I received and email from the SCAN Foundation with a list of “10 things you should know about aging with dignity and independence”.  The list is an eye-opener… and a real bummer.

Here are some of the very interesting points from the email which will make you think about your plans for getting old…. or make you want to join the Hemlock Society.

70 percent of us who reach the age of 65 will need some form of care or services for an average of three years.

Research shows that 43 percent of Americans over the age of 55 have less than $25,000 saved for retirement.

In 2011, nursing home care cost an average of $78,110 a year for a semi-private room.

Assistance at home, such as a visit from a home health aide, costs on average $21,840 a year.

Only short-term rehabilitative care at home or in a nursing home is covered by Medicare. [note: Long-term care is not covered by Medicare.]

Medicaid pays for about half of all nursing home or home care services. However, should you need care, the only way to qualify is to spend nearly all of your assets. The nest egg you’ve worked hard all your life to build must be spent to qualify for help.

In 2010, spending on supportive services for adults age 65 and older was estimated to be $182 billion, and projected to increase to $684 billion by 2050. Such projections threaten both state and federal budgets.

Today, over 12 million Americans rely on these services and supports, with 58 percent of those individuals over the age of 65.  By 2050, it is predicted that this number will more than double, with 27 million Americans relying upon long-term services and supports.

Less than 10 percent of adults actually have purchased a long term care insurance policy.  According to experts, few people purchase it because it is expensive, rates have historically increased rapidly, and potential buyers can be denied coverage due to pre-existing conditions.

Despite the recognition of a looming crisis in caring for aging Americans, little has been done in the past 40 years to address this problem and create a healthy network of supports and services allowing Americans to age with dignity in the place we call home.

The federal health reform law created a number of opportunities to help older people and adults with disabilities remain in their homes and communities. It includes programs to help states provide more in-home care to low-income adults in need and ways to help those living in nursing homes to return to their homes and communities.

This last statement refers to one part of the Affordable Care Act which is actually on its deathbed. The Community Living Assistance Services and Supports (CLASS) program was to be a voluntary long-term care insurance plan which working people could pay into through deductions from their paychecks.  The money would  go into a government trust and could be used by CLASS participants to pay for in-home help when they are old and infirm.  The idea is to get people to put money aside for their long-term care needs so they don’t end up in a state-supported nursing home.

Sorry for the bummer news.  Enjoy your day!

If a person is unhappy with their Medicare Advantage plan, there is a way to get out of it, and that is called the Medicare Advantage Disenrollment Period (MADP). The MADP runs from January 1 through February 14th. After that, most people are “locked into” their Advantage plan for the rest of the year. (See the exceptions to this rule below.)

During the MADP, a person enrolled in a Medicare Advantage plan (MA) may disenroll from that MA plan and return to Original Medicare.

During the MADP, people cannot switch to another MA plan. Their only option during this period is to go back to Original Medicare. Then they are eligible for a Special Election Period (SEP) to enroll in a stand-alone Part D plan (PDP).

Most people enrolled in Medicare Advantage plans are locked into their plans for the rest of 2012 – unless they take advantage of the MADP. But some people can change their Medicare Advantage plan – if they have certain chronic illnesses, or if they get help with their drug costs.

When someone who is already in a Medicare Advantage plan calls me for help, I ask if they have Diabetes, heart disease, or chronic breathing disorders such as asthma, COPD, and a few other conditions.  If they say “yes”, then they can take a look at one of the chronic illness plans.

I also ask people what they pay for their prescriptions. If they pay $2.60 for generics or $6.50 for brand drugs, I know they have the “LIS” (low income subsidy), and I know they have the option to change their Advantage plan at any time during the year.

Advice for people who are thinking about using the Medicare Advantage Disenrollment Period:  Make sure you can get a Medicare supplement when you drop your Medicare Advantage plan.  If you have health problems, you can be refused a Medicare supplement policy, and then you will have only Medicare. Medicare alone is not very good coverage – especially if you have a chronic illness, are diagnosed with cancer, or have a serious illness that requires surgery and/or a lengthy hospital stay. You will be responsible for 20% of your medical bills (beyond what Part A of Medicare covers) and that can add up to thousands of dollars with no end in sight.

Growth in U.S. Health Spending Remains Slow in 2010

U.S. health care spending experienced historically low rates of growth in 2009 and 2010, according to the annual report of national health expenditures (NHE). The low rate of growth means Americans got less health care than in previous years. The report notes that U.S. health care spending grew only 3.9 percent in 2010, reaching $2.6 trillion or $8,402 per person, just 0.1 percentage point faster than in 2009.

Should the Affordable Care Act (Obamacare) get credit for this slow growth?  Or is it that Americans, so many of them with lousy health insurance with high deductibles – or no health insurance – are afraid to go to the doctor? Nobody knows the answer to this question, but the slowing growth of health care expenditures is a good thing for government budgets and employer-based health insurance premiums.

Marilyn Tavenner, acting CMS administrator thinks the actions of the Obama administration should get some credit. “We have worked hard since the passage of the Affordable Care Act in 2010 to lower health care cost growth,” said  “We believe that the tools in health reform will help keep health care cost growth low while improving the value of care for consumers.”

Findings from the report include:

• Household health care spending equaled $725.5 billion in 2010 and represented 28 percent of total health spending, slightly lower than its 29 percent share in 2007.
• Growth in total private health insurance premiums slowed in 2010 to 2.4 percent from 2.6 percent in 2009, continuing a slowdown that began in 2003.

• Retail prescription drug spending (10 percent of total health care spending) grew only 1.2 percent to $259.1 billion in 2010, a substantial slowdown from 5.1-percent growth in 2009 and the slowest rate of growth for prescription drug spending recorded in the NHE.

• The federal government financed 29 percent of the nation’s health care spending in 2010, an increase of six percentage points from its share in 2007 of 23 percent, and reached $742.7 billion. Part of that increase came from enhanced Federal matching funds for State Medicaid programs under the American Recovery & Reinvestment Act which expired in 2011.  Medicare spending grew 5.0 percent in 2010, a deceleration from growth of 7.0 percent in 2009.

• Medicaid spending increased 7.2 percent in 2010, slowing from 8.9-percent growth in 2009.

• The state and local government share of total health spending declined from 18 percent in 2007 to 16 percent in 2010 and totaled $421.1 billion, in part due to the temporary assistance in the Recovery Act.

• Hospital spending, which accounted for roughly 30 percent of total health care spending, grew 4.9 percent to $814.0 billion in 2010, compared to growth of 6.4 percent in 2009.

• Private businesses financed $534.5 billion, or 21 percent of total health spending in 2010, down from a 23-percent share in 2007.

Information in this report can be accessed at the following web location:

http://www.cms.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp#TopOfPage