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Keep Your Long Term Care Insurance After You Move to a CCRC

August 6, 2019 by Honey Leveen Leave a Comment

As a resident at Shell Point Retirement Community (SPRC), I have had a number of interesting, eye-opening conversations with my neighbors. Many of them believe that living in a Continuing Care Retirement Community (CCRC) is an opportunity to safely let go of their long term care insurance (LTCi). I do not recommend this!

Before you make this potentially dangerous decision for yourself or your parents, please read through these 3 experiences. Hopefully, they will serve as a cautionary tale and help you from repeating their mistakes.

1. Living in a CCRC Doesn’t Always Include Payment for Home Care

Sally’s mother lived in SPRC for 26 years. Although she needed care, her mother did not own long term care insurance (LTCi), since she believed the CCRC would cover the costs of her needs. Over the years, Sally’s mother was unwilling to accept the fact that her health was deteriorating and that she needed additional care. Ideally, she would have moved to the on-site assisted living facility or elected for home care.

The majority of CCRC’s pay for assisted living or nursing home care, but they don’t pay for home care.

As you’ll hear in Sally’s video testimony below, her mother was unwilling to pay for home care, preferring to preserve her estate for the benefit of her children. Her situation got so dangerous that Sally had to enlist intervention by a professional to “force” her mother into better care. Sally realizes now that the entire situation could have been avoided if her mother had been covered by a LTCi policy.

2. Nursing Care Paid Out-of-Pocket

When Hugh and his wife moved here to SPRC, they assumed that they no longer needed their LTCi since the CCRC would pay for their assisted living and nursing care. So they stopped paying their monthly LTCi premiums and let their policies lapse.

In her last months, Hugh’s wife became extremely disabled, needing care above and beyond what the assisted living facility could legally provide. Hugh was advised to move his wife to the on-site nursing home so she could receive the care she needed. While the assisted living center provides a cheery, home-like atmosphere, the nursing home is more sterile and institutional. Hugh just couldn’t bear moving his wife into the nursing home.

By remaining in assisted living, Hugh had to pay for round-the-clock caregivers out of his own pocket. As he shared his story with me, I told him about my work. He recognized how much he regretted giving up their long term care insurance. He knows that if they’d kept their policies active, the cost needed for his wife’s additional care would have been covered.

3. The Unexpected Need for an Off-site Facility

Nancy’s husband was stricken with Lewy Body Dementia. If this sounds familiar, this is the same illness that actor Robin Williams suffered from. This form of dementia can damage thinking and alertness. Symptoms can include physical stiffness, hallucinations and even violence.

As a result of his condition, Nancy’s husband became physically violent and needed more care than SPRC could safely provide. Despite their best efforts, SPRC was unable to keep him onsite. Nancy was forced to find an off-site facility that could properly care for her husband. Those unexpected costs (paid without the benefit of LTCi coverage) nearly demolished her savings.

Learning from Experience

You don’t have to have these experiences in order to learn the same lessons. Moving to a Continuing Care Retirement Community (CCRC) does not mean it’s time to end your long term care insurance policy. In fact, this may be the time you most want that peace of mind.

Click here to receive a free, no-obligation quote for your own LTCi policy.

Filed Under: Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Misinformation About LTC Tagged With: assisted living, CCRC, home care, long-term care costs, LTC Insurance, nursing home care, Shell Point Retirement Community, SPRC

Medicaid’s Woes Highlighted

October 14, 2016 by Honey Leave a Comment

MedicaidThis past month I’ve come across a few articles describing Medicaid’s woes, and highlighting peoples need to plan for funding their own long-term care, now!

This Washington Post story describes why our system is incentivized to discharge patients when they are still very needy, but their Medicare-paid re-hab benefits are exhausted. Medicaid can then often pick up costs, but it pays facilities poorly. This incentivizes facilities to admit the least needful and costly patients. In addition, “The Medicaid system is overly cumbersome and too slow to provide benefits.”

The true heroines of long-term care, paid home care providers, earn an average of $10.11 an hour, states this September New York Times article. About a third of these caregivers rely on food stamps and 28% rely on Medicaid for health insurance. Annual caregiver job turnover rate is 40-60 percent.

The article continues by stating caregivers at Medicaid-funded facilities got their pay raised to minimum wage: $7.15 per hour last year. Such caregivers are often overwhelmed with the sheer number of patients they must care for. “Ms. Walker left her job at a nearby nursing home because “sometimes you had 12 to 15 people to take care of,” she said. “You’re trying to feed everybody, give them baths, but a lot of people got neglected.”

This testimonial about Medicaid’s flaws on the receiving end of care is heart-wrenching, “When Roy Potter was weakened from postpolio syndrome and his wife, Joan, could no longer help him out of bed, a nursing home was “unthinkable,” said Ms. Potter, 83.

For a year, they paid private aides $14 an hour to come to their home in Mount Kisco, N.Y. When they could no longer afford that, Mr. Potter qualified for Medicaid, which pays the preponderance of home care costs in this country.

Over the next two and a half years, more than a dozen agency aides — some caring and competent; some not; some disappearing without explanation — cycled through their home, as did a number of short-term substitutes.

“A new person would come, and I’d have to walk them through everything all over again,” Ms. Potter said.

She grew increasingly anxious about whether an aide would show up. “Every morning I’d hold my breath until the doorbell rang,” she said. “Several times, I had to get in the car and drive to the agency and say, ‘Who is coming today?’”

Last year, when federal overtime provisions took effect, the agency cut back helpers’ hours.

She and her children succeeded in keeping Mr. Potter at home until he died in April, at 86, but finding and keeping help proved a continual battle.

Filed Under: Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure Tagged With: home care, Medicaid, Medicare, New York Times, nursing facilities, Nursing Homes, Postpolio Syndrome, Washington Post

TX Nursing Home Employees Quitting to Work at McDonald’s

April 12, 2016 by Honey Leave a Comment

Fast FoodAccording to reporters at Lubbock’s KLBK13, in a story titled, Nurses Quit Texas Nursing Homes to Work at McDonald’s, we face a dire shortage of nursing home beds by the end of this decade.

Nursing home employees, particularly certified nurse assistants, who are “front line” caregivers, get the worst pay, typically about $8/hour.

Meanwhile, McDonald’s is hiring, and they pay significantly more. Furthermore, their employees don’t have to mess with bed pans or risk injuries from transferring patients.

The story says TX nursing homes lose approximately $300 million per year. 85 percent of TX nursing home residents depend on Medicaid or Medicare. Each Medicaid patient is underfunded by 14 percent.

This dovetails with information I just received from Seven Acres, the Jewish nursing home here in Houston. Their April 2016 newsletter says, “Over 80% of our residents are so ill and indigent that they qualify for the state Medicaid program, which underfunds Seven Acres by $33,000 a year for each Medicaid resident. This translates into a $8 million annual loss for the Home. It is only through the generous support of our friends and community partners that we are able to offset the significant cost of care that Medicaid does not cover.”

Long-term care insurance (LTCi) ownership greatly increases the odds people will not receive care in a nursing home. Even the very best nursing homes – like Seven Acres – struggle with staffing shortages.

I’ve already sent Seven Acres my annual contribution.

Filed Under: Denial, Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Fast Food, home care, home health care, McDonald's, Medicaid, Medicare, nursing home care, Nursing Homes, Seven Acres Nursing Home

Elder Orphanism

March 17, 2016 by Honey Leave a Comment

Elder OrphanismWe will be reading more about elder orphans. Even if we have a slew of kids, we are likely to wind up as elder orphans. We must plan for this right now.

Here is a link to a beautiful column describing what the future is likely to look like.

Thanks to the author, Dave Nesbit, for allowing me to re-publish this.

“New Year’s Day is a time to turn the page on our bad habits and start new and positive behaviors.

Here’s a challenge of what self-interested baby boomers should resolve to do now—reach out with personal compassion and respect to younger people. This might seem to be inverted thinking from “respect your elders.”

Over the last century, progress in transportation and technology enabled the settling of our vast country and made the intergenerational family farm all but obsolete. Maybe your children, as mine, are now adults who have relocated outside of our geographic area to fill the labor needs of America’s expanding economy. As 20th century labor mobility has undercut traditional family life, affordable cellphone plans appeared in response.

In 1915, a 3-minute coast-to-coast phone call cost $20.70, which was 3 percent of the $687 average annual income. By 1940, that same call cost $3, when the average house rented for only $30 per month. By 1970, the 70-cent cost was the same as a McDonald’s quarter-pounder. Now the insignificant cost of a lengthy call, along with Skype, might deceive us into believing that our family needs are fulfilled by inexpensive communication. They aren’t.

Today’s communication is not much more meaningful than when I as a child chimed in “Hello Grandma, I love you” during a 3-minute call. Fifty years ago, Bell Telephone advertised that “long distance is the next best thing to being there.” Maybe it is, but it’s a “poor second” and an inadequate balm for the loneliness and vulnerability of older persons who are distant from their family’s younger generations.

When I was growing up, my mother “adopted” three widows who shared special times with our family. Those surrogates helped to fill the void of absent biological grandparents, who I rarely saw. Until she was in college, our daughter did not realize how lucky she was to grow up in the same town with two sets of grandparents who she saw often and knew well.

Especially since our children live out of state, I’m glad that my wife and I own long-term care insurance and have colleagues at Keystone Elder Law. Both will be great assets when aging causes us to become frail, and we need to develop and implement a caregiving plan. It certainly would be a healthy supplement if a surrogate, family-like relationship would develop outside of our organizational environment.

I have witnessed such an intergenerational relationship develop among members of a service club, when one is missing a parent/grandparent(s) and another is missing a child/grandchild(ren). Similarly, such relationships can originate naturally among neighbors. Churches that seek a means to translate scripture into practice could encourage and nurture intergenerational surrogate families.

Pennsylvania rewards live-in caregivers. The state initiates an action during probate to recover Medicaid funds paid to provide care in a nursing home. However, live-in caregivers who do not own their own home and who lived with an unrelated frail person for at least two years prior to that person relocating to a nursing home, may inherit the home free of any estate recovery.

In his futuristic novel titled “2030,” Albert Brooks suggests that, by that date, the national debt will have outpaced the gross national product, medical breakthroughs with cancer and other diseases will enable longer life expectancy, and older persons will be confined in worn-out and all-but-forgotten cruise ships that are anchored off the West Coast. Young people, who work harder and receive less, will be incited to form gangs and become violent against older people, who seem selfish to them.

Could surrogate families be a possible antidote for both the intergenerational separation caused by mobility, and the pessimistic clash between the young and old as told in Brooks’ novel?

Over the past half century, the American melting pot has blended Catholics and Protestants, and Christians and Jews, into neighborhoods and families. Is it too hopeful to imagine that Judeo-Christian families and neighborhoods will assimilate peaceful Muslims? Would acts of kindness from Judeo-Christians to vulnerable younger Americans not only lead to surrogate families, but also make our younger generation less vulnerable for recruitment by radicals who promote terrorism?

As my wife and I visited our children and grandchildren in south Florida over Thanksgiving, I observed a significant number of interracial families. This contrasted with my recent, sad experiences with a couple of families in which a parent had alienated their child decades ago because of an interracial relationship. Could it be that racial intolerance within families is waning as rapidly as the relevance of the cost of a long-distance call?

The legislature and courts have forced a legal settlement of most of the controversial sexual preference issues. Is Brooks correct that the emerging issue for the 21st century will be the young versus the old? According to a Pew Foundation study, the declining percentage of Americans who are younger than age 15 will cross over the growing percentage of Americans who are over age 65, at the number of 20 percent, just before the year 2030.

How will the legislature and courts manage public resources and entitlements, when fewer younger people are available to support the larger number of older people who live longer? Will life-prolonging drugs be provided to the poor? Will Medicare have maximum lifetime benefit? Will the cost of long-term care for seniors deplete Medicaid funding for young families and children? Will the ethics of assisted suicide and euthanasia be considered seriously?

Politicians have kicked the can of painfully real solutions into the future. Our children will be taxed excessively, not only to repay escalating public debt created by our generation, but also to pay for entitlement programs to take care of aging baby boomers. Be proactive about this dilemma.

If not out of shear kindness, then in recognition of your probable future long-term care needs, create a surrogate family. Find younger people in your neighborhood, service club or church to befriend graciously now. Maybe they will respond in kind to manage and advocate for your care in the future.”

Filed Under: Denial, Elephant in the Room, I'll Just Self-Insure, Information About LTC, The Magic of owning long-term care insurance Tagged With: Baby Boomers, Better Homes and Gardens, Boomers, Elder Orphanism, elder orphans, home care, Information About LTC, long-term care, Medicaid

LTCi Pays – Have the Conversation Now!

March 3, 2016 by Honey Leave a Comment

LTCi PaysThe following piece was authored and is re-published here with the permission of my dear friend and colleague Tobe Gerard.

Tobe makes two points. The first is that long-term care insurance (LTCi) policies are normally purchased many years in advance of being needed. We are now seeing “the tip of the iceberg” of claimants who need to collect from their LTCi. For the foreseeable future, we should see annual increases in the number of claims being filed and the amount of money being paid out for LTC.

The second point Tobe is making is that it is typically a son or daughter who assists with the claim. LTCi claims are not onerous, but policyholders are typically not able to manage them alone. Letting kids and other trusted individuals know you own LTCi is sometimes difficult, but worth it. Knowing a parent owns LTCi proves to be a balm and a source of extra piece of mind and security for all involved.

Here is Tobe’s excellent blog:

According the the American Association for Long-Term Care Insurance, long-term care insurance (LTCi) companies paid $8.15 billion in claim benefits to 260,000 policyholders in 2015. That number is 4% more than what was paid out in 2014. We are all living longer, and though your clients hope to never have to use their policies, the good news is that policyholders and their families are benefiting from owning this important insurance protection. When the rubber hits the road, LTCi policies are paying out!

With that in mind, many advisors encourage their clients to have “the long-term care conversation” with their adult children. It’s not an easy conversation, but it is an important one. Having this conversation early allows adult children to know that their parents have thought things through and have a plan in place. Among other things, breaking the ice by having this conversation early allows adult children to know their parents own LTCi policies. The reality is that in most instances it will be the adult children who will be involved with filing the initial LTCi claim and, in many cases, supervising the care that will be required over time. Adult children want to learn what their parents have in mind. Owning a LTCi care policy should never be kept a secret!”

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: AALTCI, home care, long-term care, LTCi, the American Association for Long-Term Care Insurance

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Honey Leveen, LUTCF, CLTC, LTCP
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Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

Email: honey@honeyleveen.com

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