By Bo Carr
There is much discussion about healthcare nationally and regionally as questions surround the future of the Affordable Care Act (Obama-care), state expansion of Medicaid, strategies to solve the opioid crisis, and the shuttering of area hospitals. But December 31, 2017 marked the end of a benefit for state employees, leaving educators, in particular, uncovered and with few options.
Most teachers do not realize that Medicare and other major medical insurance policies do not cover the custodial care most seniors will require, like home health care, respite care, adult day care, assisted living, nursing home, or hospice care. Tennessee’s Dave Ramsey writes in his blog, “As people age or become ill, they sometimes need help doing daily tasks like getting dressed, bathing and more. Long-term care (LTC) provides people with those services—but it’s expensive. According to the Alzheimer’s Association, the estimated cost for end-of-life care in 2016 ranged between $217,820 and $341,651. Most health and disability insurances won’t cover long-term care, but long-term care insurance will.”
Teachers accessing the state’s 2018 health benefits website, partnersforhealthtn.gov, will find group insurance plans like major medical, dental, and disability. Long Term Care, which was once an affordable, accessible plan available to public service employees, is now absent from the list. Though most of us like to think we will never need these benefits (not many healthy middle-aged adults look forward to moving into assisted living or nursing home situations), the fact is that the great majority of us will require some type of Long Term Care before we die.
According to a 2016 US Department of Health and Human Services study, 70% of the population over the age of 65 will need some sort of custodial care, while currently only 8% are enrolled in an insurance program to protect their assets. Most educators are “stuck in the middle,” with too little savings to foot the bill and too many assets for government programs like Medicaid.
Educators start their careers assured of two things: they will have great health benefits throughout their careers, and they will receive a lifetime pension upon retirement. In Tennessee, both of these are true. Educators’ major medical plans take care of most costs at the doctor and hospital, and for prescription drugs. Most analysis ranks Tennessee’s pension fund as one of the best in the United States. In 2013, ThinkAdvisor slotted Tennessee educators in the number six best situation for retirement.
Professional Educators of Tennessee executive director, JC Bowman, commented, “Many educators spend more time in retirement than in the classroom. Our association is committed to providing the very best programs and resources to ensure educators are protected financially throughout their career and beyond. Our members rely on us to research and stay abreast of the changing landscape of healthcare in Tennessee.”
Most educators are women, so consider a simple narrative of a newly retired teacher and her husband who enjoy travel, have their home paid off, and spend time with grandkids– until a health issue occurs. In the event that the husband has an illness or accident that requires custodial care, the wife cares for him until he passes away. When long term care is needed by the wife, a retired teacher in this scenario, she is left with too little money to pay for quality care out of pocket, but with too many assets to qualify for government programs. Though many middle class Tennesseans could benefit from Long Term Care insurance, teachers are uniquely at risk for losing nearly everything they have worked for and still coming up short for the care they require.
The above-mentioned US Department of Health and Human Resources study also points out that women have a greater chance of using long term care services. Women tend to use those services for a longer period of time. And it is no surprise that the great majority of teachers in Tennessee are women.
The cost of care can vary from about $20 an hour for home care to over $100,000 a year for a private room in a Nashville nursing home. According the Genworth’s 2017 Cost of Care Survey, average costs for nursing home care statewide is currently about $80,000 a year and is projected to climb to over $120,000 in 15 years. As baby boomers age, at-home care, assisted living, nursing home care, and hospice will see its largest spike over the next two decades.
Last summer, AARP ranked Tennessee at the bottom of the list for long term care, meaning the current long term care services system in our state is already inadequate. With fewer insurance companies offering traditional long term care coverage, increasingly stringent health requirements, and expensive premiums, long term care insurance can be out of reach for Tennessee teachers. Therefore, the removal of this important state employee benefit leaves Tennessee educators with even fewer options.
Tennessee educators will need to rely more than ever on their professional associations for help. For example, Professional Educators of Tennessee has endorsed a number of solutions including home health care programs, life insurance with LTC riders, as well as traditional long term care insurance for their members. Small reasonable enrollment fees may be nominal barriers to gain access to the help many Tennessee educators are going to need in coming years.
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Bo Carr is the Member Benefits Coordinator for Professional Educators of Tennessee. Professional Educators of Tennessee is a non-partisan teacher association headquartered in Nashville, Tennessee. Permission to reprint in whole or in part is hereby granted, provided that the author and the association are properly cited. For more information about the benefits available to current and retired educators in the state of Tennessee, please call 615-778-0803 Extension 110 or email [email protected]