40 msfocusmagazine.org If you are living with MS, it is important to beginplanningforthefutureasearlyaspossible. Becauseoftheprogressivenatureofthedisease, there may come a point when you need long- term care. Perhapsyou’ve discussed the matter with your family and made plans. But what if long-term care becomes needed for your aging parents or your spouse? What happens if you are unable to provide that care? Have plans been made in the event that they need long-term services as well? Planning for future care needs should involve the whole family. If you or a loved one is “middle class,” the single greatest threat to your family’s assets and independence is chronic or long-term illness like MS,Alzheimer’s, stroke, Parkinson’s, or lung disease. Unlike most heart attacks and cancers, these chronic diseases have long-term effects on your ability to dress, bathe, toilet, eat, andtransfer(getinandoutofabed,chair,orcar). At some point, a person with these conditions may need supervision or care from family, home health aides, assisted living, ora nursing home on a permanent basis – not just for a period of rehabilitation. But this care can be expensive. Nursing homes range in cost from $ 8,000 to $ 12,000 a month in urban areas.Assisted living facilities cost$ 2,000to$ 7,000amonth,andat-homeaides range in cost from a few hundred to $ 10,000 a month. These costs can be catastrophic to the middle class and drain their life savings within a couple of months. Will Medicare or insurance pay for my care? Many assume that Medicare or health insurance policy(s) will pay for help you need fromat-homeaides,assistedliving,oranursing home. They won’t. Unless you’ve specifically purchased long-term care insurance, all other insurances, including the militaryTri-care for Life, will not pay for this so-called “unskilled” or “custodial” care. In other words, if you don’t require a doctor, nurse, or therapist, it is not a service that is covered; these policies will not pay for someone to help you dress, bathe, feed, or toilet in a non medical setting. So Medicare and its various Advantage Plans and Supplemental or Medigap policies have what is called “short-term skilled care” coverage and will not pay for any care longer than about 100 days – whetheryou are in a nursing home, your personal residence, or anywhere else. Long-term care insurance can be difficult to come by, and expensive. Studies show that premiums for long-term care insurance can cost from $ 40,000 to $ 100,000 during a 20- year period. Unless you are healthy enough to be deemed insurable and can afford premiums for more than 20 years, a LTC policy is not always the most affordable way to finance care. If I am a veteran, will theVAPay for my care? Manyveteransandtheirfamiliesmistakenly believe the VA will pay for at-home health aides, assisted living, or nursing home care because they use VA doctors and get their prescriptions from the VA. Typically only service-connected disabled vets may be an exception, but not for his or her spouse. Not even Tri-Care for Life will pay for pure unskilled custodial care in a nursing home. Planning for Your Family’s Long-term Care By Mark Shalloway, Esq. Exclusive Content