The Importance Of Strict Eligibility Requirements With Long Term Healthcare

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4. The Importance of Strict Eligibility Requirements with Long-Term Healthcare Eligibility for long-term care coverage is based on an objective process in Japan and Germany that uniformly applies the same criteria to all persons. The requirements are similar in both countries, although the review process for applicants is varied. Ultimately, Campbell, Ikegami, and Gibson concluded that the most critical aspect of determining eligibility for a long-term care plan is an objective, expeditious need-based process (Campbell, Ikegami, & Gibson, 2009). The lessons learned from Japan and Germany that would benefit the United States when operating public long-term healthcare insurance are that eligibility should emphasize the importance of…show more content…
Germany was reported to recognize and support nearly 72% of family caregivers and plan beneficiaries who have chosen to receive direct services of a cash stipend which amounts to half or less than half of the cost of home/community-based care (Campbell, Ikegami, & Gibson, 2009). In addition, if a family member had provided a minimum of fourteen hours of care per week, the long-term care insurance coverage would cover that individual’s social security premiums and respite care for vacation with the aim of making the caregiver’s job more competitive with regular employment opportunities (Campbell, Ikegami, & Gibson, 2009). In Japan, long-term care insurance coverage has attempted to support the caregiver role by offering services such as home assistance, adult day care services, respite care, home modifications, assistive devices, and visiting home health care (Campbell, Ikegami, & Gibson, 2009). The United States could learn from both of these approaches utilized by Japan and Germany according to Campbell, Ikegami, & Gibson (Campbell, Ikegami, & Gibson, 2009). The CLASS Act would have provided a similar cash incentive in the United States, and it would have allowed consumers to have the greatest amount of choice while the main drawback would have been the potential impact on the development and availability of formal services in communities (Campbell, Ikegami, & Gibson,
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