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Old 10-12-2012, 02:40 PM   #21
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Mulligan said:

Except for the fact that we bought the insurance 17 years ago, I would agree... We don't have enough assets to protect today, and are counting on our house value to provide enough if the state takes everything else for Nursing Home care before medicaid sets in. but when we bought, based on health at the time, it seemed the right thing to do. Now, with so much already invested in the insurance, it doesn't make sense to cancel.

You are fortunate to have a $50,000 nursing home available...

One interesting quote from the website cited in the above post.
Very valid points to consider. I guess for me, the reasons why I won't consider it at this point are these. 1) unreliability of premium costs down the road 2) Housing and car insurance protects me here in the now where it could have a huge financial impact on my current life. I see entering the nursing home as the end of the road with no future to protect or look forward too. Maybe down the road, if such a policy is available, I would consider some catastrophic policy that say covers everything after year 3 in the home, so I wouldn't be a burden to society if nursing care costs continue to escalate.
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Old 10-12-2012, 04:29 PM   #22
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Are there any studies of how LONG a person spends in LTC? My experience is that average LTC (after at-home healthcare) is a few months, max.

People hear a 'weekly' nursing home rate and automatically multiply it by 52 weeks; it might not be the norm. Just guessing.

At the same time, my expectation is that once the dust settles, "affordable nursing home care" will be the next arena that our government will work to improve upon and make more fair.

If not, there are tons of companies out there that help you hide your assets for a lot less than LTCI
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Old 10-12-2012, 04:37 PM   #23
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Are there any studies of how LONG a person spends in LTC? My experience is that average LTC (after at-home healthcare) is a few months, max.
It's about 2 years average, IIRC.

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. . . the next arena that our government will work to improve upon and make more fair.
I can't wait to find out what "fair" means in this context. Anyway, the government recently took a swing at designing a program to assist with LTC expenses, they abandoned it before it even took flight. It was the first significant part of the PPACA to be jettisoned.
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Old 10-12-2012, 08:43 PM   #24
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It's about 2 years average, IIRC..
Well, for 2 years average, I can't see how paying $1500 a year for 20+ years makes sense for something that may not happen. I"ll roll the dice and find a good asset hider if need be.

No wonder insurance companies have such nice skyscrapers!
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Old 10-12-2012, 09:05 PM   #25
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I can't wait to find out what "fair" means in this context.
The 'fair' I'm thinking about is one where you work all your life at a good job, pay your taxes, save what you can and LBYM only to have it depleted on LTC (because you're 'rich' you see) while the guy in the next bed spent all his money on booze and has Medicaid pay for it.

My grandad was the former and had to be 'moved on' to another facility while "Mrs X" was the latter and was able to stay in the better (best) facility. When I asked why I was told "well...you know...you know...(whisper) welfare is paying for it...".

I'd just like to see something more 'fair'...if it's not too much to ask, like maybe having everyone get the same LTC...a little better maybe if you paid into the system.
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Old 10-12-2012, 10:43 PM   #26
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I'd just like to see something more 'fair'...if it's not too much to ask, like maybe having everyone get the same LTC...a little better maybe if you paid into the system.
Oh. The "fair" I was thinking of is that everyone gets to decide for themself, as much as possible, how to spend his own lifetime income on the services he expects to receive. It's "fair" if he receives what he decided to pay for. Just like we do for food, housing, cars, etc.

Medicaid payments for senior LTC is "fair" from this perspective: every person in each state gets treated the same (i.e. they get to use resources taken from other people) if they are in the same financial and medical situation.
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Old 10-13-2012, 05:57 AM   #27
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As noted, in the case of my grandad, having LTCI was an impediment to getting the best care.

He'dve been better to impoverish himself on paper and get on Medicaid. At least here in Mass...
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Old 10-13-2012, 08:50 AM   #28
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Well, for 2 years average, I can't see how paying $1500 a year for 20+ years makes sense for something that may not happen. I"ll roll the dice and find a good asset hider if need be.

No wonder insurance companies have such nice skyscrapers!
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As noted, in the case of my grandad, having LTCI was an impediment to getting the best care.

He'dve been better to impoverish himself on paper and get on Medicaid. At least here in Mass...
Marko, you really struck a nerve with me there.

Just remember that the rest of us (including you) are paying the bill for each "asset hider" so the effect is an illegal transfer of wealth from us to the criminals. While I realize that a lot of these people in nursing homes worked hard and all, IMO their wealth should go to provide for their care in their waning days rather than surreptitiously transferred to their heirs and pushing their nursing home bill on the rest of us. Once someone has exhausted their wealth and needs public help, I have no problem with that - but I have a real problem if they are screwing me to transfer wealth to their heirs.

And actually, believe it or not, the insurers are losing their a**es on LTC which is why so many have stopped writing the product. (Though I would agree that many insurers have nice skyscrapers).
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Old 10-13-2012, 08:59 AM   #29
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Just remember that the rest of us (including you) are paying the bill for each "asset hider" so the effect is an illegal transfer of wealth from us to the criminals. While I realize that a lot of these people in nursing homes worked hard and all, IMO their wealth should go to provide for their care in their waning days rather than surreptitiously transferred to their heirs and pushing their nursing home bill on the rest of us. Once someone has exhausted their wealth and needs public help, I have no problem with that - but I have a real problem if they are screwing me to transfer wealth to their heirs.
+1

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Old 10-13-2012, 09:05 AM   #30
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After dealing with close relatives who spent their last months in nursing homes under both Medicare and Medicaid, and others that lived in private assisted living facilities, I can't believe people would willingly choose the "Medicaid options" if they could afford private care. The differences in support, care, lifestyle and quality of life in general are just too great.
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Old 10-13-2012, 09:25 AM   #31
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After dealing with close relatives who spent their last months in nursing homes under both Medicare and Medicaid, and others that lived in private assisted living facilities, I can't believe people would willingly choose the "Medicaid options" if they could afford private care. The differences in support, care, lifestyle and quality of life in general are just too great.
It is different around here. I have two great aunts in the same nursing home a few doors down the hall from each other. One is on Medicaid, the other is private pay. No difference in care that I have seen (which BTW is good in both cases), but the nursing home received almost double what they receive from Medicaid for private pay patients.
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Old 10-13-2012, 09:25 AM   #32
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I'm not sure how its done in other states, but here in Mass, there is quite an industry built on 'asset hiding'...they advertise on TV and radio non stop.

In the case of my grandad, the administrators of the nursing home couldn't believe he was paying his own way...in 20 years, they never had anyone not on Medicaid, ever (and most people there were far from 'poor')

I agree that its not the best way to go but it seems to be the 'best' way to go around here.
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Old 10-13-2012, 09:41 AM   #33
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When I'm thinking about homeowners' insurance, I don't try to figure out how often houses burn down. But people routinely do that for LTCi.

I think one important reason is that most policies have caps that mean the insurance isn't going to be there for the really big losses. That kind of negates the idea of "insurance".

At any rate, for those who really want to get into the data, I'd suggest this: SOA - Society of Actuaries - 1984-2007 Long-Term Care Intercompany Report & Tables
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Old 10-13-2012, 09:43 AM   #34
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It is different around here. I have two great aunts in the same nursing home a few doors down the hall from each other. One is on Medicaid, the other is private pay. No difference in care that I have seen (which BTW is good in both cases), but the nursing home received almost double what they receive from Medicaid for private pay patients.
One approach I have seen is for private pay nursing homes to accept new residents as long as they can pay a minimum amount, somewhere between 1-2 years. After that they can continue and the facility bills Medicaid. On average it it works, not many residents stay much longer. Not all nursing homes give specialized nursing or dementia care, this can be a problem for some.

Planning for this type of care is difficult, but this is something people with means should plan and pay for.
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Old 10-13-2012, 09:44 AM   #35
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No wonder insurance companies have such nice skyscrapers!
I'm quite sure they didn't pay for the skycrapers with LTCi profits.
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Old 10-13-2012, 09:50 AM   #36
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+1

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+1

I did not work and save all my life to spend my last years on welfare.
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Old 10-13-2012, 10:03 AM   #37
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+1

I did not work and save all my life to spend my last years on welfare.
This is an eye opener.

What I'm learning here is that in other parts of the country, those who pay for LTC get better care than those on Medicaid.

My experience locally is that virtually no one pays for their own care and rich and poor sit side by side with equal care.

I might have to move to another state or at least do so when LTC time comes.
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Old 10-13-2012, 10:08 AM   #38
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I'm not sure how its done in other states, but here in Mass, there is quite an industry built on 'asset hiding'...they advertise on TV and radio non stop.

In the case of my grandad, the administrators of the nursing home couldn't believe he was paying his own way...in 20 years, they never had anyone not on Medicaid, ever (and most people there were far from 'poor')

I agree that its not the best way to go but it seems to be the 'best' way to go around here.
A perceptive glimpse of the character of Massachusetts I suppose.....
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Old 10-13-2012, 10:10 AM   #39
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I don't want to have saved all my life and spend my last years spending my own money sitting next to a guy who squandered all his money and is there for free.
You probably should start hiding it now then. The lookback period is getting longer and longer so good luck with that.
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Old 10-13-2012, 10:19 AM   #40
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A perceptive glimpse of the character of Massachusetts I suppose.....
It's not called a "Common-wealth" for nothing!
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