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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

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

Extraordinary Story of Devotion…and No LTCi

March 14, 2016 by Honey Leave a Comment

Helping Mother Bathe
Elizabeth helps her mother bathe.
Mark Makela for The New York Times

A story in yesterday’s New York Times titled “Living With the Parents I’m Losing to Alzheimer’s blew me away. I hope non-subscribers can open it.

Here’s the accompanying slideshow.

The story is about Elizabeth Wolf, a very generous, candid, public person with a blog at www.upsidedowndaughter.com.

Read the column or blog to learn that five years ago Ms. Wolf was enjoying young adulthood and exciting new pursuits when she gave them up and returned home to become her parents’ primary caregiver. Both parents have Alzheimer’s Disease. She’s doing this with the help of her extremely devoted husband.

We know from graphic, detailed information in the story about finances and day-to-day coping, neither parent owns long-term care insurance (LTCi).

If you’re like me, you are forced to wonder how extremely different Ms. Wolf’s life and relationships with her husband and parents would be if one or both parents owned LTCi.

Filed Under: Denial, Elephant in the Room, Helpful Information About LTC, I'll Just Self-Insure, Information About LTC, New York Times Tagged With: Elizabeth Wolf, Long Term Care insurance, long-term care, LTC, LTCi, Medicare, Paula Span

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

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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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