In one form or another, there's a very good chance that members and their families will need LTC. According to insurance industry statistics, LTC at home affects almost 72% of individuals age 65 or over while over 48% of the same group will eventually be affected by LTC in a nursing home.

With LTC, there is the inevitable, and unpopular, question of cost. According to the federal Health Care Financing Administration, the average annual cost of nursing home care in 1997 was $46,000. They also found that the average annual cost for nursing care at home (6 hours weekly) was $19,300, while a home health aide, helping in daily activities at the same time, would cost about $10,600 annually.

"Unfortunately, LTC coverage under Medicare and supplement plans is limited at best," comments Insurance Coordinator Cheryl Stillman. "When members pay for such care, they will undoubtedly rely upon their own funds and then, after practically exhausting (spending down) their resources, apply for Medicaid benefits.

"As it stands right now, we should not anticipate any improvement in long term care under Medicare. Some members have turned to long term care insurance as a solution."

LTC Insurance

LTC Study By State Officials

While the feds have shown little interest in LTC coverage under Medicare, the President and Congress have enacted H.R. 4040 which authorizes an LTC insurance program for federal employees and annuitants. H.R. 4040 requires the federal Office of Personnel Management (OPM) to develop and establish the LTC program over an 18 month period.

According to the National Association of Retired Federal Employees (NARFE), the program will be "based on the 'best practices' used by private-sector firms who offer group long-term care insurance to their employees." It's expected the OPM can exercise its clout to obtain better premiums and coverage for federal workers and retirees than they could obtain on their own.

"When the current legislative session began (January 1999), I believed strongly that it was time to take a hard look at long term care in the Commonwealth," states Senator Richard Moore (D-Uxbridge) who has sponsored several Association bills in the past and now co-chairs the Health Care Committee. "I introduced S1272 for that very reason."

S1272 requires the Group Insurance Commission to conduct a feasibility study of a long-term care benefits program for state employees. The study was included in the Senate version of last fiscal year's budget (fiscal 2000), but was not in the final budget signed by the Governor last November. Currently, the bill remains in the Senate Ways and Means Committee.

Senator Moore's concern over the future of long term care is shared by other legislators and state officials who have participated in a working task force known as the Vision 2020 Task Force. For several months, this group has been looking at long range problems and possible solutions relating to the long term care needs of ever-growing elder population.

As part of its work, Vision 2020 held a public forum on long term care this summer. During the proceedings, the task force heard from health care academics, providers and advocates on the issue.

According to the Association's Legislative Chairman Bill Hill, "We're now working on several critical health care issues, including the implementation of the retiree dental insurance program and the prescription drug controversy. We applaud the work of Senator Moore and the task force on this important issue and look forward to seeing what results from last summer's forum."

Editor's Note: If you're interested in LTC, please contact our Insurance Coordinator Cheryl Stillman.