance would cover the costs if he ever needed "extended care."

But when the 83-year-old Largo man could no longer walk or bathe himself, his wife discovered that his extended care policy won't pay more than $1,000 a month in a nursing home - if it pays at all.

So far, Mrs. Stewart said Wednesday, she hasn't collected a dime because she is still haggling with General Motors over what the policy covers.

"And they are still taking $14 a month out of his pension check."

Stories like the Stewarts' are rampant, according to a study released Wednesday by AARP.

Americans are woefully unaware of the cost of care at a nursing home or assisted living home. Many people think they have insurance coverage when they do not.

"There are 9-million people over 65 who will need long-term care services this year. In 2020, an estimated 12-million people will need it," said AARP spokesman Steve Hahn. "Most Americans are unprepared to meet the financial challenge."

On average, nursing homes in America charge $6,266 a month or about $75,000 a year. That's also pretty typical for Florida.

AARP surveyed 1,456 people, aged 45 or older, and only one in 12 came within 20 percent of estimating the actual nursing home cost. Most guessed way too low, including people who thought $500 or $1,000 a month would do the trick.

Almost a third of respondents said they purchased "long-term care" insurance through work or through a private policy. Most said they felt financially prepared if they ever needed a nursing home, assisted living home or in-home nursing aide.

Unfortunately, Hahn said, that does not square with insurance industry numbers, which estimate that less than 10 percent of people 55 and older have true long-term care insurance.

Kevin Mort, administrator of Palm Garden of Largo nursing home, sees it all the time.

People think Medicare covers the first 100 days, when it usually covers far less, if it covers anything at all.

People think their Medicare supplement policies will pay the cost, but those policies pay only small amounts, in the narrowest of circumstances, and not for very long.

That's because Medicare and supplement policies cover only short-term "skilled" nursing care, like physical therapy for a few weeks after a stroke or broken hip.

Though almost all Florida nursing homes qualify as "skilled care facilities" under Florida licensing law, most of the people they serve, like Richard Stewart, need long-term "custodial" care - help with things like eating, bathing and medications.

Medicare does not pay for custodial care. Neither do Medicare supplement polices.

"When they come into a facility, they are completely overwhelmed by the situation they are dealing with," Mort said. "Their loved one was up and around and driving a car last week, or playing golf, and then had a stroke and can't communicate. They are devastated."

Very few insurance polices of any sort actually pay the bulk of the bills, he said.

"They think the policies are going to pay, or the government is going to pay, but that's not the way it works."

Ruth Stewart eventually found a lawyer who arranged the couple's finances so her husband could qualify in May for Medicaid, a government program for poor people.

She has pretty much abandoned her fight with GM over the $35 a day she thought his policy would provide.

"I don't know what the problem is," she said. "I got tired of arguing."

[Last modified December 14, 2006, 00:59:31]