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Old 01-09-2015, 05:47 AM   #21
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Who cares about assets if you are in LTC for more than 5 years and have to go on Medicaid. What % of people come out of LTC and go back to taking cruises or mowing their home lawn after 5+ years? Less than 0.01%?
The surviving spouse probably cares a great deal.
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Old 01-09-2015, 05:50 AM   #22
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The surviving spouse probably cares a great deal.
Yep.
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Old 01-09-2015, 05:59 AM   #23
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My father was in a nursing home for 5+ years due to a brain stem stroke. Medicare pays the first 30 days, then the next ~60 days are passed on to the patient at like $100 per day.

He fell at the nursing home, went to the hospital for a day, then back to the nursing home, so he had another 90+ days worth of Medicare.

I private paid his care for 12 months until he could be into a VA nursing home. The VA only goes back 12 months for asset look backs. I believe VA LT care is open to any veteran.

When I visited him in the private facility, there were both young and old people. Younger people from car accidents and some surgery recoveries.

There was one roommate of my Dad's that had a surgery accident that left him without oxygen and he was a vegetable. He was 45 and in great health until the accident. He owned a trucking company. He was just curled up in a fetal position all day/night. I spoke with his mother quite a bit who was there every day, all day.
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Old 01-09-2015, 06:12 AM   #24
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In a few discussions on M* it became clear to me that several folks maintained LTC policies because they saw that as protecting their assets to go to their heirs. It may only protect $250-$350K in today's dollars (most had inflation riders) as long as they didn't hit a very long stay.

I got the impression this was a major marketing point?
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Old 01-09-2015, 06:19 AM   #25
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I don't recall any discussion of preserving assets for heirs when we purchased. We bought our LTC policies to protect the assets of the surviving spouse.
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Old 01-09-2015, 06:28 AM   #26
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The surviving spouse probably cares a great deal.
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I don't recall any discussion of preserving assets for heirs when we purchased. We bought our LTC policies to protect the assets of the surviving spouse.
This is how I see it. An extended stay in a nursing home can be financially devasting to a healthier, surviving spouse.
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Old 01-09-2015, 06:46 AM   #27
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This is how I see it. An extended stay in a nursing home can be financially devasting to a healthier, surviving spouse.
Devastating in the fact that they won't be able to leave money to their heirs?

The surviving spouse will have a paid for house, a nice SS check from delaying SS to age 70, and extra income from a small annuity they both purchased with a portion of their 401K money.
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Old 01-09-2015, 07:09 AM   #28
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This is how I see it. An extended stay in a nursing home can be financially devasting to a healthier, surviving spouse.
That's how I see it too. The main concern should be the surviving spouse, not the heirs. And the point of deciding whether one can afford to self-insure is what is left for the spouse.

But a lot of people talked about protecting their estate for their heirs.
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Old 01-09-2015, 07:40 AM   #29
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That's how I see it too. The main concern should be the surviving spouse, not the heirs. And the point of deciding whether one can afford to self-insure is what is left for the spouse.

But a lot of people talked about protecting their estate for their heirs.
Leaving our kids/grandkids a big chunk of money isn't very high on our priority list and certainly wasn't part of our thinking when we purchased LTC policies.

As I mentioned in an earlier post, we've seen all four of our parents spend from 7 months to 3 years in a nursing home. None of them had any LTC coverage, so the financial burden to pay for care fell on the surviving spouse and whatever savings they had until the spend down to Medicaid. It was a painful process.

The emotional and financial toll on the healthy spouse was a heavy one. It is easy to discuss spending down assets from an academic point of view but it is entirely different when an individual sees their life savings evaporating over a period of a few months. Knowing "they can't take my house" and "I'll still have SS" really doesn't offer much consolation.

We're hoping to avoid some of that pain with our LTC coverage.
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Old 01-09-2015, 07:58 AM   #30
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Devastating in the fact that they won't be able to leave money to their heirs?

The surviving spouse will have a paid for house, a nice SS check from delaying SS to age 70, and extra income from a small annuity they both purchased with a portion of their 401K money.
Sounds like quite a few very judgemental assumptions here. First, not everyone enters LTC in their 70s or later. Not everyone has a paid for house. Not everyone can afford to wait until 70 for their SS. There are often complications well before and even during LTC that would eat up the 401(k), and if they had purchased an annuity with it there wouldn't be money for the care. They'd probably have to take out a loan to cover it because their money would be locked up in the annuity. There goes your assumed comfy cushion. Back to dog food. Of course, I guess you could divorce the sick spouse so you'd have your money.

I might agree that some/most people on this site might be able to manage based on your assumptions, but very few other people would.
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Old 01-09-2015, 08:05 AM   #31
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Sounds like quite a few very judgemental assumptions here. First, not everyone enters LTC in their 70s or later. Not everyone has a paid for house. Not everyone can afford to wait until 70 for their SS. There are often complications well before and even during LTC that would eat up the 401(k), and if they had purchased an annuity with it there wouldn't be money for the care. They'd probably have to take out a loan to cover it because their money would be locked up in the annuity. There goes your assumed comfy cushion. Back to dog food. Of course, I guess you could divorce the sick spouse so you'd have your money.

I might agree that some/most people on this site might be able to manage based on your assumptions, but very few other people would.
So you are saying people who can't afford to pay off their home or delay SS to age 70 CAN afford the high premiums of LTC insurance?

Or are you just pointing out that there are people who can't afford either one?
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Old 01-09-2015, 08:10 AM   #32
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I saw a situation little discussed but very worrisome with my aunt. She moved from independent living to assisted living, close to where my mother lived so DM could help care for her. Two years later she fell and badly broke her arm. It did not heal well, and over the next 6 months she went back and forth between the hospital and a skilled nursing facility. She reached the 100 day max that Medicare pays for hospital / nursing homes but required much more care, at that point she had to pay the continuing cost out of her pocket. At the same time she had to continue paying for her home in the assisted living facility or they would move her out and rent to room to someone else. The monthly cost for those two things was around $16K. The risk of her drawing down all of her asset went from very low to very high in just a couple of months.

The risk of consuming all the assets in just a couple of years is higher than most people think.
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Old 01-09-2015, 08:17 AM   #33
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$16K a month and she still needed extra care provided by DM?

One would think for $200,000 a year that these private facilities would do everything for you.

Do the LTC policies pay out whatever absurd rate the facility of your choice charges?
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Old 01-09-2015, 08:19 AM   #34
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If LTC were so profitable, more companies would write it so I don't think it's a big gravy train for insurers. I once worked for an insurance sub of a large non-insurance conglomerate and when they sold their insurance operations off, the one entity the acquiring company (a very large insurer) didn't want was the LTC provider.


I haven't bought LTC and don't intend to. The stories that scare the crap outta me are the ones that start with a spouse developing Alzheimer's in their 60s. No matter what the healthy spouse is "allowed" to keep, it won't be enough. I think there was a story here where the wife was permitted to keep $100K plus $2K/month in income. They were living in a retirement community (apparently not one with Alzheimer's care) and the fixed expenses were about $2K/month.


DH is 76 and has some health issues so a nursing home stay that goes on for years is extremely unlikely. We can fund that. What's left should be fine to provide for me, and DS (bless him) says he doesn't want any of my money. If I lose DH I'm not marrying again- too many financial entanglements imposed by the state.
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Old 01-09-2015, 08:20 AM   #35
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So you are saying people who can't afford to pay off their home or delay SS to age 70 CAN afford the high premiums of LTC insurance?

Or are you just pointing out that there are people who can't afford either one?
No, I'm just saying that life seldom works out according to your plans, and that until you've seen the way things can pile up it can seem very simple and clean cut as to how you'd deal with them. I've had recent experiences with LTC, Medicaid, extraneous expenses and such. If you get real lucky it would work out like you've described. I'm not that lucky. If I was I'd solve my problems with a Powerball ticket.

We don't have LTC insurance ourselves. We're going with the Smother Buddy plan for debilitating long term illness/injury. Limits costs, decreases personal misery, leaves assets intact for spouse and heirs. Only downside is if I start snoring too loud it might kick in early.
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Old 01-09-2015, 08:43 AM   #36
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No, I'm just saying that life seldom works out according to your plans, and that until you've seen the way things can pile up it can seem very simple and clean cut as to how you'd deal with them. I've had recent experiences with LTC, Medicaid, extraneous expenses and such. If you get real lucky it would work out like you've described. I'm not that lucky. If I was I'd solve my problems with a Powerball ticket.

We don't have LTC insurance ourselves. We're going with the Smother Buddy plan for debilitating long term illness/injury. Limits costs, decreases personal misery, leaves assets intact for spouse and heirs. Only downside is if I start snoring too loud it might kick in early.
Yes, I realize life can kick you when you are down, then kick you some more. It sounds like LTC insurance could end up being nothing more than a bandaid on a severed artery.

I don't know if you are really series about the smother buddy plan, but DW and I have seriously talked about how we don't want to stay alive as a vegetable like a previous poster in this thread claimed a mother was keeping their child. The kicker would be if one of us had a sound mind but were permanently disabled to the point they could not feed or care for themselves. I think we each likely push the spouse to take us to a country with legal assisted suicide in that case.
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Old 01-09-2015, 08:55 AM   #37
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According to NYS the average nursing home in Long Island (where I live) is $398 a day, or $145,344 a year.

I don't know how anyone can afford this without Medicaid.
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Old 01-09-2015, 09:03 AM   #38
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Like others have said here... We have LTCI for now, when young, rather than when old. Don't care about assets surviving past death. Care more now for accident or early age disease that can affect spouse. We've seen it happen to a few young people right now, and it is scary. ("young" being less than 80). We'll eventually let it lapse assuming all goes well in life.

That said, I have the same brand insurance as Nords dad and it is making me nervous.
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Old 01-09-2015, 09:12 AM   #39
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Leaving our kids/grandkids a big chunk of money isn't very high on our priority list and certainly wasn't part of our thinking when we purchased LTC policies.
That's why I was surprised that "preserving the estate" was such a major goal of LTC holders over on M*. Folk here are much less concerned with maximizing what they pass on.
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Old 01-09-2015, 09:15 AM   #40
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$16K a month and she still needed extra care provided by DM?

One would think for $200,000 a year that these private facilities would do everything for you.

Do the LTC policies pay out whatever absurd rate the facility of your choice charges?
No they don't. They pay out a fixed rate per day, with a maximum total payout. People can buy insurance riders so the amounts increase over time until needed, but there is still a limit. There is no "extreme case" coverage. What is covered is a fixed amount, so deciding whether to purchase LTC is partly a matter of deciding whether you already have that amount in excess of your remaining spouse's spending needs.
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