Does Self-directed Long-Term Care Make Sense to You?

By John F. Wasik, Next Avenue Contributor

“Think of how much energy it takes to take care of yourself,” says Katy Votava, a nurse practitioner and president of Goodcare, a consulting firm specializing in the economics of health care. “And people don’t know how to shop and be an advocate for themselves.”

When Kathleen Ujvari sought long-term care for her disabled 83-year-old father, she knew that “he would not think of how to do it on his own.” Many retired Americans who have disabilities simply can’t fathom what they need to do to take care of themselves.

Like many caring for parents, though, Ujvari knew there were multiple options available. In her role as a long-term care researcher for the AARP Public Policy Institute, she’s been examining how older Americans can “self-direct” their own care, choosing from an array of options that can be provided at home.

Innovative Approaches, Person-Centered Choices

Along with Merle Edwards-Orr, a senior consultant with Applied Self Direction (a long-term care consulting firm), Ujvari found that several states are using innovative strategies to provide long-term care at home. They involve offering “person-centered” choices to those being supported by Medicaid. Every state has these programs, although they vary in quality and scope.  -read more-

Medicare Part D Drug Coverage Gap Closing at Faster Clip

By Rachel L. Sheedy, Editor
May 31, 2018
From Kiplinger’s Retirement Report
Dr. Katy quoted in this article:

The gap was never scheduled to close 100%,” says Dr. Katy Votava, president of GoodCare.com. Once it closes, “beneficiaries will still pay 25% out of their pockets.”

Headlines earlier this year announced the “doughnut hole” in Medicare’s Part D prescription-drug coverage is closing ahead of schedule. That’s welcome news for the beneficiaries who fall into the coverage gap, many of whom should see savings next year. But as is often the case, the devil is in the details.

The Bipartisan Budget Act of 2018 accelerates the closure of the gap for brand-name prescription drugs so that beneficiaries pay 25% of drug costs in 2019, down from the scheduled 30%.

The change makes it all the more important to be prepared to compare your Part D options later this year during Medicare open enrollment. Depending on the specific drugs you take and the cost-sharing structure of plans in your area, you may save some money.

The coverage gap had been gradually shrinking for several years since the Affordable Care Act set a path to close it by 2020.  “The gap was never scheduled to close 100%,” says Dr. Katy Votava, president of GoodCare.com. Once it closes, “beneficiaries will still pay 25% out of their pockets.”

Read the article here:

How to Vet a Home Care Agency

By John F. Wasik
May 26, 2018
From Morningstar’s Ecology of Money

Dr. Katy is quoted in this article:

 “I recommend that people reach out to the national Eldercare locator service as their first stop to find eldercare resources, including home care information, in every U.S. community,” Votava says. “Eldercare locator gives people access to trained professional counselors providing information and referral assistance free of charge.”


When my father, now 91, was no longer able to fully care for himself, his emerging needs unfolded slowly. At first, we noticed unpaid bills began to stack up, which my younger brother and I took over managing. Then there were other daily details of his life, such as cleaning and eating, that began to deteriorate.

Since my father had no intention of moving into assisted living–he rejected the places we toured–yet couldn’t continue to be completely on his own, the third option, which we knew little or nothing about, was home care.

For years, options for long-term care were limited to taking an older relative into your home or placing him or her in assisted living or a nursing home. For working families, the first choice can be difficult, and the second option can be prohibitively expensive.
But as America ages, the home healthcare industry is evolving, providing lower-cost alternatives to residential assisted living. More than one million jobs will be created to meet this growing need through 2020, according to the U.S. Bureau of Labor Statistics.

How can you know if home care is a viable option for yourself or a loved one?

Home Care Basics

There are several layers of home care, and you can order them a la carte. Basic services, such as home cleaning or homemaking, are the least expensive and are a good place to start. More personal services, such as companion care and health aides, perform nonmedical tasks, such as transportation to doctors and checking on medication. The top level of care is skilled nursing, where registered visiting nurses come into the home to provide basic medical services.
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