How the Medicaid Debate Affects Long-Term Care Insurance Decisions

Worth the read. Long term care is a ticking time bomb for Boomers. Medicare doesn’t cover it and future Medicaid budgets are iffy. 

I recommend considering the new life insurance “use or use it” over stand alone long term care plans.

https://mobile.nytimes.com/2017/07/14/your-money/how-the-medicaid-debate-affects-long-term-care-insurance-decisions.html

Questions to ask your doctor.

My thoughts on some of the six excellent questions Elizabeth Rosenthal, author of “An American Sickness,” suggests you should ask at every doctor’s appointment to make sure your medical bills are what you expect.

Question #1. How much will this cost?  Your provider’s office staff will know the fee a procedure, or series of procedures are billed at. And they will be able to tell you if your health plan has negotiated a different fee schedule including your flat copay or co-insurance percentage. To be forewarned is forearmed.

Question #4: Are there cheaper alternatives that are equally good, or nearly so? One example I see is a medication that is a combination of two, or more, off-patent generics. Check your health plan’s drug formulary and compare the co-pays. If the new combination pill is high priced ask your prescribing doctor why the one pill is recommended over taking two; sometimes the only benefit is convenience.

Question #5. Where will this procedure take place and how does that selection affect my cost?  Your health plan may have a preferred pricing arrangement (called “in network”, “participating” or “contracted”) with other facilities. Ask your doctor about performing the procedure at one of those.

One more suggestion. Contact your health plan agent or member services representative when planning an appointment with a new provider or facility.  Your plan may have preferred providers, usage limitations and pre authorization requirements. 

http://www.pbs.org/newshour/making-sense/column-6-questions-to-ask-at-every-doctors-appointment/?utm_source=facebook&utm_medium=pbsofficial&utm_campaign=newshour

Comparing Short Term Care to Long Term Care Insurance.

Long-term-care

What is Long Term Care? Almost 70% of people turning 65 will need long term care at some point in their lives. Long term care is when we need help with two or more daily activities such as bathing, dressing, eating or using the bathroom. (i)  Care can be provided in a nursing home, assisted care facility or at home.

Costs vary depending on whether the care is provided in our home, in an assisted living facility or nursing home.  (Here is a helpful link to look up the cost of care in your area.) You’ll see nursing home costs are about double that of home care.

Doesn’t Medicare Pay These Costs?  Don’t count on it. Part A covers skilled nursing care in a skilled nursing facility (not home care) under certain conditions for a limited time; and even then it’s usually related to a hospital stay and discharge.  (ii)  And, no, Medicare does not cover long term or custodial care. (iii)

So, How Would I Pay for This?

In the U.S., 10,000 people turn 65 daily. Most do not have the financial reserves or long term care insurance    protection against what could wipe out your lifetime of savings and accumulated assets.   Why not? Well,the three reasons why people defer obtaining a long term care policy are:

  1. The cost. Let’s face it, traditional long term care premiums can be pricey. Not as expensive as one year of care but beyond what many middle age household budgets can afford.  (Paying off mortgage, college education(s), retirement funds, etc.)
  2. Denial. “I am not part of the 70% that will need care.”  “My children will take care of me.” “I have good genes.”
  3. Complexity.   Underwriting for eligibility can involve extensive medical forms, physician statements, lab results and pharmacy screens to confirm eligibility.  (Download FREE Shopper’s Guide to Long Term Care Insurance target=”_blank” )

And So How Does Short Term Compare to Long Term Care Protection?

 Short Term Care

  • Benefits paid for up to one year
  • A 20 to 60 day waiting period
  • No Plan of Care Required
  • Simple Application
  • More Affordable
 Long Term Care

  • Benefits paid for up to ten years
  • A 90 to 365 waiting period
  • Yes, a Plan of Care Is Required
  • Extensive Application
  • More Expensive

Next Step

Call me at (518) 346-2115 and we can review the 10 Yes /No eligibility questions and create your customized premium quote.

Please visit and follow our Facebook Page. Daniel G. Alcorn, a licensed and independent agent, represents licensed insurance companies in Massachusetts and New York.  Dan may receive compensation for individual enrollments in Medicare Advantage, Medicare Supplemental Insurance , Medicare Prescription Drug or Long Term Care /Short Term Care plans.
Sources:

(i) http://longtermcare.gov/the-basics/what-is-long-term-care/

(ii) http://www.medicare.gov/coverage/skilled-nursing-facility-care.html

(iii) http://www.medicare.gov/what-medicare-covers/not-covered/item-and-services-not-covered-by-part-a-and-b.html

Family Caregivers Kit: 9 Free Publications

helpManage a loved one’s finances and health care with knowledge and confidence.

The Family Caregivers Kit is a collection of publications that help you understand your duties as an agent under a power of attorney, keep track of medications, protect your loved ones from scams, and more.

 

PUBLICATIONS FEATURED IN THE FREE FAMILY CAREGIVERS KIT

( Download Adobe Reader to view these publications.)
  1. Consumer Action Handbook  Family Caregivers Kit -1
  2. Health Scams Family Caregivers Kit -2
  3. Money Smart for Older Adults: Financial Exploitation  Family Caregivers Kit -3
  4. Managing Someone Else’s Money: Fiduciary   Family Caregivers Kit -4
  5. Managing Someone Else’s Money: Court Appointed Guardians Family Caregivers Kit -5
  6. Managing Someone Else’s Money: Representative / VA Fiduciary Family Caregivers Kit -6
  7. Managing Someone Else’s Money: Trustees / Revocable Living Trust Family Caregivers Kit -7
  8. My Medicines  Family Caregivers Kit -8
  9. Use Medicines Wisely  Family Caregivers Kit -9

 As an independent licensed Life, Accident and Health Insurance professional, I represent several insurance companies authorized to conduct business in New York.  For more information about how affordable insurance can protect your assets and provide you greater control over your financial planning, please contact me at (518) 346-2115 for a confidential and complimentary consultation.

"This service is provided by the Consumer Financial Protection Bureau, 
Food and Drug Administration's Office of Women's Health and the 
Federal Citizen Information Center at the General Services Administration."

The value of voluntary long-term care insurance.

Recently I was involved on a case where adult children, as part of their financial planning, explored the purchase of long term care protection on their parents. (Of course, the parents had to consent, and qualify medically.)

The rationale was this:  the adult children and spouses understand that 40% of women, and 37% of men, at some point will assist an individual requiring long term care.  (And 70% of people 65 or older can expect to use some form of long term care. Source)

Statistics also that report nearly 2/3 of those caregivers end up making work accommodations to provide care for a family member – usually a parent or in-law that most often is still living at home.

As the parents do not have long term care insurance, the adult children are exploring purchasing the policies as a way to extend their parents’ limited resources and protect their own respective incomes in the event long term care become necessary.   Yes, this seems like a generous gift to their parents but this is also smart balance sheet planning on their part.

(The adult children know that AARP has found data showing that a 50-year-old or older family caregiver who leaves the workforce to care for a parent forgoes, on average, $304,000 in lost salary and benefits over their lifetime. These estimates range from $283,716 for men to $324,044 for women.)

Here is a helpful link to a page where you confirm today’s cost of care  and what it may cost in the future.

As today there are more options available for long-term care protection solutions, let’s talk.

Dan

New York State residents: for a complimentary consultation and review of available options, please call me at (518) 346-2115 or schedule a telephone appointment at a time most convenient for you.

caregivers-profile

Source:
http://www.pbs.org/newshour/rundown/what-working-a-part-time-job-for-five-years-for-free-looks-like/

Using Annuities in Medicaid Long-Term Care Planning

Annuities, long-term care insurance or a hybrid life insurance / LTC rider are better options than trying to go-it-alone.

Guide to Long-Term Care blog

Medicaid applicants with too much money or assets are denied coverage for long-term care and have to pay their own nursing home bills. For many, their savings would be depleted within months, leaving the Medicaid applicant’s spouse destitute. Annuities can magically wipe away these excess resources that are preventing Medicaid eligibility and replace them with a monthly check, payable to the applicant’s spouse (referred to as the “community spouse”).

Sound too good to be true? It’s not, and when done properly, this technique can preserve a large portion of a couple’s resources to provide for the community spouse, who may live for many years, and possibly, the couple’s heirs.

Read complete article here: http://www.nolo.com/legal-encyclopedia/using-annuities-medicaid-long-term-care-planning.htm

For annuity quotes: http://guidetolongtermcare.com/forms/quote.html 
(some annuities offer LTC benefits that pay out more than the annuity value)

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Families providing care

image

39% of U.S. adults care for someone with significant health issues, up from 30% in 2010.