Texas Announces Plans to Combine Medicare and Medicaid Benefits

For people who receive both Medicare and Medicaid benefits from the state of Texas, things might be getting a whole lot easier. The state of Texas just received approval from the federal government to test an idea that would combine the delivery of Medicare and Medicaid benefits to individuals enrolled in both programs.

Why the Change?

Officials say that the combination of the two services could help make it simpler for enrollees to receive their benefits while also potentially reducing costs for both the state and federal governments.

“Combining a person’s Medicaid and Medicare services into one plan makes sense for the consumer and for the taxpayer,” said Chris Traylor, chief deputy commissioner of the Texas Health and Human Services Commission. “We’ll be able to improve the coordination of care, helping people get the right care in the right setting, and we can save money for both the state and federal governments.”

Right now, Medicare pays for the covered services and then Medicaid picks up the rest of the tab afterwards. By merging the benefit services, it could help coordinate communication between the different programs and encourage better management of care that serves both programs, instead of only financially benefitting one. The new idea could help save money because combining the two services would increase the incentive to support policies that reduce the need for hospitalization, thereby cutting back on inpatient hospital stays and institutional care.

Who is Eligible?

400,000 people living in Texas are currently receiving benefits from both Medicare and Medicaid. Those people are eligible for Medicare based on either their age or disability and simultaneously eligible for Medicaid because of their income status. People enrolled in both programs are referred to as “dual eligibles”.

The program will be piloted in 6 Texas counties that include 168,000 of the dual eligible Texans. In order to enroll in the pilot program, you must be at least 21 years of age. The pilot will begin on March 1, 2015 and information will be sent out to eligible residents in January of next year.

For those who are dual eligible, the long term care expenses that Medicare doesn’t cover are picked up by Medicaid. For those who only qualify for Medicare (and therefore will not be included in this new program), it’s important to remember that despite your age, Medicare does not cover all of your health care expenses. There are many different kinds of out of pocket expenses that Medicare will not pay for, including long term care, which can be extremely expensive. Read more details about the upcoming program here.

To learn more about the cost of long term care in Texas, click here.

Harvard Report Addresses Caregiver Burden Amidst Rise in Long Term Care

Unpaid care is the main source of long term care in the United States and with an increasing need for care comes an increasing burden on caregivers. A recent Harvard report tackles the issue of caregiver burden and its potential effects.

Long Term Caregivers

According to the report, an estimated 43.5 million friends and family are currently acting as unpaid caregivers for their loved ones. Although the majority of Americans aren’t prepared for the risk of becoming or needing a caregiver, an estimated 7 in 10 seniors will need long term care at some point. 9 in 10 of those that receive long term care receive it from a friend or family member and most long term care takes place at home.

When it comes to unpaid care giving, there is often some sort of burden involved. The objectives of the report, which was published in the Journal of the American Medical Association last month, were to outline the epidemiology of caregiver burden and provide strategies for physicians to help those with caregiver burden.


The study published in JAMA found that most caregivers are women who spend between 20 and 40 hours every week providing care. Women are more likely to be caregivers because they have longer life expectancies, meaning they are more likely to be around to provide care when their spouse or partner needs it. 20% of all caregivers spend more than 40 hours each week providing care to a friend or family member. Though this time spent providing care takes some physical and emotional tolls on the caregiver, the report noted caregiver burden is often overlooked by clinicians.

When providing long term care to a loved one, many different effects occur in the caregiver’s life. Common ones include physical or emotional exhaustion, financial troubles, missing work, and becoming socially isolated. The Harvard study found that 32% of caregivers have high caregiver burden, which can often manifest itself by way of depression, social isolation, illness, and financial problems. The authors of the study recommend that in addition to checking the health of the patient during a clinic visit, physicians should also check the caregiver’s health.

“Most physicians haven’t been trained to ask patients about it, and it’s a new clinical habit that you have to consciously adopt and work on,” says geriatrician Dr. Anne Fabiny, medical editor of Caregiver’s Handbook, a Special Health Report from Harvard Medical School.

Assessing Caregiver Burden

Ways to assess the health of the caregiver is asking how they are coping with the responsibility of being a caregiver, how they would describe their quality of life, how often they get out and engage in social activity, and other similar questions. The answers clinicians receive can help them direct the caregiver to resources that can provide help or temporary respite when necessary.

The average dementia patient receives unpaid care valued at $56,290  from friends and family members each year. As the need for long term care grows across the nation, the number of available caregivers continues to shrink.

An AARP report found that the ratio of available caregivers to long term care recipient is estimated to drop to 4:1 in 2030, down from 7:1 in 2010. This coupled with the fact that the number of Americans aged 85 and older will double between 2000 and 2030 means planning for long term care must become a priority before it becomes an overwhelming financial problem for the nation.

Long Term Care Insurance can help those with assets hedge their risk of needing care and protect their nest egg from the growing cost of care. Long Term Care Insurance isn’t right for every one, but it is often right for those with retirement savings not meant to be spent on health care.

Read more about planning for long term care or if you are interested in learning more about the cost of a policy, request a free quote today.

Saving for Retirement Means Prioritizing

The retirement crisis in the United States is all over the news, but most people still haven’t saved enough to support themselves throughout retirement.

Key to a Secure Retirement

We all want a happy, stress-free retirement, but how do we go about attaining that? Many people, especially in current economic times, believe that limited income dissolves the ability to adequately save for retirement. However, with careful planning, anyone can put money towards their retirement and end up with a lump sum over time. One man from Georgia told his story to the Daily Finance and is helping bring a new perspective to retirement planning.

Danny is a 38-year-old teacher who, with his wife and two daughters, lives on a teacher’s salary of approximately $41,000 annually. The couple has already managed to save $60,000 for retirement, no small feat on such a small income. His number one tip is simple: prioritize.

In Danny’s words, “most people don’t have an income problem — it’s an outgo problem”. It’s easy to get wrapped up in products and services that you think you absolutely need now while ignoring the bigger costs that are waiting down the road. Avoiding this trap is the key to saving successfully for retirement and having enough assets to your name to live comfortably when the time comes to stop working.

Health Care Costs 

Unfortunately, despite your best efforts, your retirement nest egg might not be quite ready for unexpected medical expenses. No matter how much you plan, there is always a chance that a catastrophic event could empty your savings in a matter of months.

A recent study estimated that the average 65-year-old couple retiring in 2013 will need $220,000 for out of pocket health care expenses during retirement. That’s not the end of it either: that estimate doesn’t include the skyrocketing cost of long-term care, something that affects 1 in 2 Americans. As we get older, insurance coverage for this type of medical emergency becomes even more important.

Insure Against the Risk

Long-term care is care that someone needs when they are either injured, ill, or unable to perform activities of daily living on their own. The cost of care varies greatly, but in-home care, the least expensive option, still averages nearly $30,000 a year. Assisted living facilities are pricier at more than $40,000. A private room in a nursing home will run you a shocking $94,000, on average, in the United States.

This is more than just some petty cash – these costs amount to a massive chunk of money, which most people aren’t prepared to dish out during retirement when they are already living on a fixed income.

Long-term care insurance provides coverage for this type of care should you ever need it, and eases the worry that you will be flooded with medical bills. Though a small percentage of Americans have this kind of insurance, more are beginning to recognize the benefits and understand the massive amounts of money that a policy can save you at a time when you are most vulnerable.

Interested in learning more? Read more about long term care insurance.

Need a quote? Request a personalized comparison of the top policies now.

Long Term Care Insurance Helps Texans Remain in Their Homes

A recent report ranked Texas as the state with the worst nursing homes in the country, causing people all across the state to rally in support of improving the many long term care facilities in the Lone Star State.

As many people fight to find quality nursing homes and improve the standard of care statewide, others are turning to different solutions to receive their long term care.

Home Sweet Home 

Long term care brings about a lot of changes, physically and emotionally. Whether you need care from a recent surgery, a fall, stroke, or Alzheimer’s or another form of dementia, transitioning into long term care can be stressful. Moving into a facility can add to this stress if the patient is reluctant to leave the comfort of the home they have lived in for years.

Fortunately, nursing homes and assisted living facilities aren’t the only care setting available for long term care patients. In-home care has become increasingly popular over the years, for obvious reasons. Receiving care in your own home retains a sense of normalcy that moving into a facility typically can disrupt. Rather than completely changing your life, you can stay where you are happiest and feel most at ease.

There’s no denying the cost of long term care in Texas is exceedingly expensive, and the majority of people can’t afford to pay out-of-pocket. According to Genworth, one of the top long term care insurance providers, the median cost of in-home care in Texas is $41,184 annually. Even 1 year of care can substantially impact your retirement savings and leave you in financial disarray. Long term care insurance provides a way to safeguard against this risk by protecting your assets from the cost of care and providing the option of in-home care.

Facing the Cost of Care

While none of us really know if we will ever need long term care or not, the fact is, the risk of financial fallout associated with the cost of care is too severe to ignore. This fact has become more apparent to the Baby Boomer population, many of whom are currently dealing with the care of their aging parents.

An important key to purchasing this type of insurance is buying the right amount of coverage at the right time. Applying for a policy when you are in your 40s or 50s will help you save a substantial amount of money compared to if you wait to apply until your 60s. This is because age and health both play a large role in what premium rate you are assigned. Texans in good health are likely to qualify for a discount from the top companies.

Long term care insurance policies from the top companies typically offer the option of in-home health care, instead of facility care. This care, which is substantially cheaper than facility care, can help you avoid exhausting your policy as quickly and keep you happier during your time of care. Some companies even offer home modifications and installation of emergency response systems to keep you as safe as possible in your home environment.

Be sure to work with an independent agent who has experience with the top providers and can help you determine whether or not your chosen policy offers in-home care. If you are interested in learning more about a policy, request a quote and we will contact you shortly.

Medicare Won’t Pay for Long Term Care

Most of us know someone who has needed long-term care services at one point or another. Whether it was a grandparent, friend, or simply an acquaintance, it isn’t hard to recognize that long-term care often has emotionally and financially devastating effects on families.

Too often, people assume that Medicare will pay for their long term care if something ever happens. When a real medical emergency arises, they find themselves scrambling to find a new plan after being told the truth: Medicare won’t pay for long-term care.

Preparing for the Cost

Americans are living longer and healthier lives, so more of us need care in our old age than in past generations, when life expectancy was much shorter and the standard of care was much lower. These days, people want and expect high-quality care, so creating a long-term care plan is essential to ensuring you receive the type of care you prefer.

The cost of long term care in Texas just about aligns with the national average, if not a bit lower, but it’s still far from affordable. In Texas, the median cost of a private room in a nursing home is more than $5,200 a month. Assisted living facilities in Texas are less expensive, but can still add up quickly, at a median monthly cost of more than $3,300.

Even just a few months of care in a facility can substantially reduce your retirement savings, which is why establishing a plan ahead of time is such a smart move.

Long Term Care Insurance Can Help 

Many people think that long term care won’t ever happen to them, but something as simple as a fall can lead to the need for long term care, even if just for a few weeks or months. Preparing a method to pay for any such care helps reduce the stress and confusion that arises from trying to coordinate delivery of services.

Long term care insurance has provided millions of Americans with protection from the high cost of care, helping them shield their assets and have peace of mind that they will receive high quality care.

Long term care insurance policies help pay for the cost of care in a nursing home, assisted living facility, or even at home if the policy allows it. Though some companies have raised rates lately to align with the increasing health care costs, the price of premiums is still extremely low when compared to the cost of care.

If you are in good health, you can get a substantial discount on your rates. There are several top-rated companies that insure Texans and have excellent reputations in terms of claim payments. Read more about long term care in Texas or request a quote today.

UT Dallas Study Shows Brain Training Can Improve Cognitive Health

New research from the University of Texas at Dallas shows that brain training can improve cognitive health and even reverse cognitive decline.

Enhanced Brain Functions

In a recent study, scientists put patients in complex “directed brain training” for 1 hour a week for 12 weeks. What they saw was significant changes in three specific brain functions:

– an increase in global and regional cerebral blood flow

– greater synchrony in important brain networks

– increased white matter integrity (wiring in brain that helps information travel)

As we age, our brain function declines and we lose specific skills, such as memory, attention span, and the ability to reason. Patients in the study displayed improvements in two cognitive domains after the mental activity: strategic reasoning and the ability to abstract concepts.

“Greater levels of brain blood flow are associated with higher cognitive performance,” Dr. Sandra Bond Chapman, founder and chief director of the Center for BrainHealth, said in a University press release. “With upwards of 8 percent increase in brain blood flow, this research shows that participants are regaining measurable brain health.”

Lasting Effects 

A follow-up test conducted 1 year later confirmed that the enhanced cognitive abilities remained, proof that the results were not merely a short term effect of the training. Because dementia ranks as the number one cause of long-term care in the United States, affecting more than 5 million Americans, research continues to surge in nearly every related area. Studies on brain health have slightly shifted focus in recent years, from searching for a cure towards identifying preventative measures, like this complex targeted training.

The research was funded by several different groups: the National Institute on Aging at the National Institutes of Health, the T. Boone Pickens Foundation, the Lyda Hill Foundation and the Dee Wyly Distinguished University Endowment. The researchers attributed the ability to conduct this type of study to advancements in imaging technology.

Dr. Chapman and Dee Wyly, Distinguished University Chair, explained the implications of the study: “Until recently, cognitive decline in healthy adults was viewed as an inevitable consequence of aging. This research shows that neuroplasticity can be harnessed to enhance brain performance and provides hope for individuals to improve their own mental capacity and cognitive brain health by habitually exercising higher-order thinking strategies no matter their age.”

Risk of Dementia

Alzheimer’s and other forms of dementia pose a large risk to many, especially those with a family history. A recent report found that the number of Alzheimer’s cases in Texas is expected to triple by 2050, so planning for this potentially devastating situation can help save you from financial stress in the future, which can help reduce the associated emotional toll.

Remaining mentally and socially engaged are key to helping your brain stay active and healthy. Exercise and proper nutrition can also help prevent dementia, according to research. Read more about how to protect yourself from the risk that long-term care poses.

Texas Ranks Worst in Nation for Nursing Home Quality of Care

Families for Better Care, a Florida-based nursing home resident advocacy group, recently released a report detailing the quality of nursing homes across the nation.

The report found that nursing homes in the US aren’t up to the standards they should be, and for a lot of states like Texas, it’s much worse than that.

Texas Receives Failing Grade

The group touted the study as the first of its kind, a state-by-state nursing home report card. The study was based on eight federal measures, including facility deficiencies, staffing hours, health inspections, and verified ombudsman complaints. Texas received an F and was the only state to receive a failing grade in 6 of the 8 measures.

Brian Lee, the group’s executive director said “Texas epitomizes what’s dreadfully wrong with nursing home care and oversight in America.”

“It seems skeleton crews are working the hallways of Texas nursing homes,” said Lee.  “With so few staff to care for residents, it’s not surprising that less than 20 percent of Texas nursing homes scored above average inspection ratings and almost 95 percent were cited one or more deficiencies.”

Ombusman Complaints Verified

Ombudsmen are volunteers who act as advocates and representatives for residents in long term care facilities. Ombudsmen work to ensure the patients and residents at these facilities receive quality care and respect in a dignified, appropriate setting. When a complaint is made, ombudsmen are tasked with identifying, investigating, and helping to resolve the complaint.

According to the recent report, Texas ombudsmen verified 92.19% of the registered complaints, ranking 44th in the nation.

Nationwide Problem

To gather the data for the report, Families for Better Care utilized staffing data compiled by the Kaiser Health Foundation, performance measures from the Center for Medicare and Medicaid Services’ Nursing Home Compare, and the Office of State Long-Term Care Ombudsman complaint data.

Texas was far from the only state with obvious issues: close to 90% of all nursing homes were cited as having a deficiency. Another disturbing statistic is that 96% of states offered residents fewer than three hours of direct resident care per day. Given that lack of social interaction has a profound effect on the rapidness of mental decline, these numbers highlight yet again the massive need for caregivers that our country is experiencing.

Unfortunately, a number of these nursing homes lack substantial funding. Texas, especially, suffers in the area of long term care due to the fact that the state has the lowest Medicaid reimbursement rate in the nation.

Preparing for a long term care situation far in advance can give you the time to research facilities and know your options. Long term care insurance can help you hedge your financial risk from the cost of long term care and provide a safeguard for your nest egg, should you ever need care. Even minimal coverage can help save significant money down the road, and if you work with an independent agent, you can get a plan from a solid company for an affordable rate.

Fill out the quote request form if you are interested in learning more about long term care insurance and we will be in touch with you shortly.

Ombudsman Programs Help Long Term Care Residents

When the time comes for someone to need long term care, it is typically because they are unable to perform some daily tasks on their own. Bathing, dressing, cooking, food preparation, and getting around with ease are some of the activities that people are likely to need help with when they are in a long term care setting.

Nursing Homes

For those individuals who need more supervised care, nursing homes are often the choice. Medical assistance is provided more readily at nursing homes, so the patients tend to be more incapacitated, either mentally or physically, than those living at assisted living facilities or receiving long term care at home.

This unique situation of need leads to a great deal of vulnerability for these seniors receiving care. Many whom do not have family or whose family lives across the country spend their days without someone checking in on them to be sure everything is alright. Unfortunately, this leaves many opportunities open for neglect and sometimes even elder abuse.

In order to reduce elder abuse and nursing home neglect as much as possible, programs have been created that designate advocates for nursing home residents who might otherwise be unable to speak up for themselves.


The Long Term Care Ombudsman program was started in 1978 and provide advocates for nursing home residents. These ombudsman volunteers spend time in long term care facilities working with patients to best understand their situations and needs.

The volunteers understand what works best for nursing home patients and help advocate for quality care and life in long term care settings.

Ombudsmans are responsible for identifying, investigating, and resolving any complaints made in nursing homes. This means they are often the people that nursing home residents rely on in a time of need, when they feel they have no one else. This program is invaluable to those elderly residents who might otherwise be without a voice in the situation.

Texas Program

The Texas long term care ombudsman program is part of the Texas Department of Aging and Disability Services.

The Texas Long Term Care Partnership Plan helps provide Texans with long term care insurance that is tax-deductible and qualifies for a Medicaid spend down waiver should you ever exhaust your long term care policy.

Plan ahead for the future and the possibility that you might need care at home or in a nursing home one day. Read more about long term care in Texas.