Do you have long term care insurance?

[Skippy918]

This has always made me angry. Middle class folks struggle to pay nursing home costs, while rich people hide their assets to get the government to fund theirs. We have had financial planners suggest this type of legal scam, they were immediately disqualified to work with us. Our money is there to be spent on our care, not just handed down to our kids

My friend’s mom got disqualified cause of the lookback period, but at the time she needed nursing home care, she had nothing because when her husband (friend’s step dad)died he left everything to his adult children. Because she lived in a state with filial law, my friend got stuck with all the nursing home bills. Her mom was in there for over a year. It sucks they didn’t have money for a lawyer to help with getting Medicaid.

 

[Pea-n-Me]

My disabled young adult person is on MEDICAID medical insurance. For now he still qualifies under his Dad's insurance so the Medicaid is only used for surgeries & specialists (rarely used) because they accept it.

It is all a complicated process and sadly most do not understand it. It is underused by some and abused by others.

I said in my second post on this thread in response to @CdnCarrie that it’s complicated.

That wasn’t meant to be an end-all-be-all answer, it was a glimpse into the differences between Medicare and Medicaid, since often, as had happened there, people use the wrong terms, and was a quote I pulled directly from a government website.

Medicaid varies by state. So, depending on where you live, what qualifiers and services one utilizes can differ. It would be impossible to capture every single nuance of the Medicare and Medicaid programs in any one narrative.

I work in a hospital so I see the magic that social workers perform every day trying to get people qualified. @barkley understands this as a social worker herself. I’m glad your loved one got the services he needed.

 

[LuvOrlando]

Seems like it's time to rework both the mindset on eldercare and the way all this works.

There is zero reason why people need to spend down to indigence to get support, this is a very old world way too see things created at a time when all sorts of terrible ideas were thought to be sacrosanct by the people writing these mind numbing rules. The world can't just work for out ok for billionaires and everyone else is smashed to rubble

Why should middle class families who are paying all the current taxes lose all the families accumulated wealth with the passing of the oldest generation? What kind of subversive class control nonsense is this? Time to go

No-one in the US should need extra insurance or do without care.

 

[tvguy]

Nope. Our financial advisor convinced me that we should self-insure.

Really no different that home owners/renters/auto insurance/flood/earthquake/medical insurance. If you have the financial ability to cover any potential expenses, you don't need it.
I'm 65 and between homeowners and auto insurance I have submitted claims in my lifetime totaling less than one year's premiums for both. But one major incident, and I could be wiped out financially. I don't want to think about how much I have paid out in premiums over my lifetime.

 

[robinb]

The really nice ones around here are a part of Life Care facilities....where you plunk down hundreds of thousands of dollars and start out in an apartment....the assisted living facility and long term care facility are on site at those places....presumably for when you need them.

My DH's aunts and uncles moved to a place like that. It is very nice. One uncle, in his 90's, is still alive and living in his independent living apartment on which he is paying rent. His wife died shortly after moving into the place. The other uncle died a few years ago and his wife could not take care of herself because of dementia. The facility moved her out of the apartment and into a shared room in the skilled nursing center and then eventually into the memory care. Her care was very, very good. She recently passed away after years of living in the nursing center. I believe that her family did pay a bit more OOP for a personal caregiver to spend some time with her during the day. I also think that her estate received a bit of a refund of the original amount they paid to My 90+ year old MIL moved into a similar place in another state. She is also still in her apartment.

 

[robinb]

Really no different that home owners/renters/auto insurance/flood/earthquake/medical insurance. If you have the financial ability to cover any potential expenses, you don't need it.
I'm 65 and between homeowners and auto insurance I have submitted claims in my lifetime totaling less than one year's premiums for both. But one major incident, and I could be wiped out financially. I don't want to think about how much I have paid out in premiums over my lifetime.

No, it's not. At least not the insurance that were were looking at. The insurance we were looking at in our mid-50's was one where we would pay a lump sum and then it would pay up to 3x that lump sum with some kind of refund if you didn't use it all. At first blush it looked like a win-win because we would get our money back out of it. The advisor showed that if we invested the lump sum instead we would have more than the payout by the time we would probably need it.

 

[QueenIsabella]

Seems like it's time to rework both the mindset on eldercare and the way all this works.

There is zero reason why people need to spend down to indigence to get support, this is a very old world way too see things created at a time when all sorts of terrible ideas were thought to be sacrosanct by the people writing these mind numbing rules. The world can't just work for out ok for billionaires and everyone else is smashed to rubble

Why should middle class families who are paying all the current taxes lose all the families accumulated wealth with the passing of the oldest generation? What kind of subversive class control nonsense is this? Time to go

No-one in the US should need extra insurance or do without care.

I have to respectfully disagree with you on this. If you have assets, why SHOULDN'T they go to pay for your care in your declining years? Why should you be able to keep them to pass on to your children (or whoever) instead? I'll pay for my care, you pay for yours. If either of us have something left, THEN, heirs can receive it.

Medicaid is in place to help the truly indigent. Should they get first-class service if they're not paying? Certainly, they should get decent care--a bed (maybe in a shared room), reasonably healthy food, access to medical care. Someone who can pay for extras can get extras--kind of like staying in a fancier hotel or flying first class.

DH and I are hardly billionaires, but we've worked hard, saved, and given up things in the short term to have sufficient savings for our retirement and beyond. If there's some left over when we're gone, the kids are welcome to it, but we've made it clear, we're not saving for them, we're saving for a "million dollar disease". If we die quickly and painlessly (it would be my choice, anyway), then the kids inherit. Otherwise, they'll have to save their own nest eggs.

 

[TwoMisfits]

Seems like it's time to rework both the mindset on eldercare and the way all this works.

There is zero reason why people need to spend down to indigence to get support, this is a very old world way too see things created at a time when all sorts of terrible ideas were thought to be sacrosanct by the people writing these mind numbing rules. The world can't just work for out ok for billionaires and everyone else is smashed to rubble

Why should middle class families who are paying all the current taxes lose all the families accumulated wealth with the passing of the oldest generation? What kind of subversive class control nonsense is this? Time to go

No-one in the US should need extra insurance or do without care.

But then who pays for it? The wealth of someone has to pay for the care. We're running 1 trillion dollar + deficits right now...

Now, we can discuss the way it's set up to pay...but really all that will be is rearranging the deck chairs b/c if families' can't or won't take care of their elders, the elders will need really expensive out of home care, and someone has to pay for it, and we're a country with no more money in the coffers to pay for anything new, let alone what we already have...

 

[tvguy]

No, it's not. At least not the insurance that were were looking at. The insurance we were looking at in our mid-50's was one where we would pay a lump sum and then it would pay up to 3x that lump sum with some kind of refund if you didn't use it all. At first blush it looked like a win-win because we would get our money back out of it. The advisor showed that if we invested the lump sum instead we would have more than the payout by the time we would probably need it.

That is exact what my mom had and it was a huge win. I'm not sure what investments you are talking about that would triple your investment. I guess it's possible but not likely especially if you aren't buying the coverage until your mid-50s.

 

[LuvOrlando]

But then who pays for it? The wealth of someone has to pay for the care. We're running 1 trillion dollar + deficits right now...

Now, we can discuss the way it's set up to pay...but really all that will be is rearranging the deck chairs b/c if families' can't or won't take care of their elders, the elders will need really expensive out of home care, and someone has to pay for it, and we're a country with no more money in the coffers to pay for anything new, let alone what we already have...

We pay for it, this is American tax money. I keep reading about billions here and billions there in the news, it's throw away from the US like confetti meanwhile the retired workers who paid in their whole lives only get to keep 2K to their name before these programs step up and families lose all that accumulated wealth as the estate is broken down to scraps. I don't accept that people are asking too much to think their own money should take care of them and theirs.

Maybe we should all be questioning where these points of view came from because they are self harming, we wouldn't run our households this way. Never made sense to me.

 

[LuvOrlando]

I have to respectfully disagree with you on this. If you have assets, why SHOULDN'T they go to pay for your care in your declining years? Why should you be able to keep them to pass on to your children (or whoever) instead? I'll pay for my care, you pay for yours. If either of us have something left, THEN, heirs can receive it.

Medicaid is in place to help the truly indigent. Should they get first-class service if they're not paying? Certainly, they should get decent care--a bed (maybe in a shared room), reasonably healthy food, access to medical care. Someone who can pay for extras can get extras--kind of like staying in a fancier hotel or flying first class.

DH and I are hardly billionaires, but we've worked hard, saved, and given up things in the short term to have sufficient savings for our retirement and beyond. If there's some left over when we're gone, the kids are welcome to it, but we've made it clear, we're not saving for them, we're saving for a "million dollar disease". If we die quickly and painlessly (it would be my choice, anyway), then the kids inherit. Otherwise, they'll have to save their own nest eggs.

Because they already paid, if they kept it all they would have tons but they shared in civic dutiful taxes when young so same people should be made whole at the end.

If you don't want it, by all means, don't take it but there are many families trying to get ahead and they can't, this sort of thing is an obstacle especially for groups prone to medical issues due to various inequities, mostly minority groups but all sorts, really.

It's ok if we disagree, I wouldn't object to people giving more into the system but a person shouldn't need to be penniless to feel the benefits.

 

[dvcgirl67]

I have to respectfully disagree with you on this. If you have assets, why SHOULDN'T they go to pay for your care in your declining years? Why should you be able to keep them to pass on to your children (or whoever) instead? I'll pay for my care, you pay for yours. If either of us have something left, THEN, heirs can receive it.

Medicaid is in place to help the truly indigent. Should they get first-class service if they're not paying? Certainly, they should get decent care--a bed (maybe in a shared room), reasonably healthy food, access to medical care. Someone who can pay for extras can get extras--kind of like staying in a fancier hotel or flying first class.

DH and I are hardly billionaires, but we've worked hard, saved, and given up things in the short term to have sufficient savings for our retirement and beyond. If there's some left over when we're gone, the kids are welcome to it, but we've made it clear, we're not saving for them, we're saving for a "million dollar disease". If we die quickly and painlessly (it would be my choice, anyway), then the kids inherit. Otherwise, they'll have to save their own nest eggs.

I agree that if you can pay for your care, then you should.. But I wouldn't say that Medicaid is only for the indigent, especially if a spouse remains in the community. And I've learned that 62% of all LTC is covered by Medicaid....including people who are able to get Medicaid to pay for home care. With respect to nursing homes....70% of everyone in a nursing home is on Medicaid. And by no means are all of those people indigent.

In our case, because we still have one parent in the community, we're following all of the rules set by Medicaid in our state and he can keep $137,000 in assets (he's only got about 90K left), and spend down my MIL's $137,000 on allowable expenses. Again, she's only got 90K on her side, but it looks like we'll be able to spend 60K of that on items my FIL needs. The income limit for the spouse is $3,260....and in NJ you can keep a home with a value up to 840K. In our case it's only 350-375K or so, so way under the limit. Under these rules my MIL will qualify for medicaid pretty quickly. And we can legally gift money to my FIL to supplement his income once she is approved....which we'll likely need to do.

And, with some estate planning people can legally keep plenty of other assets. In our case, we're like you in that we're saving extra in case of a very expensive illness or LTC situation (although we'd surely like to avoid it). We have no children and so depending on how things unfold an assisted living situation with a rehab and LTC facility on site may be in the cards. Hope not, but it may happen.

 

[QueenIsabella]

Because they already paid, if they kept it all they would have tons but they shared in civic dutiful taxes when young so same people should be made whole at the end.

If you don't want it, by all means, don't take it but there are many families trying to get ahead and they can't, this sort of thing is an obstacle especially for groups prone to medical issues due to various inequities, mostly minority groups but all sorts, really.

It's ok if we disagree, I wouldn't object to people giving more into the system but a person shouldn't need to be penniless to feel the benefits.

I'm not understanding your comment. Who already paid? Don't we all pay taxes? Then, I already paid, too. Why should I pay again, so your kids can inherit? Taxes pay for lots of things--the military, roads, tons of stuff. Just because you paid taxes doesn't mean you should get all of it back when you're old. You can't be made whole--you benefitted from those roads and the military and so forth. Whether or not you agree on what the tax money was spent on, it's already been spent. Even Social Security--do the math, you're never getting back what you paid in, plus what it would get if invested in even low-risk CDs.

I recognize that lie isn't fair relative to diseases and poor health, although people can certainly mitigate some risks (ie., eat healthy, don't smoke, etc.). But the government can't make everything exactly equal for every single person. And people need to rely on themselves more, NOT wait for the government to bail them or make things equal or whatever. For one thing, the government doesn't have the resources. And for another, they seem to squander the resources they do have on stupid stuff.

 

[LuvOrlando]

I'm not understanding your comment. Who already paid? Don't we all pay taxes? Then, I already paid, too. Why should I pay again, so your kids can inherit? Taxes pay for lots of things--the military, roads, tons of stuff. Just because you paid taxes doesn't mean you should get all of it back when you're old. You can't be made whole--you benefitted from those roads and the military and so forth. Whether or not you agree on what the tax money was spent on, it's already been spent. Even Social Security--do the math, you're never getting back what you paid in, plus what it would get if invested in even low-risk CDs.

I recognize that lie isn't fair relative to diseases and poor health, although people can certainly mitigate some risks (ie., eat healthy, don't smoke, etc.). But the government can't make everything exactly equal for every single person. And people need to rely on themselves more, NOT wait for the government to bail them or make things equal or whatever. For one thing, the government doesn't have the resources. And for another, they seem to squander the resources they do have on stupid stuff.

Yes we all pay. No, I don't think anyone should pay twice. I think if we paid taxes then everyone should be able to give their kids what they accumulated and not be forced to deplete to zero for programs we paid into. I may be misunderstanding but you seem to be saying you do not want the relief, which if this is the case it is ok by me, noone should be forced to take support they don't want but I disagree with thinking everyone else needs to follow suit.

As to the bolded part, why not? People say it but can't really explain to me good reasons why old people need to give up everything they have and be destitute in exchange for living.

We shouldn't need insurance policies to survive old age.

 

[QueenIsabella]

Yes we all pay. No, I don't think anyone should pay twice. I think if we paid taxes then everyone should be able to give their kids what they accumulated and not be forced to deplete to zero for programs we paid into. I may be misunderstanding but you seem to be saying you do not want the relief, which if this is the case it is ok by me, noone should be forced to take support they don't want but I disagree with thinking everyone else needs to follow suit.

As to the bolded part, why not? People say it but can't really explain to me good reasons why old people need to give up everything they have and be destitute in exchange for living.

We shouldn't need insurance policies to survive old age.

Why not? Because it's simply not there! The government has spent it on things that are, presumably, for the good of the country. The FBI, the post office, National monuments and parks--any number of things. I don't want to get into a debate over whether the government spends on the right things or not, or if they spend too much, or if one party is worse than the other. Every year, the government spends more than it takes in. This would be stupid if I did it, it's even stupider that our government does it, but there you have it.

It's not a matter of me wanting relief, there's no relief to be had. As long as I've been an adult, I've been saving for retirement. We've gone without any number of things to do this. Not to enrich our children, although they've benefitted to the extent that we've paid for college and taught them to work hard. Mostly, we don't want them to have the burden of caring for us in our old age. When I started my first "real" job--1985!--I didn't think Social Security would be around at retirement time. Now, I'm not convinced it will be around in the same form--they may raise the age, decrease benefits, means-test it, something.

 

[tvguy]

Yes we all pay. No, I don't think anyone should pay twice. I think if we paid taxes then everyone should be able to give their kids what they accumulated and not be forced to deplete to zero for programs we paid into. I may be misunderstanding but you seem to be saying you do not want the relief, which if this is the case it is ok by me, noone should be forced to take support they don't want but I disagree with thinking everyone else needs to follow suit.

As to the bolded part, why not? People say it but can't really explain to me good reasons why old people need to give up everything they have and be destitute in exchange for living.

We shouldn't need insurance policies to survive old age.

Just plain good estate planning to me to have a LTC policy so you don't bankrupt a spouse that may not need care, and you can leave more to your heirs. Nice to have a backup with Medicaid because I know it isn't possible for everyone to save enough to pay for the care they may need. Like LTC insurance, it is something you paid into, and it is possible if you need it, it will pay out far more than you paid in.
And having looked at what Medicaid accepting facilities are like, a great big no thank you.

 

[kymom99]

Just plain good estate planning to me to have a LTC policy so you don't bankrupt a spouse that may not need care, and you can leave more to your heirs. Nice to have a backup with Medicaid because I know it isn't possible for everyone to save enough to pay for the care they may need. Like LTC insurance, it is something you paid into, and it is possible if you need it, it will pay out far more than you paid in.
And having looked at what Medicaid accepting facilities are like, a great big no thank you.

That last sentence is very false in my state. My husband worked as environmental services supervisor in a state of the art facility that had a number of Medicaid beds. There are a certain number the state will pay for and the various ltc facilities fight over them. It’s guaranteed money. The people caring for residents have no idea who is private pay and who is Medicaid.

 

[dvcgirl67]

That last sentence is very false in my state. My husband worked as environmental services supervisor in a state of the art facility that had a number of Medicaid beds. There are a certain number the state will pay for and the various ltc facilities fight over them. It’s guaranteed money. The people caring for residents have no idea who is private pay and who is Medicaid.

100% correct. The best Life Care facility in the county where my in-laws live...has the apartment side, rehab side and the LTC side. I'm talking about the nicest one of the bunch in their area. But....they also take residents directly into the nursing home side to fill those beds. And they have 68 medicare/medicaid beds....with 64 residents currently on either medicare/medicaid. They'd fill them with private pay if they could for sure.....but the fact that 64 of them are filled by medicare/medicaid tells the story.

And having just visited medicare.gov to see this info....guess how many stars my MIL's facility gets.....five. I honestly couldn't believe it. It did only get three out of five stars for staffing. The high end place got five overall stars as well, and four out of five for staffing. There's just not a ton of difference once you get behind the fancier lobbies and day rooms....when you get down to the day to day care.

It's really no different the student loans in a lot of ways. Only a handful of colleges in this country could survive without government aid....unless they have massive endowments. No, the families of LTC residents are not having to take out "LTC" loans, but the end result is the same....both the college and the LTC can continue to charge ridiculous fees because the government is propping up the funding. Nursing homes don't have massive endowments, which is why LTC is soooo expensive. Medicaid pays about 75% of the average LTC fee.....private pay residents are paying so much more to offset the difference.

Also, a lot of the deal with LTC admissions is, at least initially, "you get what you get...and you don't get upset." When one needs a LTC bed, it's *very* common that there won't be a bed at the facility of choice. So...you end up where there is a bed and hope that one opens up where you'd like to go. There are currently no available beds on the LTC side of my MIL's facility. And....the oldest of the Baby Boomers have really not even entered this world yet at only age 74....so I'd expect things to get tougher.

 

[dvcgirl67]

That last sentence is very false in my state. My husband worked as environmental services supervisor in a state of the art facility that had a number of Medicaid beds. There are a certain number the state will pay for and the various ltc facilities fight over them. It’s guaranteed money. The people caring for residents have no idea who is private pay and who is Medicaid.

100% correct. The best Life Care facility in the county where my in-laws live...has the apartment side, rehab side and the LTC side. I'm talking about the nicest one of the bunch in their area. But....they also take residents directly into the nursing home side to fill those beds. And they have 68 medicare/medicaid beds....with 64 residents currently on medicaid. They'd fill them with private pay if they could for sure.....but the fact that 64 of them are filled by medicaid tells the story. The middle of the pack place where my MIL is....has private pay residents. Also remember, a lot of people start out paying the full rate and spend down their funds, then qualify for medicaid. My MIL will be in for over 5 months before she even qualifies for medicaid. It's a numbers game.

It's really no different the student loans in a lot of ways. Only a handful of colleges in this country could survive without government aid....unless they have massive endowments. No, the families of LTC residents are not having to take out "LTC" loans, but the end result is the same....both the college and the LTC can continue to charge ridiculous fees because the government is propping up the funding. Nursing homes don't have massive endowments, which is why LTC is soooo expensive. Medicaid pays about 75% of the average LTC fee.....private pay residents are paying so much more to offset the difference.

Also, a lot of the deal with LTC admissions is, at least initially, "you get what you get...and you don't get upset." When one needs a LTC bed, it's *very* common that there won't be a bed at the facility of choice. So...you end up where there is a bed and hope that one opens up where you'd like to go. There are currently no available beds on the LTC side of my MIL's facility. And....the oldest of the Baby Boomers have really not even entered this world yet at only age 74....so I'd expect things to get tougher.

 

[Cogswel_Cogs]

Look at the rate of college failings it’s like 2%. Look at every other industry which is in 20s. I feel some of these schools should be paying back at least part of that $10k.