In less than four decades, the senior population in the U.S. will double.

At the last count, the total was 41 million, and it will magnify to over twice that by 2050.Globally, the number of people 65 and older expands from 531 million to 1.5 billion. Countries like Japan, South Korea, and Germany will find their majority population to be over the age of 50.This July, the once in a decade White House Conference on Aging gathered. Senior care experts, members of the legislature and President Obama joined in the discussions.They addressed the challenges that seniors and family caregivers face and want to tackle the issues with proposed programs to empower all Americans.So, while the experts and government work on the major concerns, let’s talk the real world, right now, one issue at a time.The fact is, most people don’t know what services are available when caring for seniors, how much it costs, or who will pay for them. For example, did you know that Medicare does not pay for long-term custodial care?Most retired people want to live an ordinary life and the private sector and the government hope to help with that.But if you haven’t experienced challenges that come with aging, there are several things you must know. I hope to touch on these with each Aging Matters column.First, let’s talk about one of the biggest issues as we age: How will we pay for the costs of health care? Here are the common ways that seniors pay for care:• Medicare: It is a medical insurance program that pays for acute medical care, doctor visits, drugs and hospital stays.It does not pay for long-term personal attention, the kind that seniors need with everyday activities like bathing, toileting, mobility and dressing.• Medicaid: It pays for some medical expenses and tight regulations stipulate who qualifies. It is a joint program by the federal and state governments and helps low-income folks pay for health care and medical needs and long-term custodial care.Before an individual can get help through the government agency, one must meet the very strict income limitations.• Private Health Insurance: It covers most health care expenses but pays limited long-term care costs.• Disability Insurance: It replaces income only. It does not pay for any medical or care expenses.• Long-term care insurance: It pays for care at home and in a facility. If you have an LTC policy, check with your agent to learn what it covers.If you do not — before you buy one, understand what services are covered and when it will pick up the expenses. Make sure it pays for in-home and residential care.The fact is, caring for an older person is expensive, and most services pay out of pocket. Consumers are not prepared because they are ill-informed about the coverage offered by Medicare and Medicaid.People operate under false hopes that both pay for elder care.The Aging Conference helped bring senior issues to the general public. We all need to get involved and to help support the proposed programs.America’s population is changing, and we need to recognize how it will forever alter the health care landscape.Carol Marak, aging advocate and editor of SeniorCare.com, is creator of the Aging Matters weekly column.Her background is family caregiving. Carol’s mother lived with chronic illnesses, and her father lived with Alzheimer’s disease. As a family, they faced many elder care obstacles.Marak offers anyone an open invitation to dialogue with her at

Carol@SeniorCare.com.