5 LTCI selling points from that new Medicare cost study

For Medicare enrollees who lived in a nursing home or other long-term care facility in 2010, out-of-pocket dental care costs accounted for an average of less than $175 in out-of-pocket spending – and less than 1 percent of total out-of-pocket spending.

One possibility is that caregivers may stop paying much attention to the oral health of people who are already frail enough to be living in a nursing home. Another possibility is that lack of attention to oral health caused or aggravated the conditions that led to a need for nursing home care in the first place.

One clue: Medicare enrollees who were in excellent health in 2010 spent much more out-of-pocket on dental care than enrollees in poor health. The average level of dental spending was $538 for the enrollees in excellent health and just $111 for enrollees in poor health.

In Kansas, for example, researchers found that only 16 percent of nursing home residents surveyed had dental insurance, and 29 percent said they were getting no dental care at all. 

One lesson for post-retirement health planning clients is that brushing teeth, flossing, getting regular dental care, and paying for a dental insurance policy or a solid dental services discount program are as critical as paying the Medicare Part A premiums.

A second lesson is that one reason for clients to have private long-term care financing arrangements – and well-chosen, well-briefed care managers – is to increase the odds that the clients will get proper care for their teeth and gums in their later years.

See also: LTCI Watch: The Teeth.

4. People who have $20,000 to $30,000 in annual income may have an above-average need for LTCI and other insurance products, because, in the past, at least, those people have experienced above-average growth in out-of-pocket health care services costs.

Between 2000 and 2010, for example, Medicare enrollees spent somewhat more on health insurance premiums and used that spending to hold their increase in out-of-pocket health care services spending to 39 percent, to $2,692. People with incomes in the $20,000 to $30,000 invested less in insurance, and their out-of-pocket costs increased an average of 51 percent, to $3,060.

See also: Middle-income boomers aware of new retirement landscape.

5. The current gaps in what Medicare covers are unlikely to shrink any time soon.

Well-meaning, high-powered commissions have been talking about what the country should do about LTC costs. The Commission on Long-Term Care did what it could to get past congressional gridlock and remind lawmakers that both Democrats and Republicans get old. The Council on Alzheimer’s Research, Care and Services continues to meet regularly and talk about matters such as how nice it would be if someone collected better data on caregivers.

The Alzheimer’s council seems to be talking more about how to get family caregivers enough training and support that they don’t burn out than about any serious hope of squeezing more money for caregiving out of Congress.

Most of the people who are in Medicare and use long-term care (LTC) services today are part of the relatively small “Greatest Generation” or the “Silent Generation,” not the Baby Boom generation. The Greatest Generation and Silent Generation members who are in nursing homes now reached their prime at a time when the economy was strong and employer pension promises were generous.

But the Kaiser analysts still found that people ages 85 and up –  who have enjoyed the benefits of growing up and aging in such a prosperous era — still have to pay an average of $8,191 per year on out-of-pocket on health care costs

Consumers who want to plan for future health care bills would be wise to count on needing deep pockets.