I am currently looking into adding some LT care insurance to supplement my Medicare-Medigap policies. There is some overlap, so I would most likely step down from my Medigap Plan I, to something lower like plan F or H.

The hardest nut in this equation is the LT preminum that one would pay for the built-in "inflation protection". There is the automatic 5% compounded adjustment that would allow the daily benefit to go up every year but the preminum would stay the same. This is best for someone who is under 70 years of age. Over 70 years of age, a simple compounded adjustment would be more suitable.

Another policy offered to in-laws of IBM employees (my SIL) feature a Future purchase Option in which the policy is offered for renewal every three years, 5% compounded; BUT, the preminum would be charged at the advanced age of the policy holder. Premiums would escalate as one got older and eventually could force one out of the system because it becomes unaffordable. This was hidden in the fine print of the policy I was seriously considering.

One planner suggested buying a life insurance policy that would replace the spend-down assets after death. That was dumb. I want a modicum of protection so I can have the security of knowing the LT health bills are going to be paid...and I can play with the rest of my portfolio while I am still able.

Monday, I meet with a Certified Senior Advisor to hash all this out and find out if I can afford this additional health insurance 10 or 15 years down the road; as well as the criteria to trigger the use of the policy and benefits covered. The last thing I would want to do is exhaust my resources and end up on Medi-Cal.

Other Ideas....

There are other philosophies that can be offered here too...for example having the children chip in for the LTC payments and also have an insurance policy paid up by them.



...

Use today wisely,
It's the only one we get.

Oh, for so short a time,
we are on loan to each other.

Jim

Jim,
good ideas ... but at this point I am much more solvent than any of my children. They all waited long to have children, so they are now in the catch-22 of raising children, funding college plans, their own retirement plans and still want all the good things in life. Budgeting is soooooo boring ya know!!

Jim,
The eldercare online side of this forum has some very good articles on LT insurance. I read all of these to educate myself before my meeting on Monday.

http://www.ec-online.net/inschannel.htm

Getting deeper into the fine print of LT care policies. It's getting ugly.

http://www.longtermcarelink.net/find_insurance_benefits.html#8

More of the fine print on LT Care. My appointment with an agent tomorrow afternoon should be very interesting after I read through all of this. I have unearthed so many loop holes that self-insuring is looking better all the time. Conservatively invest the preminums over a 20 year period of time and I may be ahead of the game.

http://www.longtermcarelink.net/about_insurance.html

Between the high cost of health insurance, prescriptions and LTC insrance, what do people live on? It still comes down to big business controling the quality of your life.Sonia, I think you are right.If you have and liquid assests it is better to put them in conseravative investments.One is annuities.I have just set up a meeting with my bank to look into annuities.One thing the initial principal is protected.Just be careful of many of the brokers.They are not always on your side.With an annunity you can determine how you will want to have your money dstributed .If you use it for income and do not really need the payments, re invest or purchase a very short term CD.It is not wise o put all your eggs in oe basket.These policies are very expensive and the cost will continue to rise.What people have to do is the moment your are born you have to save for the so called golden years.If your lucky you will be able to afford to live life with some compforts.You will buy a house, work hard to keep it and when you want to enjoy it the most, the taxes will be so dam high you will not be able to keep it.So actually you are paying rent for a lot of years.I comes down to the fact that your life will be only as big as your bank acct.But that has always been the american way.The fat cats gets bigger at your expense.Our politicians are prime examples.These people settle for nothing less than millions at the expense of the backs of their employees and those they claim to represent.Another issue is we need a natl. health plan.The health issues is so serious in this county and it is not being addressed.Why, because the pharmaceutical companies have big lobbies as does the big hospitals.

Oh, the comfort, the inexpressible comfort of feeling safe with a person, having neither to weigh thoughts nor measure words, but pouring them all out, just as they are, chaff and grain together, certain that a faithful hand will take and sift them, keeping what is worth keeping, and with a breath of kindness blowing the rest away.

Hi Sonia,

I've been reading your messages regarding long term care insurance, and felt I should respond.

Four years ago, my husband and I applied for long term care insurance. I was approved immediately, but Roger was denied coverage because of hydrocephalus. (That was the first time we had ever heard the word hydrocephalus, but that's another story).

At any rate, because Roger was not able to get long term care insurance, and because his health is deteriorating, we have worked with our financial planner to protect our assets. What we've done is to establish a revocable trust. The process is to gift our assets to the children, and they, in turn, gift those same assets to the trust. The children are called the settlors and I am the trustee, so I still have basic control of the assets.

The reason for doing this is to make Roger eligible for MA when/if he has to go into a nursing home. Yes, there is a look back period, and that is presently three years, although it could be bumped up to six years or more.

We have worked with American Express for more than ten years and they have been simply incredible. Your financial planner should be well versed in creative ways of protecting your assets. Going through a lawyer and financial planner to set up a revocable trust will cost some money, but probably less than long term care insurance premiums over the course of ?? years.

I don't know if this will help you or not, but at least it's another train of thought for you to explore.

Good luck!

Chris

Chris,
Thanks for the idea on revocable trusts; I'll check it out. I was up until 2 AM reading all kinds of stuff and summarizing it onto three pages. I'm now ready to match wits with the agent this afternoon.

Hey Sonia,

How did the meeting with your financial planner go today? I've been waiting for your update!

Chris

Hello Sonia...

Financial planners can be a headache but are often worth the trouble. Please let us know what's happening with your options and chosen solutions.

Wishing you well...
Joan Marie

"Dream as though you will live forever. Love as though you will die tomorrow."

Long-term care insurance:
The meeting went well with the insurance agent. An hour meeting extended to 2.5 hours. I am sure he spent the time because I was prepared; questions and scenarios led to others and time flew. I asked questions in such a way that I knew the answers before he told me (just checking on how honest he was going to be with me). This was a trick that my husband used on me all the time; I hated it, but it was very effective.

I just e-mailed a page full of questions. But I have just about decided to buy the LTC package of Lincoln Benefit. It has a good core of care including home care, assisted living care and nursing home care, without a lot of bells and whistles. We are hammering out the details and trying to bring them in line to a level I can afford the premiums. I can lock in the price (before they raise the premium 15-20% .. expected this month) and then I have 30 days to hash out the final details before purchasing or rejecting the policy. Once accepted, I have another 30 days to look it over and again accept or reject. I am also using my SIL as a sounding board.

There are certain features of this policy, and all policies, that deserve some in-depth discussion here: inflation protection, and the "elimination period" being but two. The lack of one and the wording of the other can sink a policy to a useless state when it is needed most.

Chris,
I re-read your "revocable trust" post, used to protect assets from use by a nursing home, should that become necessary. My question is, medicaid has some real problems for those receiving it. Quality of care could become a very big issue for both of you, and especially your husband, since he would be on the receiving end.

I am not sure where you would start, but I suggest that you do some investigation into the quality of local nursing homes that accept medicaid patients and the quality of care that is provided. Better now, than when the need arises.

Hi Sonia,

I'm glad to hear that your appointment went well yesterday, and that you're on track with purchasing long term care insurance.

Being Roger was not able to purchase LTC insurance, we had no other choice but to pursue a revocable trust. If the situation had been different, we certainly would have gone the LTC route.

I guess that I feel comfortable with the choices that we've made, and don't question the level of care received for those who are self pay opposed to those on MA. Could there be a difference in the way that different states manage the system? I don't know; I'm just questioning. We live in Minnesota and MN offers a high standard of care and quality assessment.

Good luck to you!

Chris

Chris, I have discovered that muco funds does not guarente good care.Just avoid for profit instituations.We have a very exclusive facilty not far from us.All the plush, etc.Big cars coming and going.I have spoken with aides that go there and they have stated the care is not as god as the price tag.There are many good facilities, most arenot on the east coast , except for New York.They do not mess with these neglectful facilities.In out area , the best seem to be run by the catholoic church.They are the one who seem to be put on he honor roll for care.I think certain areas care more for the patient and not concerned for all the glitz.I do agree , do your home work now, just in case.Good luck with all that you attempt to do.

Oh, the comfort, the inexpressible comfort of feeling safe with a person, having neither to weigh thoughts nor measure words, but pouring them all out, just as they are, chaff and grain together, certain that a faithful hand will take and sift them, keeping what is worth keeping, and with a breath of kindness blowing the rest away.

Yippee!!! Nothing stands between me and a LTC policy except the amount of the preminum. All of my tests came back normal. Next meeting with the LTC agent is next week.

Further conversation lead to discovery that there is some degree of GERD (heartburn). The only major symptom is a feeling like a pill is stuck in mid-chest. Previcid (30 mg) and change in diet should take care of that. Just a simple matter of eliminating all the good stuff:

coffee, tea, chocolate
decaf coffee
highly spiced foods
alcohol
citrus juices
tomato sauces and juices
fatty foods
carbonated beverages
apple juice
aspirin
vitamin C

Increase foods such as bran, raw vegetables, green salads; lose weight, no heavy lifting; eat smaller meals; stay upright for 2 to 3 hours, before bedtime. If severe enough, elevate the head of the bed 4 to 6 inches.

Doc said GERD is really common in the U.S. My husband had an ultra-severe case of it, along with all his other problems. So, of course, I had no experience with milder varieties.

quote:

---

It can cause symptoms of chronic cough, asthma and sinus congestion. Respiratory nerve endings are stimulated by the refluxed acid which can cause congestion and mucus production in the lungs and sinus, leading to cough and/or wheezing. Sinus congestion from reflux can lead to sinus headaches.

---

Great news here, Sonia...

Much rather know it's treatable GERD (heartburn) as opposed to the more frightening theories. What a relief that must be for you!

And, while I'm here, please allow me to thank you for sharing the real scoop on the mind-boggling LTC insurance. That is no easy challenge to figure out.

Take care... and keep seeding ...Joan Marie

"Dream as though you will live forever. Love as though you will die tomorrow."

Chris,
The agent that I am consulting with for LTC gave me a lengthy article that apparently is only available to agents. I give the web link here, but can't access it:

http://www.ltccw.com

The section that I am quoting here is from a chapter on Common Misconceptions. I believe you said your assets were in a revocable trust, which means you can still manage your assets. As I read the quote below, only an irrevocable trust, one whose assets you cannot touch, would allow you to escape the spend-down of assets before qualifying for medicaid.

quote:

---

"All of my assets are protected from being spent on long-term care because they are in a living trust!"

A living trust only avoids the lengthy probate period in your state. Assets that are held in a living trust are counted as assets when determining Medicaid eligibility. With a living trust, because you have access to the assets, your state would require that you spend down those assets first, before qualifying for medicaid. You should consult your tax and estate planning advisors.

---

[This message was edited by sechang on February 16, 2004 at 11:47 PM.]

Sonia,

I'm up bright and early this morning and found your message regarding revocable trusts.

From what I've learned from our financial planner, it's not so much about establishing the revocable trust; it's about gifting. I did not fund our revocable trust directly; I first gifted the assets to our children, and they, in turn, gifted the assets to the trust. In MN, the date of gifting is what is looked at, not the date an asset was placed into a trust. The trust is simply there for mine and my husband's protection.

Our son is a CPA and in his fourth year of law school. He ran this scenario past his law professor who specializes in elder law, and he said our financial planner had set it up exactly as he would have. In fact, he had set up his in-law's trust in exactly the same manner. So, I feel confident that I've done the best that I can under the circumstances.

I agree that a revocable or an irrevocable trust may not always be the answer, but, if they've been set up correctly, they should work right for the individuals involved.

Thanks for your concern!

Chris