Dementia and Care Dollar$

Last week I wrote out the monthly checks to pay my mom’s care expenses. At these moments, I’m thankful that she was such a saver who planned wisely for the future. But I worry about family caregivers in my generation. We didn’t grow up with the same ethic about saving — and today almost every type of business has cut costs by shaving worker health benefits. How can we meet our own future health care costs?


Caregivers face a grim set of questions when they look at the financial landscape. There’s no telling how Medicare costs will change over the coming decades. Elected officials have health plans paid for by our tax dollars. Their solid health benefits insulate them from the reality of rising healthcare costs. According to the project of the Annenberg Public Policy Center, on average “the government pays 72 percent of the premiums for its workers, up to a maximum of 75 percent depending on the policy chosen.” They can select plans like the “Blue Cross and Blue Shield standard fee-for-service family plan [with] a total premium of $1,327.80 per month [for which they] would pay $430; or the Kaiser standard family plan [with] a total premium of $825.15 per month, of which the employee pays only $206.29.” Members of Congress qualify for other health benefits, too. They can receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee ($491 in 2007), or get care at military hospitals like Walter Reed Army Medical Center and National Naval Medical Center.

While Congressmen enjoy this deluxe menu of choices, Bruce Jaspen’s 2013 article in Forbes Magazine warns that, in the near future, the rest of us may be competing to get the any doctor’s attention once we enroll in Medicare.  In response to today’s federally-set low Medicare reimbursement rates “one in five physicians are restricting the number of Medicare patients in their practice and one in three primary care doctors – [those who are] keeping the cost of seniors’ care low – are restricting Medicare patients.”

Our future doctor shortage will be further complicated if we are collecting the same levels of benefits our elders now receive. The January/February 2013 AARP Bulletin estimates that the average annual out of pocket costs for Medicare are $3069.80. That total includes Part A for hospital stays, Part B for doctor’s visits, and Part D for drug coverage. But the figure doesn’t include the cost of pricey specialty drugs that have no generic counterpart. These are exactly the medications we’ll want  if we, like our elders, require dementia treatment.

Maybe this means that the best strategy for meeting our future health costs is to save more money. But one factor that never seems to enter into financial discussions is the income that many family caregivers forego so they can look after a loved one with dementia. On many occasions I have reduced my workload to make myself more available to help my mom. And I know there are thousands of other children and spouses out there who don’t collect overtime or seek promotions because more work would upset the care routine.

If there’s any good idea out there, it’s probably long-term care insurance. It was mom’s genius decision — one that has greatly eased her financial burden. The dementia epidemic has probably made some insurers cut benefits on future policies. But if you want more power to cover your future health costs, start doing research now to get yourself the best deal you can afford. Now that mom’s monthly bills are paid, I think I will use some of my “free” time to take my own advice.




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