By Haley Sweetland Edwards
By late 2014, Chabela Lawrence wasn’t doing well. She had mostly stopped cooking and cleaning for herself and began, every so often, to get lost on her way home from the neighborhood coffee shop–the one she’d been to a least a hundred times. The following March, the 74-year-old former catering manager was diagnosed with dementia, and it was clear she needed help. But it was then that she ran headlong into one of the most crushing failures of the U.S. health system: there’s no good way to pay for extended long-term care. Medicare doesn’t cover it. Private health plans don’t cover it. And for most, paying roughly $80,000 out of pocket, the average annual cost for a shared room at a skilled nursing facility, is simply out of the question.
Those in need of prolonged care face a dilemma. They have to be either poor enough to qualify for Medicaid or rich enough to shoulder the cost alone. Anyone who falls between those income extremes is out of luck. And that leaves many Americans vulnerable: 47% of men and 58% of women who are retirement age or older will experience a need for long-term care in the future, according to a February 2016 study by the Department of Health and Human Services. “It’s an insane situation,” Chabela’s daughter Ruby Lawrence says, recounting her mother’s experience. “You either have to be super-rich or super-poor to get benefits.”
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