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Old 08-11-2013, 11:13 PM   #61
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Add me into the chorus of folks that would like to see an LTC policy for catastrophic loss with a high deductible (say $100k or $150k).

My nightmare scenario is that either me or DW end up being in a NH for 8 or 10 years.

I would think that since so few people stay over 2 years that a catastrophic loss policy could be affordable.
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Old 08-11-2013, 11:21 PM   #62
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Originally Posted by daylatedollarshort View Post
There are many Medicaid exempt asset classes and income streams where money can legally be moved to prior to the five year look back period. I don't see needing to insure or self insure for more than 5 years plus some planning time. Plus the average nursing home stay is less than 3 years.
As for the first point, this assumes the look back period will stay 5 years. At one time, it used to be 3 years. In the future, it might be 7 years or 10 years or forever. As boomers age, much stress will be put on Medicaid for long-term care. I hope the law will stay as it is now, but experience would say that it was more realistic to fear that it wouldn't.

As for the second point, the fact the average nursing home stay is less than years doesn't help at all if DH or I are part of the more than average.

About 1/4 of nursing home residents stay there more than 3 years with 10% more than 5 years.

FASTSTATS - Nursing Home Care
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Old 08-11-2013, 11:24 PM   #63
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Originally Posted by pb4uski View Post
I would think that since so few people stay over 2 years that a catastrophic loss policy could be affordable.
Well it isn't that few. In the study I cited in my post before this 25.6% had been in the nursing home more than 3 years with 10% there more than 5 years. For an insurer, that would seem fairly risky. No one would pay for the catastrophic policy unless it was affordable but I could see the insurer thinking that an affordable policy didn't provide it enough premiums to cover the quarter of people that stay more than 3 years. Further with health advances, it is entirely possible that in future stays will increase as it is more possible to keep people alive longer.
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Old 08-12-2013, 12:32 AM   #64
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Has anybody looked into lump sum LTC/Life insurance hybrid?
Someone I know got this thing called Asset Care 1 Basic Life and he paid a lump sum premium and LTC is piggy-backing with life insurance.

I just googled it.
Asset-CareŽ Long-Term Care Whole Life Insurance | Asset-Based Long Term Care - State Life Insurance Company, a OneAmerica company

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Asset-Care is whole life insurance that allows access to 100% of its death benefit for qualifying long-term care expenses (paid monthly). Clients can help protect their assets from the risk of long-term care expenses while at the same time receiving guaranteed cash value growth and death benefits. Even if care is never needed, Asset-Care provides value. It can be purchased with a one-time single premium or annual premiums.
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Old 08-12-2013, 12:34 AM   #65
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I am just thinking... if there is any chance that you are moving to another country, getting an LTC insurance may not be a good idea, right? (or you can take it out of the country?)
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Old 08-12-2013, 02:07 AM   #66
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Originally Posted by Katsmeow View Post
As for the first point, this assumes the look back period will stay 5 years. At one time, it used to be 3 years. In the future, it might be 7 years or 10 years or forever. As boomers age, much stress will be put on Medicaid for long-term care. I hope the law will stay as it is now, but experience would say that it was more realistic to fear that it wouldn't.

As for the second point, the fact the average nursing home stay is less than years doesn't help at all if DH or I are part of the more than average.

About 1/4 of nursing home residents stay there more than 3 years with 10% more than 5 years.

FASTSTATS - Nursing Home Care
How much risk you are willing to accept is a personal choice, but we are going with the self insured, Medicaid planning route. In the future the look back period might be less than 5 years, or there might be more non-countable assets and income streams than there are now.

There are pretty long lists in books and on the Internet of ways to convert countable assets to cash and then use the cash to purchase noncountable assets, including businesses, business property, retirement accounts in spouse's name, personal residence, and certain annuities.

Not everyone is going to end up in a nursing home and for those that do the stay is usually less than 3 years, so we are going with the odds.
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Old 08-12-2013, 05:48 AM   #67
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I sometimes hear men say this (including Mr. A. who doesn't even own a gun). I always wonder at what point, before total dementia, that somebody would "know" all hope is lost, it's time to pull the trigger, and would still be able to do so. Gruesome line of thinking!

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I know two people that shot themselves after getting a "no hope" cancer diagnosis. The problem with relying on that approach with dementia is that the person with dementia doesn't realize or accept the diagnosis. I doubt anyone with dementia would actually commit suicide.
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Old 08-12-2013, 08:44 AM   #68
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I am just thinking... if there is any chance that you are moving to another country, getting an LTC insurance may not be a good idea, right? (or you can take it out of the country?)
The LTC policy I have through mutual of Omaha covers Canada and the UK. Not sure why only the UK and not other EU countries
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Old 08-12-2013, 10:14 AM   #69
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I'm interested in the forum participants wisdom on the issue of self-insuring for LTC.

My own situation is as follows:

DH and I each have LTC policies (not linked) that we purchased at 60. Each policy started at $170/day in benefits with automatic annual increases of 5 percent(now about $216/day). The benefits are good for only 4 years of use. Each policy has a 90 day period of residency before benefits kick in. Each policy could be used for in home care. The annual premium for both policies is $5,000.

Our finances are: Fully cola'd pensions, SS total 137,000/year. Total Annual expenses of $185,000, including Fed& State taxes of $50,000 (high partly to cover conversions of tIRA's to Roth over time). TA of $2,850,000. No debt.
I've made some reading errors recently, so I'm trying to be careful with the numbers, but this is what I see.

According to the MetLife survey, the average cost for NH care is $248/day or $90,000/yr. That's for one person.

If I were in your situation, I'd notice that our combined SS + COLA'd pensions is $185,000. Half of that would nearly cashflow NH expenses, though the person in the NH also has other expenses.

Once I'm in the NH, I can stop planning for a 30 year life span. Half your assets, which would be $1,425,000 would certainly be enough to cover that "other expenses" for many years. It could be spent at the rate of $142,500 per year for 10 years, for example, which is way above what I could imagine "needing".

With those numbers, I'd say that I don't need LTCi, I'm not going to die broke. LTCi would be a psychological benefit in knowing that I've got a belt-and-suspenders-and-another-belt plan.

(FTR, we're operating on less than half your income/assets. We haven't bought LTCi, though I see it as a very close call for us.)
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Old 08-12-2013, 10:55 AM   #70
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Since we've talked about Medicaid, we should also mention the partnership programs that allow a person/couple to qualify for Medicaid while keeping a lot more of their assets. To do this, you need to buy a LTC insurance policy that is approved by the state for this "partnership program", then when you've spent down your assets to pay for LTC to the value of that policy, you can keep the rest of your money/assets and still go on Medicare. It's one way to avoid total impoverishment of the surviving spouse.

The bad news is that these "partnership approved" policies generally (always?) must include the inflation protection, so you can't get away with the much less expensive "decreasing real value" option and qualify for Medicaid at the higher asset level.

The (minor) good news is that some states allow a state income tax deduction for LTC insurance premiums.
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Old 08-12-2013, 11:48 AM   #71
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Originally Posted by pb4uski View Post
Add me into the chorus of folks that would like to see an LTC policy for catastrophic loss with a high deductible (say $100k or $150k).

My nightmare scenario is that either me or DW end up being in a NH for 8 or 10 years.

I would think that since so few people stay over 2 years that a catastrophic loss policy could be affordable.
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