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View Poll Results: LTC - how do you plan to manage/cover this risk?
purchase LTCI 31 18.24%
Purchase Life insurance with LTC rider 1 0.59%
Self Insure -- how are you doing this? 81 47.65%
Purchase annuity that could be used for LTC, distributed other wise 1 0.59%
Other 7 4.12%
Roll the dice -- no real plan (yet) 49 28.82%
Voters: 170. You may not vote on this poll

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Old 08-17-2015, 06:05 PM   #141
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In New York if you avoid Probate court they can't recover Medicaid expenses. So put all accounts to transfer at death, put all real estate in Life Estate Deeds, problem solved.
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Old 08-17-2015, 06:10 PM   #142
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If 1 spouse goes in the nursing home the other can remain in their home until the first spouse dies or until the 2nd spouse goes into a nursing home then Medicaid can use the home to pay back what Medicaid has paid. Been through this a few times with relatives, etc.
I think this goes beyond that scenario and is aimed at the children of the parents to pay any charges beyond what was covered.
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Old 08-17-2015, 06:23 PM   #143
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I think this goes beyond that scenario and is aimed at the children of the parents to pay any charges beyond what was covered.

And I assume its only pertains to state where the parent resides. Fortunately mine ,though divorced, are still in my state. I need to figure out how to get 2 peoples licenses suspended and put on the "no fly list" in the next 5-10 years to minimize any undue financial risk.


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Old 08-17-2015, 07:38 PM   #144
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Hey, redduck, are you there? California is on that list.

I was thinking about the post where you said your kids were forcing you to make placards saying "Down with geezers". Here's your chance to show them this info to lean on them to cut you some slack.
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Old 08-17-2015, 08:36 PM   #145
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The LTC insurance is very expensive, so we are putting aside some money in order to cover our needs. Will it be enough is hard to say but similarly I can ask could you overpay insurance company for an amount you may need? Will the insurance company you pay to be there when you need it?
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Old 08-18-2015, 04:53 AM   #146
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In New York if you avoid Probate court they can't recover Medicaid expenses. So put all accounts to transfer at death, put all real estate in Life Estate Deeds, problem solved.
sorry - problem not solved .

while what you posted is true it is true with a big but and this can be very complicated . it is no where near as simple as you described it .

recovery and qualifying are two different things .

THE ISSUE IS YOU CAN'T QUALIFY FOR MEDICAID IN THE FIRST PLACE with those jointly held assets exceeding 14,250 except under 2 circumstances

To qualify for Medicaid, the recipient is limited to resources of no more than $14,250. However, certain resources are exempt, such as retirement accounts that are in the payout status or a home having an equity value of $786,000 or less.


Medicaid will count your IRA or 401k as an available source of funds to pay for your care, unless it is in payout status. "Payout status" means that you are taking at least the required minimum distribution out of your plan on a monthly basis.

If it's not in payout status, it may be beneficial to take the cash out and pay the income tax on it, and then transfer it to a trust. This avoids your retirement account being counted as a resource that you will have to "spend down" under Medicaid eligibility requirements. Instead, your money can be used for your benefit during your lifetime, and whatever is left can be passed on to your beneficiaries through the trust.

If the account is in payout status, your retirement assets are not counted as resources, but the monthly payments that you receive are considered income. If you are receiving Medicaid home care benefits, any excess income can be protected by a Pooled Income Trust . Use special trusts to guard cash, income, investments and other liquid assets). However, if you’re getting Medicaid nursing home benefits, the nursing facility is entitled to all of your monthly income except $50.

If you are receiving Medicaid benefits in a nursing home and your life expectancy is not very long, it may be to your children's financial advantage to leave the retirement plan in payout status and allow the nursing home to collect the income from your IRA or other plan while you are still alive. Upon your death, your kids, as your beneficiaries, can withdraw the balance in a lump sum or over time.

you can't just remove the recipients name from the assets if they go in to a facility since the 5 year look back period is in effect .

folks this stuff is very very complex and requires very skilled attorneys to navigate through.

usually a simple answer to a complex question is usually going to be the wrong answer .


today estate attorneys are avoiding a lot of the above because ny is a state that supports negotiations with medicaid .
rather than try to manipulate assets negotiations are being used to find reasonable amounts that a stay at home spouse can afford to pay without being impoverished over time .

of course though with ny offering total asset protection ltc plans our first choice is to take them up on it by purchasing 3 years insurance and avoiding all the other issues above .
"

http://www.wny-lawyers.com/2012/05/2...-law-repealed/


http://www.cutner.com/401k_IRA_Medicaid.html
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Old 08-18-2015, 08:43 AM   #147
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The system is set up so a sophisticated person can shield most assets with estate planning, while the simple people get wiped out.
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Old 08-18-2015, 09:03 AM   #148
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In a few months, we'll both be in our 80th year, so the planning is easier.

With somewhat limited assets, our plan is in the "other" category.

Already living in a CCRC (in regular home), ther are easy access roads to living in a needs covered apartment, if the house becomes too much to handle.. assisted living, nursing home, or Alzheimer unit... al in the same complex.

We do have $100/day LTC policies, purchased in 1995, with premiums that haven't gone up except for small increases in management costs. $2400 for both policies.

Today's outlook makes up good for another 12 years, assuming a 3 year stay in the nursing home... ie, if either of us should needs go to the nursing home, lifestyle would not change.

In the event of a major unexpected hit to our net worth, and the LTC was needed, the healthy spouse would remain in our home, and let Medicaid pay for the nursing home. I continue to be surprised at how few of the members here seem to be aware of this alternative. It allows for continuation of life in a normal manner without the upset of moving for the healthy spouse.

In effect, the medicaid solution avoids trauma, and obviates the sale of the residence. For us, it allows for simplified accounting, since the home value can be included as a liquid asset in planning. (You have to think on this.)

At this age, LTC planning becomes real.
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Old 08-18-2015, 09:15 AM   #149
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With medicine advances to keep people living longer and requiring help, yet more are "outsourcing" the cost to the state by transferring assets to their heir, no wonder the government is running out of money.
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Old 08-18-2015, 11:08 AM   #150
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Self insure for me, but it's just done 'gut feel'. I would have been in the majority on the older poll (don't think we have good products to buy, don't trust insurance companies, etc).

Since I was trained as an Industrial Engineer, we formalize decisions. So I wanted to build a decision tree for the LTCi decision. Decision tree analysis -
Of course we just juggle the numbers to get the answer we want
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Old 08-18-2015, 11:45 AM   #151
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People appear to be living longer, but not better. Hardly seems worth it, and I wonder why people bother. I am being serious.
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Old 08-18-2015, 11:51 AM   #152
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People's survival instinct is very strong. We do not know how we will really feel and act until we are there.

My father lingered on for a long time when it was so hopeless, and was willing to take any step to stay alive, although he was confined to a bed and asleep all the time during his last 3 months. In talking to a nurse, I learned that it meant he was not in pain and only felt very lousy, as terminal cancer patients tend to want to die to end the pain. My father died from complications caused by kidney failure.

And on the other hand, a distant relative of mine was diagnosed with kidney failure, refused to have dialysis and died from it. He was in his 70s.
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Old 08-18-2015, 01:38 PM   #153
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It is also worth noting that the majority (I think) of states have filial responsibility laws that enable them to sue seeking reimbursement from one or more of your children if they so choose. Granted, to date, these laws have not been aggressively enforced, but that may be changing.
What future decades will bring is certainly hard to predict. But I'm confident that even in ultra-broke Illinois, we won't be responsible for a penny of MIL's expenses while she's in a NH on Medicaid. You may think this, but I think you're wrong.
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Old 08-18-2015, 01:45 PM   #154
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What future decades will bring is certainly hard to predict. But I'm confident that even in ultra-broke Illinois, we won't be responsible for a penny of MIL's expenses while she's in a NH on Medicaid. You make think this, but I think you're wrong.
Illinois currently does not have a filial responsibility law. If it enacts one, the exact (or inexact) language of the statute (as always) would govern any responsibility that you might have. Given the status of executive/legislative relationship in the state right now, it is not likely that anything will happen soon...

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Just as an example, Tennessee claims the right, to the extent permitted by federal law, to seek reimbursement for medicaid expenses from "parents, spouses, children, and guardians" "for any benefit or benefits rendered to the recipient." That's pretty broad and unambiguous....
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Old 08-18-2015, 01:48 PM   #155
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The LTC insurance is very expensive, so we are putting aside some money in order to cover our needs. Will it be enough is hard to say but similarly I can ask could you overpay insurance company for an amount you may need? Will the insurance company you pay to be there when you need it?
i would say with most states backing them and with most states requiring healthy company's to take over weaker ones when asked i would say they stand a better chance of the money being there when you need it then your own volatile portfolio does .
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Old 08-18-2015, 02:10 PM   #156
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Illinois currently does not have a filial responsibility law. If it enacts one, the exact (or inexact) language of the statute (as always) would govern any responsibility that you might have. Given the status of executive/legislative relationship in the state right now, it is not likely that anything will happen soon...

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Just as an example, Tennessee claims the right, to the extent permitted by federal law, to seek reimbursement for medicaid expenses from "parents, spouses, children, and guardians" "for any benefit or benefits rendered to the recipient." That's pretty broad and unambiguous....
Well, there we go, finally a solution to funding LTC care! We will just move from Illinois to a state with filial responsibility and then our survivors can pay for our LTC whether they choose to or not. And they can do the same, and so on, and so on, and so on....
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Old 08-18-2015, 02:20 PM   #157
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Just as an example, Tennessee claims the right, to the extent permitted by federal law, to seek reimbursement for medicaid expenses from "parents, spouses, children, and guardians" "for any benefit or benefits rendered to the recipient." That's pretty broad and unambiguous....
And that's why I don't think it's going to happen. The first time a state goes after an adult child to pay back a parent's Medicaid expenses will begin the process of demonstrating how arbitrary and capricious it will be.

For example "a 60 year old dad has to give up his own kids college savings to pay the state for his estranged (hasn't seen in 40 years) father's Medicaid-paid NH bills." I don't think so......

I understand politics is involved so anything is possible. But, like eliminating SS, this would be election-suicide for whoever pushes it.

The real answer is to extend look-back periods to beyond 5 years so a person's resources can never be transferred to someone else in order for them to qualify for Medicaid and to make Medicaid paid NH stays be in NH's with fewer amenities. For example, Medicaid might only pay for mom or dad to be in a 4 - 6 bed ward. That would make for less incentive to hide resources in order to qualify for Medicaid yet still provide basic care.
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Old 08-18-2015, 02:26 PM   #158
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i would say with most states backing them and with most states requiring healthy company's to take over weaker ones when asked i would say they stand a better chance of the money being there when you need it then your own volatile portfolio does .
You've stated that that is the case in your own personal situation and I understand how folks can get into that predicament. But it's not the case in my scenario and I assume not in the scenario of many others.
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Old 08-18-2015, 02:32 PM   #159
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And that's why I don't think it's going to happen. The first time a state goes after an adult child to pay back a parent's Medicaid expenses will begin the process of demonstrating how arbitrary and capricious it will be.

...
It's happened in Pennsylvania. (There, the law allowed the Nursing home itself to successfully file the suit.) That was several years ago....

I agree that n one level it looks bad. OTOH, if I were representing the state, I'd be able to make a very good argument that kids who were raised and educated by the indigent person and made a great deal of money (compared to the jury or judge) shouldn't be able to foist their obligations off onto the public at large. (Note, too, that some of the statutes have outs for children who've been estranged for lengthy periods of time).
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Old 08-18-2015, 02:39 PM   #160
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It's happened in Pennsylvania. (There, the law allowed the Nursing home itself to successfully file the suit.) That was several years ago....

I agree that n one level it looks bad. OTOH, if I were representing the state, I'd be able to make a very good argument that kids who were raised and educated by the indigent person and made a great deal of money (compared to the jury or judge) shouldn't be able to foist their obligations off onto the public at large. (Note, too, that some of the statutes have outs for children who've been estranged for lengthy periods of time).
What are some of the guidelines you'd use? Multi-millionaire children get sued? Or maybe also kids with one million? Maybe kids who are solidly middle class but really don't have anything "extra" unless they sell the house, pull their kids from college, etc. How about kids just barely getting by and currently ill-prepared for retirement? Would you sue them? Give us some examples of where you'd draw the lines.
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