LTC advice

[brewer12345]

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Originally Posted by Sarah in SC Oh and PS, Brewer, my young Russian co-worker just passed level 3. Over the moon!!! I knew she was smarter than me, now I can prove it!

Congrats to her! That is a huge accomplishment and no doubt a relief.

[hnzw_rui]

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Originally Posted by samclem Much depends on the inflation "protection" that is included. The tool at this web page allows you to see what LTCI through the Federal LTC program costs for a policy similar to the ones you're looking at. You might expect to pay more or less, but it should give you a point of reference. coverage.

Those plans, I'd actually consider getting. Does anyone else offer an "unlimited" plan?

[samclem]

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Originally Posted by mathjak107 3 years coverage still leaves you with a two year gap if you intend to shift assets . but they already increased the look back from 3 to 5 years

But they've got a "shared coverage" policy, so they have enough time to get the first person through the lookback zone. That's a big deal for many couples. This technique is still not without risk (increase of the lookback period, both people needing LTC at once, etc), but it covers a big portion of the present "hole".

[brewer12345]

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Originally Posted by hnzw_rui Those plans, I'd actually consider getting. Does anyone else offer an "unlimited" plan?

When I last discussed this with industry players a couple years ago, there was really nobody left commercially offering unlimited LTC. Too many got their heads handed to them with this product and now they concentrate on 3 and 5 year plans.

[samclem]

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Originally Posted by hnzw_rui Those plans, I'd actually consider getting. Does anyone else offer an "unlimited" plan?

Not that I know of, and I wouldn't be surprised if that is no longer an option for new policies the next time they revise this program. The "unlimited" time period is a great offering, and does what many people expect insurance to do--cover them for an unanticipated catastrophic event. States ought to be pushing to at least have these "unlimited time period" plans offered, as a means to keep people off Medicaid. The ACA removed caps on health insurance, but they remain prevalent in LTCI.

[mathjak107]

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Originally Posted by hnzw_rui Those plans, I'd actually consider getting. Does anyone else offer an "unlimited" plan?

usually you do not need unlimited . with a good partnership plan medicaid picks up the bills while you keep the assets .

many states are actually encouraging medicaid use after the insurance runs out by making it part of the plan. ny even created a special form called MEC medicaid extend coverage to go with the plans .

[samclem]

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Originally Posted by mathjak107 many states are actually encouraging medicaid use after the insurance runs out by making it part of the plan. ny even created a special form called MEC medicaid extend coverage to go with the plans .

Another way to view this is that states are encouraging people to buy LTCI by integrating it with Medicaid (through the Partnership Programs). That serves the interests of the states (and also the purchasers of LTCI). But I wouldn't say the states are interested in increasing their Medicaid costs--quite the opposite.

[mathjak107]

the states do not want to see their residents impoverished , especially the say at home spouse .

already CT , NY AND FLORIDA are following the lead of the high court in CT and ordering medicaid to negotiate a settlement when a spouse says no and the settlement cannot diminish the stay at home spouses lifestyle .

our estate attorney who is one of the most popular in nyc said he has zero law suites brought by medicaid now , only negotiations for an acceptable amount

[Debinnov a]

Mathjak, can you explain what you mean about ordering Medicaid to negotiate a settlement when a spouse says no? Recently retired and considering long-term care and trying to understand this. Does the amount of your retirement savings come into play when determining whether to choose a state partnership plan?

Sent from my KFTHWA using Tapatalk

[mathjak107]

A spouse has the right to say no under the medicaid act and not pay for the spouse in the home and he can't be thrown out.

But medicaid has the right to recovery . Either suing the spouse or waiting until the stay at home spouse dies and reclaiming from the estate.

Well medicaid sued a woman in ct. And the case went to the highest court.

The judge ruled he was not going to impoverish the people of his state because this country has a bad system.

So he left it open ended by ordering mrs jones and medicaid to find an acceptable amount that she could pay without taking a big step downward in life style.

Ny ,ct and florida courts have been following suit and at this point negotions have been taking place between medicaid and the estate attorneys who do this kind of work.

[ZMAN]

When we made our LTC plunge here in NY we decided to go with a lifetime duration LTC product from Mass Mutual with a starting daily of $300 (a few years ago) plus inflation protection. We liked that MM had survived the 2008 crash without a downgrade.

We decided against the NY Partnership program. I calculated that with a nursing home stay over 3 years (we could self insure for 3 years: not pleasant but doable) we would each have too much RMD or SS income which could then be grabbed by Medicaid. That income could not be even partially shielded without a lot of trouble and work, and could not be fully shielded in any event. I remember this was a pretty complex look ahead calculation, and I was not sure I had it right.

The cost of our MM policy is just over $11,000 for the two of us and has not changed (yet). We were 61 for me and 59 for DW when purchased. The Partnership Policy was around $6500 for the two of us for 3 years. With the NY State tax credit and the Federal deduction against my self employment income we figured the lifetime policy was worth it.

I think of it as a term policy and each year we decide whether to stay with it. So far we have but so far MM has not raised the premium.

[mathjak107]

the ny partnership plan has no limitations on income for the stay at home spouse if medicaid is required .

that was one of the perks that made us go for the plan . no income limit and no shifting of assets was the deal maker . unlike the below 3k a month limitation on regular medicaid the MEC version of medicaid you go on has no limitiations and only a request that you contribute 25% for the spouse being cared for but it is only request . even at 25% it would be a bargain .

[youbet]

mathjak107......


With your partnership plan, if you live long enough to exhaust the LTC insurance coverage and switch to Medicaid, do you get switched to Medicaid accommodations in the NH or do you get to stay in the nicer private pay section?

[mathjak107]

you have to check when you choose a home whether on your own money or insurance whether they will take medicaid .

most of them if not all will .

they may not except medicaid patients day 1 but once you are in they assume at some point unless you are wealthy you will get medicaid at some point .

[youbet]

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Originally Posted by mathjak107 you have to check when you choose a home whether on your own money or insurance whether they will take medicaid . .

I'm sure it varies from state to state. Here, due to difficulties NH's have getting the state to pay Medicaid money owed, NH's are becoming less willing to have Medicaid accommodations that are similar to their private pay accommodations. Some don't take Medicaid at all anymore and some of those that still do only offer multi-bed ward type situations. Ugh!

We worked hard to get MIL into a private pay situation where when she ran out of funds (as she has), her ongoing care would be similar to that she received as private pay and, so far, we seem to have succeeded. But here it's a challenging situation. In MIL's NH, the vast majority of clients are private pay and that seems to help.

I'd encourage folks trying to put together plans for their own or loved ones LTC to consider carefully the Medicaid situation in your state before going with a plan where the "perk" is being on Medicaid when the insurance runs out. It might be OK....... Or it might not. Ask questions and inspect up front. Understand exactly what Medicaid accommodations and services will be vs private pay.

[bingybear]

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Originally Posted by youbet mathjak107...... With your partnership plan, if you live long enough to exhaust the LTC insurance coverage and switch to Medicaid, do you get switched to Medicaid accommodations in the NH or do you get to stay in the nicer private pay section?

I think mathjak107 is referring to a ny partnership plan with unlimited asset protection. Only 2 states offer such plans, NH is not one of them. I believe he could not use NH facilities and get the unlimited asset protection. Thus the community spouse would have limits in NH and most other states. I don't know if he'd have to change facilities under the modified medicaid agreement in the partnership plan. Likely dependent on the LTCF. Many use to grandfather patients in if they had be there for a while footing the whole bill. Have not checked recently since my mom went into a facility.

[mathjak107]

yes the total asset plan is what we have . most states offer only what is called dollar for dollar . but what about income protection , do they offer that ?

[World Traveler]

Thanks All.

[Independent]

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Originally Posted by brewer12345 Most do not sell LTC any more, but for the record: NWM, MassMutual, NY Life, Guardian, TIAA-CREF, Thrivent, USAA. There are a few smaller guys out there with solid credit profiles, but those are the big boys in most markets.

Sorry for the slow response, but thanks for your advice.
I'm kind of surprised Thrivent is still in the market, I thought they dropped LTCi as part of the merger.
I'll look at these.

[brewer12345]

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Originally Posted by Independent Sorry for the slow response, but thanks for your advice. I'm kind of surprised Thrivent is still in the market, I thought they dropped LTCi as part of the merger. I'll look at these.

To be clear, those are the companies I think have extremely strong financial profiles, not necessarily ones that sell LTCI. To my knowledge, Thrivent has not sold that product in many years.