Filed Under:Health Insurance, Ltci

Filial Responsibility and Long Term Care

In about 10 years, these children might have a legal obligation to pay their parents' long-term care bills. (AP Photo/Seth Perlman)
In about 10 years, these children might have a legal obligation to pay their parents' long-term care bills. (AP Photo/Seth Perlman)

The U.S. Census Bureau recently reported that the dependency ratio, or the number of people 65 and older to every 100 people of traditional working ages, is projected to climb rapidly from 22 in 2010 to 35 in 2030. This time period coincides with the time when baby boomers are moving into the 65 and older age category. After 2030, however, the ratio of the aging population to the working-age population (ages 20 to 64) will rise more slowly, to 37 in 2050. The higher this old-age dependency ratio, the greater the potential burden.

The projections are not based on 2010 Census results. Rather, they project 2000 Census counts forward using components of population change — births, deaths and net international migration.

The expected steep rise in the dependency ratio over the next two decades reflects the projected proportion of people 65 and older climbing from 13% to 19% of the total population over the period, with the percentage in the 20 to 64 age range falling from 60% to 55%.

The findings are contained in the report, "The Next Four Decades: The Older Population in the United States: 2010 to 2050," which presents information on how the age structure of the overall population and the composition of the older population in terms of age, sex, race and Hispanic origin are expected to change over the next four decades. The report provides an analysis of national population projections released in August 2008.

As aging continues to be an issue and have far reaching impact, on the economy, on families and on individuals it now appears that the sins of the father will visit the sons, sort of.

A Pennsylvania state appeals court has ruled that the adult son of a nursing home resident is responsible for her unpaid $93,000 bill. And the decision has some elder care lawyers wondering if this is just the beginning of a trend.

Pennsylvania is one of 30 states that have filial responsibility statutes—laws that impose a duty on adult children to care for their indigent parents. About two-thirds of those states, including Pennsylvania, allow long-term care providers to sue family members to recover unpaid costs.

These filial responsibility laws are not new. In fact, they can be traced back 400 years to Poor Relief laws in England. In the U.S. many states have had them on the books for decades, but they have been rarely enforced.

That may be changing. With the costs of long-term care rising (an average nursing home stay now exceeds $200/day), and with increasingly strict Medicaid rules making it tougher for people to receive government assistance, senior services providers may find themselves with more unpaid bills. These suits may generate bad publicity but may also be a facility’s only recourse.

While these laws don’t directly apply to Medicaid recipients, they may force children to pick up their parents’ long-term care costs long before mom is ever eligible for Medicaid. Such a step could still shift significant costs from states to families. This is another reason advisors need to include long-term care in their assessments they do with their senior clients and offer solutions that not only protect their senior clients but ensure their legacy is not one of burden for their family. For more information check out Elder Law Answers web site.

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