Long-Term Care Insurance

The earlier in age you purchase the program the cheaper it is, is what we found out last year when we were doing our research. The plans were not too expensive up until about age 55, since we were in our early 60's the price was starting to jump up then.
If I remember correctly the Gold Plan which went for around $1200 a month until you needed it, covered everything from that point forward, you could also do a one time payment of $50/60K that would cover you the rest of life. Other plans were for a limited amount of years, generally 10.
Okay, you are doing the trust thing to have the govt pay your care center bill. Knowing they have a five year look back, why didn’t you get a five year LTC policy? Or is that what you did?
 
Tiny non profit nursing home in northern Iowa runs $320/day($9,700 month). They basically run you out of money and then medicaid takes over. Unfortunately going through this process right now with a parent. The truth is that it doesn't really matter at this point. The only thing she ever spends money on is insurance, drugs(legal), and groceries. Oh she also spends money on heat. When I was a kid she kept it 72 in the house year round. Now it seems to be about 82 year round.
 
Okay, you are doing the trust thing to have the govt pay your care center bill. Knowing they have a five year look back, why didn’t you get a five year LTC policy? Or is that what you did?
The difference was the cost, the trust was a couple of thousand and will allow our funds to quickly go to our children without having to go through the process we had to with my mom when she passed, which had to go to the courts and took about 6 months. With the trust, the process should take a couple of weeks at most, and one the benefits it shields your assists against paying for nursing care down the road if you need it, if the trust has been set up for 5 years, that is the amount of time the nursing home can go back to look at your assists. We just set up the trust and then took the money that the insurance was going to cost us each month and put that into a different account, that money is there if we ever need it, and if not it goes along with everything else in our trust to our 3 kids.
 
This can also vary by state. Washington, for example, doesn’t require your assets to be drained to use some Medicaid.

 
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Some life insurance policies will have riders that can pay out for long term care. Check with your insurance agent about such policies.
My adopted mom recently passed away. She bought her LTC policy in 1994 and never used it. Because she had the policy with the rider for more than 20 years all of her premiums were refunded. Quite the surprise

She forgot to change the beneficiary to her trust so now we have to do probate
 
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This was the major reason we set up a trust last year, we have to have all our assets in the trust for 5 years, but after that point, a nursing home cannot ask about your assets as a way to determine your bill. The cost of long term care for someone like a spouse that has had a stroke or something and can live in the facility for years has caused a few farmers I know to divorce their spouse so they did not lose the farm to the nursing home.

I am concerned about the Medicaid Estate Recovery Program (MERP). My wife was recently diagnosed with mild cognitive impairment. The Nerologist thinks this will eventully escalate into dementia (but not Alzheimers). We are going to meet with our estate attorney to add protections against MERP. This would come into play if we had to apply for Medicare. Hopefully, I hope we do not need to go down that path. The laws governing a state's Medicaid Estate Recovery program varies based on the state in which one resides. So, be aware of the rules that apply to your state.


 
@1SEIACLONE

I'd be interested in what they tell you. Where I work, they have a lot of workshops. One of those workshops dealt with LTC and they said one option is to get a single premium immediate annuity that has no cash value. This would provide income for the person that doesn't have to go on medicaid.
 
I've always heard (and did some research to learn more) that you need an irrevocable trust in order to fully protect assets from the Medicaid look back. If they're in a revocable trust, Iowa Medicaid may still consider those assets.
 
@1SEIACLONE

I'd be interested in what they tell you. Where I work, they have a lot of workshops. One of those workshops dealt with LTC and they said one option is to get a single premium immediate annuity that has no cash value. This would provide income for the person that doesn't have to go on medicaid.
Like I stated we looked at two different insurance companies, they came out to the house and ran us through the different programs. We were right at 60 years of age when we were looking and that increased the price. Most of the programs were for a set amount or years or a set amount of dollars they would pay out depending on the costs. The plans ranges from a basic plan of about $500 a month up to $1200 a month of a deluxe plan that covered everything. After getting the info, we sat down and figured that neither my wife's parents or mine had ever spent time in a nursing home, and we have no cases of dementia in either of our families. So we passed on the idea and decided to take the money that we would have spent on the insurance, and just put that into an account that would be there if we needed it and if not would go to our children.
 
They have a lot of requirements in the fine print about what they pay for, and when they pay. The one my mom has doesn’t pay the full policy amount until you are in a full care rest home. Assisted living only gets you about 60% of the full rest home coverage.
 
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I did the math on it, it caps out so low that if you just invested the $$ to begin with you would have more than the benefit.
Same for me when I looked into it in 2008. Only paid $100,000 over three years. Invested in the IRA and we have the cash now no matter what. Single biggest expense my parents have during retirement is the long term care insurance.
 
My parents had long term care plans. The plans would pay 40% of the cost for hospice or a long term care facility. I don't recall the assisted living benefit. There was no limit on years. The plan only kicked in after the first month was paid by my Mom or Dad. My mom never lived in a nursing home. She was in a Hospice House for about 20 days. I think the cost was about $320 per day six years ago. The LTC plan did not apply because of the short time period. My Dad developed cancer and needed the nursing home for the last 8 months of his life. He had a private room with a private bathroom. The cost just last year was $350 per day. The long term care insurance, his SS, and his pension paid for almost 100% of his expenses.

My parents paid more in premiums than they got back out of LTC insurance, but I know it provided a lot of piece of mind for my Dad.

I haven't checked into LTC insurance, but the big risk I see to not having it is if I or my wife end up in a nursing home for an extended number of years and the other is still alive. Retirement savings could really be drained for the surviving spouse.

I would like to leave some inheritance for my kids, but I also know that they both are very capable professionals that can build their own wealth.
 
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I've always heard (and did some research to learn more) that you need an irrevocable trust in order to fully protect assets from the Medicaid look back. If they're in a revocable trust, Iowa Medicaid may still consider those assets.
Yes, if you can still make changes, they can go after assets. Revocable avoids probate. You need irrevocable to avoid asset seizure.
 
Going through this right now with my mother. In 6 months time, she went from living alone and all there mentally to breaking her hip and now being in a nursing home for life. In small town Iowa, the not-for-profit nursing home is charging her $9k/month. Right now I'm in the process of getting everything together for when she has to go on Medicaid. At 90 and in her condition, it really doesn't matter. She has zero expenses beside the nursing home. I could see how this would be really bad if it was husband/wife.

On a side note, I was ignorant when it came to the impact on breaking a hip. I had always heard how bad it is to break it when you're old, and assumed they were talking about walking. For her, it was the anesthesia. Apparently, when you're old it can cause major damage mentally, which it did.
 
Going through this right now with my mother. In 6 months time, she went from living alone and all there mentally to breaking her hip and now being in a nursing home for life. In small town Iowa, the not-for-profit nursing home is charging her $9k/month. Right now I'm in the process of getting everything together for when she has to go on Medicaid. At 90 and in her condition, it really doesn't matter. She has zero expenses beside the nursing home. I could see how this would be really bad if it was husband/wife.

On a side note, I was ignorant when it came to the impact on breaking a hip. I had always heard how bad it is to break it when you're old, and assumed they were talking about walking. For her, it was the anesthesia. Apparently, when you're old it can cause major damage mentally, which it did.
The neighbor wife broke her hip while in the care center. She was mid 90s or so. The surgery would have killed her so they had to just make her comfortable and hoped it would heal as much as possible. She live many months of not a year or better like that. She had dementia at the end so we stopped visiting since she had no clue who we were.
 
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Just had a neighbor pass away from Parkinson's. The last couple of years the FD or ambulance would be at their house as she had fallen. She was spending the last few months in LTC, but she decided she had had enough and didn't want the meds anymore. She lasted about two weeks in hospice.
 
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Yes, if you can still make changes, they can go after assets. Revocable avoids probate. You need irrevocable to avoid asset seizure.
Furthermore, irrevocable trusts are not suitable for all situations, especially when they are set up and administered correctly. And the transfer to the irrevocable trust has to be made so it doesn't fall within the 60 month look back. There is no simple pain-free.magic bullet solution to Title XIX planning.
 
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Furthermore, irrevocable trusts are not suitable for all situations, especially when they are set up and administered correctly. And the transfer to the irrevocable trust has to be made so it doesn't fall within the 60 month look back. There is no simple pain-free.magic bullet solution to Title XIX planning.
I just plan to continue being poor. If they can find that 10 dollar of pennies I have hidden they can have my life savings then.