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Honey’s State of the LTCi Industry

March 21, 2016 by Honey Leave a Comment

Honey Sally Tobe Betty at ILTCII’ve just returned from the Society of Actuaries 16th annual Intercompany Long-Term Care Insurance Conference a few days ago.

I believe most attendees left the conference feeling more enthused about the future of long-term care insurance (LTCi) than we have in a while.

New carriers are entering the market. I got to preview National Guardian Life’s new LTCi policy, due for release this Spring. I am told its rates will be competitive and it will have some “sweet spots.” It’s an exciting plan and has some innovative, very attractive “spins” on traditional features.

Additional new products are entering the market, too!

My sentiment, and I believe that of the majority of attendees, is that the worst is over. Interest rate assumptions can’t be lower. Lapse rates, mortality and morbidity (how many policyholders will die or need LTC) have already been adjusted for “worst case,” hyper-conservative scenarios.

Long-term studies based on extensive experience & appropriate adjustments have convinced actuaries that the current generation of LTCi products are and will be very rate-stable.

The new, asset-based (also called “hybrid” or “combo”) LTC products are now mature, excellent products.

We now have a broader portfolio of rate-stable LTC solutions, reasonably priced, than ever before.

The press, this past year, has done excellent reporting on why Medicare and Medicaid cannot and will not pay for our LTC. Media has reported well on the high odds of needing LTC and the heartbreak patients and families often suffer due to unplanned LTC needs.

Demographically, there remains a huge, underserved market of Boomers and others who are unprepared and vulnerable to the “spending shock” of having an unplanned LTC need.

Some things have not changed in the 25+ years I’ve been working with LTCi. The public is still steeped in profound denial about their need for LTC. People would rather pay for fun things like travel and other toys than face the facts about needing LTC. There are still misinformed journalists who describe LTCi coverage erroneously, and inaccurately harp on wanton LTC rate hikes.

Filed Under: Denial, Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: annuity-based LTC, asset based LTC, Long Term Care insurance, long-term care, LTCi, Medicaid, Medicare, Spending Shock

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

What are the Best LTCi Options?

February 19, 2016 by Honey Leave a Comment

LTCi Benefit BankIn part one of his two part series about understanding long-term care insurance (LTCi), Forbes columnist Wade Pfau describes how LTCi prices are determined. He explains what an elimination period is, what a benefit period is, what a monthly benefit is, and what a LTCi “pool of money” or “benefit bank” is. He also describes different types of inflation protection.

In part two of the series What Are The Best Coverage Options for LTCi? Dr. Pfau describes the types of care LTCi covers and what entitles you to collect from your LTCi.

One thing is clear from reading these articles: LTCi is complex. No matter how bright someone is, ethical advice, preferably from an experienced LTCi specialist like me, is necessary for one to make a confident, wise decision on affordable LTCi they’ll be satisfied with for the rest of their life.

Mr. Pfau actually recommends having an elder law attorney study review LTCi contracts. This is unnecessary. Elder law attorneys generally specialize in wills, trusts, probate, etc, not insurance contracts. In addition, today’s LTCi policies generally have straightforward language a college educated consumer can read and understand. An experienced agent can and will confirm what the contract language means. The elder law attorneys I know are not particularly astute on LTCi contracts. A few of them are clients who relied on me for advice.

I’ve loved Dr. Pfau’s Forbes LTC series because he is so credible and astute. He expresses complexities in easy-to-understand language. He has truly done readers a service with this LTCi series.

As much as I respect and admire him, I think he’s wrong about some minor details, but as a whole, he really gets things right. This series is powerful and useful.

Filed Under: Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Forbes, Long Term Care insurance, long-term care, LTCi, Medicaid, Medicare, Wade Pfau

Potential Concerns and Risks for Traditional LTCi

January 29, 2016 by Honey 2 Comments

Bait And SwitchForbes contributor Wade Pfau is doing the world great good with his series of articles about the urgent need for long-term care (LTC) planning.

What I like so much about Mr. Pfau is his credibility. He is a highly qualified financial planner and academic at The American College.

Financial advisors are generally fee-based, not commission-based, like I am. Because he does not make commission from his advice, some may consider him to be more credible than agents who sell long-term care insurance (LTCi).

In his January 19, 2016 Forbes column titled, “Potential Concerns and Risks of Traditional LTCi” Mr. Pfau describes the history of long-term care insurance and the mistakes made with this product in the past.

Since he is not an LTCi specialist, I can’t fault him too much for not quite “getting the whole story” on what causes and caused past LTCi rate hikes.

An example is this “bait and switch” accusation, which is wrong: “Buying based on who offers the cheapest price is risky, since the company may be seeking upfront sales with the intention of increasing premiums later.” It’s more complicated than this. Carriers are not interested in making lots of sales now and suffering unhappy clients, bad public relations, and reduced sales later. This has never been their strategy.

With an average LTCi buying age of 57 and an average claim age 25 or more years later, plus ever changing mortality rates and demographics, no prior experience to go on, and required reserves earning unusually low interest rates for longer than anyone could have imagined, how could the earliest LTCi carriers realize that their assumptions would be so far off that significant rate increases could not be avoided?

Mr. Pfau does correctly state that today’s LTCi products are expected to have very stable rates.

He also correctly describes the public’s resistance to buying LTCi. He gives some good reasons but fails to point out the #1 reason people don’t buy LTCi: DENIAL! To be fair, however, he has mentioned denial in his prior columns.

Mr. Pfau does mention people sometimes lapse their LTCi shortly before they need to use it, due to cognitive decline. This doesn’t happen often, but I have seen and dealt with it, and it is highly upsetting. It is also highly avoidable. By and large, LTCi policies have very low lapse rates. The study Mr. Pfau refers to giving high lapse rates has been refuted.

It is up to policyholders to plan for the high odds of mental incapacity by appointing and empowering, not arguing with, trusted individuals to act on their behalf. I have learned that one of the earliest and most subtle indicators of mild cognitive impairment is making bad business decisions. Such bad decisions often go unnoticed, again, due to denial by the policyholder and family members.

Today’s LTCi policies, thankfully, have stronger protection against unintentional lapses.

I still love Wade Pfau and greatly appreciate his very clear writing and ability to make complicated concepts understandable. His articles are very factual, with very few flaws.

 

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Forbes Magazine, Long Term Care insurance, long-term care, LTCi, Medicaid, Medicare, The American College, Wade Pfau, www.forbes.com

Two Options for Funding LTC Expenses

January 27, 2016 by Honey Leave a Comment

Self FundingIn his January 12, 2016 Forbes column, Wade Pfau describes why Medicare, Medicaid and health insurance do not pay for long-term care (LTC). This column describes what can and often does happen, financially and psychologically, even to highly affluent people, when LTC planning is ignored and people wind up self funding for LTC with personal assets.

Mr. Pfau has heart. He gives us facts, but he also shares accurate human insights. He wisely urges people to prepare now for their last years, and to share their plans with those they most trust.

This piece is accurate, accessible and concise.

He states, “For self funding, ask yourself if you have sufficient financial resources to cover an expensive long-term care shock and still meet the remaining financial goals for retirement. Which specific resources could be used for long-term care expenses? How will they be invested? What impact would these expenditures have on the standard of living for remaining household members and potential beneficiaries? Is this a risk that can be accepted, or could insurance provide a positive impact by helping pool this risk?”

“Self funding could force an individual to rely more greatly on family care, which introduces a number of potential opportunity costs not included in formal cost calculations. Caregivers often experience increased stress and health problems, and they could be forced to make sacrifices in their careers that could result in substantially reduced lifetime earnings. The health problems created by providing long-term care could potentially result in the caregiver needing long-term care for themselves as well.”

Filed Under: Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: caregivers, caregiving, Forbes, health insurance, home care, Long Term Care insurance, LTC, LTCi, Medicaid, Medicare, Nursing Homes, Wade Pfau

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Honey Leveen, LUTCF, CLTC, LTCP
“The Queen, by Self-Proclamation, of Long-Term Care Insurance (LTCi)”
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Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

Email: honey@honeyleveen.com

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