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Old 10-23-2014, 02:16 PM   #41
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Originally Posted by mathjak107 View Post
no limits , just like any other insurance. but in order to keep a customer base an insurer has to watch the costs.

the original increases were because they had no idea how to price the early policies.

today they have a better handle on things.

like all insurance sold in our state insurers here have to agree to absorb the customer base of any troubled company. many states have the same insurance rules.

AM BEST gives genworth an "A" rating of excellent
We bought two $100/day policies in 1994 after health scare for DW and me. Since then, the original policy has been transferred to three different companies eventually ending up in a Trust...
SHIP - About SHIP

I figure we've paid in about $45K. The premiums have gone up less than 10% since we purchased. $36K/yr doesn't go too far in covering an $80K/yr cost, but it helps. Wouldn't cancel now.
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Old 10-23-2014, 02:36 PM   #42
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Readers of this thread should bear in mind that mathjak107's LTCI situation is for his state of NY. Through a program called "Partnership," NY is chosing to pass out some benefits relating to the transistion to Medicaid (if required) after insurance benefits are used up. Not all states are doing this. And there is an implication that you must receive your care in NY for these benefits to apply.

Quote:
The NYS Partnership for Long-Term Care (NYSPLTC) is a unique Department of Health program combining private long-term care insurance and Medicaid Extended Coverage (MEC). Its purpose is to help New Yorkers financially prepare for the possibility of needing nursing home care, home care, or assisted living services someday
http://www.nyspltc.org/

Caveat Emptor. While mathjak107's arguments sound like good points for LTCI in general, in actuality they would apply only to New Yorkers and perhaps folks in other states with similar situations, if there are any.

Do I understand the situation correctly mathjak107?
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Old 10-23-2014, 02:51 PM   #43
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Readers of this thread should bear in mind that mathjak107's LTCI situation is for his state of NY. Through a program called "Partnership," NY is chosing to pass out some benefits relating to the transistion to Medicaid (if required) after insurance benefits are used up. Not all states are doing this. And there is an implication that you must receive your care in NY for these benefits to apply.

Caveat Emptor.

Do I understand the situation correctly mathjak107?
Thanks for explaining this. I was wondering how the spend down, and shared assets requirements for medicaid were "waived" by the LTCI person.

I don't think the medicaid deals work in PA, KY, or CA - the states I've looked at for family reasons.
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Old 10-23-2014, 02:51 PM   #44
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No LTCi for me, which is one of the reasons I will be moving into a CCRC at age 75 or so. The one we are looking out has a buy-in and does not kick you out if your health or financial situation changes. Cost is approx $3k / month per couple for independant living, $5k / month for Assisted Living per couple and $5k / month per person for memory care.
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Old 10-23-2014, 02:53 PM   #45
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We are self insuring for now. If one of us needs nursing home care in our later years, we could handle the cost depending on how long it lasts. The disaster scenario is that we both need nursing home care for many years - which just means that DD and DS would get a much lower or no inheritance.
At 67 years old, we feel like the LTCI train has pulled out of the station for us. If we could qualify for LTCI, premiums would be very high due to both our ages and some minor health issues. Fortunately, like you, we are able to self-insure without any awkward financial strategies that would reduce our current portfolio performance. That is, no need to modify our desired AA to account for potential upcoming LTC costs.
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I guess in a way, the potential redundancy of a low WR is our LTC insurance.
+1
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I have priced out LTC insurance and the cost seems much to high in relation to the likely benefits.
I have also done this. I asked all three agents about the availability of a less costly "high deductible" type policy and all said nothing was available.


Additionally, the type of care a policy will pay for still seems to be unpredictable and varies from provider to provider. An older (77) work-chum of mine has a Genworth policy he has held for many years. He is on oxygen 24 X 7, has a artificial heart valve and is morbidly obese. He does still drive and seems mentally competent. He lives alone. His doc is concerned that he's living alone but so far Genworth is telling him he does not qualify for any help. That is, he needs to deteriorate further. It seems that the line you need to cross to qualify for help is a bit fuzzy.
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Old 10-23-2014, 03:07 PM   #46
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Me bed-stricken, a nurse, and 6 million dollars. Only one way that story ends.


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I assume you mean that the "one way" that story ends is that you are glad you're comfortably self-insured for LTC and focus on recovery or at least on being as comfortable as you can until the grim reaper shows up.

If you have an income of over a quarter million dollars (4% of 6 million plus whatever else such as SS, pension, etc.), that would allow you to pay $120k for quality care and leave $130k+ for your spouse (or whomever) to get by on.

Sounds like a plan........

Or, look at it in lump sum terms. You spend one million bux on LTC before you croak. Your estate is still five million.

Not a bad situation. And, BTW, nice job on your wealth accumulation! While "money can't buy ya love," it sure can remove worries about LTC.
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Old 10-23-2014, 04:57 PM   #47
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At 67 years old, we feel like the LTCI train has pulled out of the station for us. If we could qualify for LTCI, premiums would be very high due to both our ages and some minor health issues. Fortunately, like you, we are able to self-insure without any awkward financial strategies that would reduce our current portfolio performance. That is, no need to modify our desired AA to account for potential upcoming LTC costs.
+1 I have also done this. I asked all three agents about the availability of a less costly "high deductible" type policy and all said nothing was available.


Additionally, the type of care a policy will pay for still seems to be unpredictable and varies from provider to provider. An older (77) work-chum of mine has a Genworth policy he has held for many years. He is on oxygen 24 X 7, has a artificial heart valve and is morbidly obese. He does still drive and seems mentally competent. He lives alone. His doc is concerned that he's living alone but so far Genworth is telling him he does not qualify for any help. That is, he needs to deteriorate further. It seems that the line you need to cross to qualify for help is a bit fuzzy.
In general the critical issue for payment is the so called activities for daily living. Since he is still driving he clearly can get to the toilet and wash himself which are two of the activities (here is the full list:
  • Eating
  • Bathing
  • Dressing
  • Toileting
  • Transferring
  • Maintaining Continence
) and also transfer so it is not likely he would qualify at this point for any policy.
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Old 10-23-2014, 05:56 PM   #48
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Readers of this thread should bear in mind that mathjak107's LTCI situation is for his state of NY. Through a program called "Partnership," NY is chosing to pass out some benefits relating to the transistion to Medicaid (if required) after insurance benefits are used up. Not all states are doing this. And there is an implication that you must receive your care in NY for these benefits to apply.



Long Term Care Insurance - New York State Partnership for Long-Term Care

Caveat Emptor. While mathjak107's arguments sound like good points for LTCI in general, in actuality they would apply only to New Yorkers and perhaps folks in other states with similar situations, if there are any.

Do I understand the situation correctly mathjak107?
yes you are correct as each state is going to be different .

however certain things still apply.

as i said folks say we are self insuring ,but to really self insure unless you have a lot of money involves keeping that money safe and a way from potential drops that may make the amount you need unavailable.

that is a very important factor since if you then consider you can invest that money elsewhere all you need to do is spend a little bit of those gains for the premuim then it is really a different story.

by the way the state sponsered plan will still pay the agreed amount out if you move to another state but they have no control over that states look back period or agreement not to take income over the medicaid limit for the stay at home spouse..

according to information i saw on the PA partnership link below states and the federal gov't are working on agreements to reciprocate with each others partnership plans.

"12. If I bought a Partnership Policy in another state, can I get asset protection if I go onto Medical Assistance here in Pennsylvania?
The Partnership is a national effort and states are coordinating their activities as well as working with the federal government to provide for reciprocity standards between states. We expect that most states will agree to these standards, so that if you buy a Partnership Policy in another state, you will be able to get Pennsylvania’s asset protection benefits if you go onto Medical Assistance here. Those reciprocal standards would also apply if you buy a policy here in Pennsylvania and then move to another Partnership state and need long-term care there. Back to Top
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Old 10-23-2014, 06:02 PM   #49
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Thanks for explaining this. I was wondering how the spend down, and shared assets requirements for medicaid were "waived" by the LTCI person.

I don't think the medicaid deals work in PA, KY, or CA - the states I've looked at for family reasons.
i don't know about all those states but PA HAS A PARTNERSHIP PLAN.

Health Insurance
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Old 10-24-2014, 06:38 AM   #50
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Somehow, when we discuss Long Term Care, the important part about couples and home ownership seems to get confusing.

Sheltering up to $800,000 in home ownership by spending down to allow Medicaid to pay for LTC for a partner, can be important for those with limited assets.

Mathjak107 presents the argument well. This NOLO website is about a 5 minute read, and gives a broad overview of what may and may not be pertinent, according to your own situation. Without considering the "whole", the parts will determine whether or not LTCI would be worthwhile.

http://www.nolo.com/legal-encycloped...-medicaid.html

Just one small part of the article:
Quote:
First, you should know that some assets do not have to be spent or sold to qualify for Medicaid, so these don't need to be spent down. These non-countable assets include the home, a car, personal effects, household goods and furnishings, some prepaid funeral and burial arrangements, and a limited amount of cash ($3,000 for a couple), to name just a few. But the determination of whether these assets are exempt, and to what extent, is made on a case-by-case basis. Your state’s Medicaid program will take into account individual state laws as well as your marital status, living arrangements, and other factors.
Other headings:
Non-Countable Assets
Permissible Expenses
Legitimate Debt
Purchasing Noncountable Assets
Funeral and Burial Expenses
Caregiver Agreements

Now, here's the rub...
It would be nice to be able to put off the decisions until some form of Long Term Care is on the horizon. Of my own knowledge, in four cases that involved relatives and friends, two worked out well, because of Eldercare legal assistance well in advance of the needs, while the other two led to a relative disaster for the surviving spouse... left with almost nothing after a five year nursing home stay.

Another case here:
http://www.early-retirement.org/foru...ml#post1498233
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Old 10-25-2014, 10:21 AM   #51
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as i said folks say we are self insuring ,but to really self insure unless you have a lot of money involves keeping that money safe and a way from potential drops that may make the amount you need unavailable.

Everyone is in their own unique situation as relates to their financial situation and their investment skills and philosophy.

In your case, things have worked out so that self-insuring for LTC apparently would not work out, or would not be optimum. In my case it has.
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Old 10-25-2014, 10:53 AM   #52
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two worked out well, because of Eldercare legal assistance well in advance of the needs,
+1

I certainly agree. Knowledge of the ins and outs of LTC costs and of Medicaid rules can be a huge factor in planning for the final years of one's life, especially for a couple.

My only first hand experience comes from getting MIL situated in a NH and our case was fairly simple. MIL, a long time widow, had no need to leave a legacy and her only asset was the equity left in her condo after netting out a reverse mortgage. This amount turned out to be just right to get her into a nice, primarily private facility where she self-insured for about 18 months and then switched to Medicaid. There was enough money to get her into a quality place but not so much that her heirs were left wringing their hands over lost inheritance. LTCI would likely not have been much help and she couldn't afford it anyway.

OTOH, I'm familiar with several couples with mid-level assets who wish they had LTCI. These are folks with some resources but not enough that a long NH home stay might not impoverish the survivor without some planning and manuvering. In one case, the couple has much more tied up in their house in Wisconsin than they'd otherwise have, but it's their way of making sure LTC costs can't impoverish the survivor.

It's an interesting path to walk and I agree with you that some professional help in determining how to handle things might be called for, especially for a couple or someone with a dependent they need to protect.
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Old 10-25-2014, 05:32 PM   #53
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I told my two children I was paying college tuition instead of buying LTC insurance and asked them to be sure to turn the wheelchair so the sun was not in my eyes and to wipe the drool off my chin. I hope they remember.
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Old 10-25-2014, 07:19 PM   #54
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+1


OTOH, I'm familiar with several couples with mid-level assets who wish they had LTCI. These are folks with some resources but not enough that a long NH home stay might not impoverish the survivor without some planning and manuvering. In one case, the couple has much more tied up in their house in Wisconsin than they'd otherwise have, but it's their way of making sure LTC costs can't impoverish the survivor.
Speaking a bit tongue in cheek why not get a divorce and shack up. Common law marriage has been repealed. How would medicaid treat two unrelated folks (since after a divorce that is what they would be) living together?
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Old 10-25-2014, 09:47 PM   #55
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Speaking a bit tongue in cheek why not get a divorce and shack up. Common law marriage has been repealed. How would medicaid treat two unrelated folks (since after a divorce that is what they would be) living together?
Somebody told me this is why The Captain and Tennile got divorced recently. He's got an expensive medical condition
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Old 10-26-2014, 06:17 AM   #56
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I told my two children I was paying college tuition instead of buying LTC insurance and asked them to be sure to turn the wheelchair so the sun was not in my eyes and to wipe the drool off my chin. I hope they remember.
And the beauty of it is that if they don't remember you may not know the difference. que sera sera
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Old 10-26-2014, 07:57 AM   #57
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Thanks for explaining this. I was wondering how the spend down, and shared assets requirements for medicaid were "waived" by the LTCI person.

I don't think the medicaid deals work in PA, KY, or CA - the states I've looked at for family reasons.
It looks to me like CA has a partnership program.

http://www.dhcs.ca.gov/services/ltc/...Asset_2010.pdf
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Old 10-26-2014, 08:00 AM   #58
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In one case, the couple has much more tied up in their house in Wisconsin than they'd otherwise have, but it's their way of making sure LTC costs can't impoverish the survivor.

It's an interesting path to walk and I agree with you that some professional help in determining how to handle things might be called for, especially for a couple or someone with a dependent they need to protect.
I'll agree that his is complicated.

Note, however, that WI has a LTCi partnership program:
Wisconsin Senior Issues - Long-Term Care Insurance Partnership Program
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Old 10-26-2014, 09:09 PM   #59
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How would medicaid treat two unrelated folks (since after a divorce that is what they would be) living together?

I think the 5-year look back applies. If you divorced less than 5 years ago they may treat the couple as still married.
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Old 10-26-2014, 09:19 PM   #60
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I think the 5-year look back applies. If you divorced less than 5 years ago they may treat the couple as still married.
A bit more I found out, Medicaid disregards pre-nups. The advice also says both parties need their own attorneys if they want to go the divorce route.
The main thing that would be lost in a divorce situation is less important with the 5.x million estate tax exemption, the ability to transfer any amount to a spouse at death.
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