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Horrible Story Illustrating Why Medical Insurance and Medicare Supplements Don’t Pay For LTC

July 8, 2014 by Honey Leveen Leave a Comment

I just came across an all-too-common, tragic story titled “Insurance abruptly stops covering Spokane man’s long-term care.”

This article came through my Google alerts, which are set for “long-term care insurance.” The title instantly caught my attention because I thought this might be bad press about long-term care insurance (LTCi). It wasn’t.

It turns out that this is a horrible story about what can happen without long-term care insurance.

In the over 23 years I’ve been selling LTCi I have never seen a LTCi policy not pay a legitimate claim. LTCi would certainly pay for the care described in this situation.

What this story illustrates so well is that Medicare and medical insurance cannot, will not, do not pay for long-term care. The story is about an innocent man named Doug who had a horrible motorcycle accident and suffered brain damage. His condition will not improve (that’s part of what’s causing the crisis). He needs constant skilled care. Medical insurance and Medicare do no not cover long-term care when there is no possibility of improvement. The best medical insurance and Medicare supplements only cover the type of care Doug needs for limited lengths of time.

In this horrible situation, the nursing home wants to kick him out. “The nursing home called me at 6:30 in the morning on the 11th, saying I had until the 15th to get him moved,” claimed Mrs. Barr (Doug’s wife).

Premera Blue Cross told her Doug’s condition “…wasn’t showing significant progress.”

She said that if she cannot find another solution, her only remaining option is putting Doug on Medicaid. Yet, her lawyer told her that once Doug is on Medicaid then she loses all of his social security, retirement, and life insurance.

In desperation, Mrs. Barr said, Doug even asked the people at the dialysis clinic to help him die.

Why Staff (Is All That) Matters in Choosing a Nursing Home (Not!)

May 14, 2014 by Honey Leveen Leave a Comment

In all of my 23 years specializing exclusively in long-term care insurance (LTCi), the Houston Chronicle has done scant reporting on LTCi and long-term care planning. They’ve done a story on how to financially plan for aging and left out mentioning LTCi altogether. On the rare occasion they’ve made mention of LTCi they’ve gotten vital facts wrong.

In a city as large as ours, I’m very embarrassed about the Houston Chronicle’s dearth of coverage of LTCi, a subject that would help its readers. I believe New York, Washington, DC, Chicago, and many smaller cities than Houston, have had good coverage of LTCi lately. Houston still hasn’t.

In her recent Houston Chronicle column, “Why Staff Matters in Choosing a Nursing Home”, reporter Cindy George advises using various online tools to help you “shop” for a facility that won’t neglect or abuse your loved one. She makes this task sound as easy as, say, researching a computer or vacation online.

If you do the proper research, her article implies, your loved one won’t be subject to neglect, abuse, or the murders or beatings that have recently occurred at two Houston nursing facilities. Or maybe your loved one will be subject to just some abuse and neglect, but not beatings or murders? To accomplish this just use the tools she provides; it’s that easy.

Here’s what I wrote to her on my Facebook page:

“Cindy George of the Houston Chronicle, I know you’re trying to help by offering advice on how to choose a functional nursing home, in light of the recent nursing home violence we’ve had in Houston. Your advice may make readers feel good in the short term by giving them the impression there are decent odds they might have any control over the quality of their care if they cannot afford to pay for it. I would like to help add depth to your reporting and hope you will accept my invite to lunch or coffee.”

The problem with stories like “Why Staff Matters in Choosing a Nursing Home” is that it lulls people into believing doing correct facility research and shopping is all they’ll need to access quality long-term care. Responsible long-term care planning is not necessary. The government is there and will be there to pay for quality long-term care.

Search on this blog for “Nursing Homes” to learn a lot about why the government can’t – and won’t – pay for meaningful, adequate long-term care.

Government financing for long-term care is decreasing. Nursing home failures, neglect, abuse, tragedies, are increasing.

Generation Warfare is Brewing

May 12, 2014 by Honey Leveen Leave a Comment

In her April 9, 2014 column, one of my heroines, Terry Savage, describes looming Generation Warfare.

In a nutshell, our government is spending far more than it takes in. Check out Truth in Accounting, a nonprofit that keeps track of both our current national debt and the burden of future government payment promises. We now have an “official” national debt of more than $17.4 Trillion. The ticking clock on their website shows that we have promised to pay a total of $76 trillion to future Social Security and Medicare recipients, not to mention interest on our debt, along with military retirement benefits, etc.

In other words, we owe a lot of money! More than the government can raise in taxes.

In the meantime, Washington is playing a shell game. Instead of figuring out how to grow the economic pie, they are obsessed with dividing up the existing pie.

Generational warfare is brewing. Young people are enticed to take out student loans at interest rates many times what the government pays to borrow — and then graduate into an economy that is not providing jobs so they can repay those loans.

Younger workers pay into a Social Security “trust fund” that is scheduled to move onto shaky ground long before they can expect to receive benefits. They’ll be supporting government retirement benefits for someone else’s parents and grandparents.

And from the seniors’ side, isn’t it generation warfare for the Fed to keep interest rates low (depriving seniors of the opportunity to earn interest in their retirement years), so that the government’s unprecedented borrowing (a burden on the young) can continue?

And isn’t it generation warfare to reduce the government’s support for Medicare Advantage plans and limit Medicare reimbursements to physicians and hospitals, just when seniors most need the care?

Here’s another article about oncoming Generation Warfare that came out about the same time Terry Savage’s column did. It echoes what Terry predicts.

My April 9, 2014 blog is about how astonishingly huge and unsustainable our national debt is. Tax collection doesn’t put a dent in it. Medicare and Medicaid, the primary ways long-term care is paid in the US, are on the firing line and already suffering cutbacks. The giant bulge of Baby Boomers, most of whom are wholly unprepared to pay for their long-term care, is just beginning to hit our system.

At age 65, there’s a 70% chance any of us will need long-term care during our lives. I urge you not to depend on the government to provide your long-term care.

Long-Term Care Insurance is Good for America!

April 9, 2014 by Honey Leveen Leave a Comment

I want to share part of a powerful address that Tom McInerney delivered at the recent Society of Actuaries Long-Term Care Conference. His talk had great impact on me.

Mr. McInerney is the CEO of Genworth Financial, a leader in the long-term care insurance (LTCi) marketplace. He stated the federal government faces at least $40-70 trillion in entitlement liabilities (Medicare, Social Security and Medicaid). A 2009 GAO Report supports a $45 trillion number. A more recent Heritage Foundation report estimates $45 trillion for Social Security and Medicare alone. All three of these programs are “Pay-As-You-Go”, which means they need to be paid for through current payroll or income taxes.

Our current federal tax revenues are $2.7T per year (see CBO Report FY 2013 estimate). If you add $40 – 70 trillion of entitlement to our existing $17 trillion deficit, even a doubling of taxes, which would further slow our economy, wouldn’t put much of a dent on the public sector’s true liabilities of $60 – 80 trillion! To add to this dilemma, we currently have a ratio of fewer than three workers per retiree supporting Social Security. According to the Social Security Administration, this ratio gets worse every day.

Let me add that our legislators know that Medicare, Social Security, and Medicaid need reform urgently. But for their own reasons, neither party will broach this subject. I have blogged about this here and here. With each passing day, the entitlement crisis grows worse, and Mr. McInerney states that counseling that we should rely exclusively on a taxpayer-funded solution to pay for long-term care in the US is irresponsible. I don’t think it’s irresponsible. I think it is off-the-deep end unrealistic and irrational to believe publicly paid long-term care is possible! Yet such irrational, “feel good” solutions seem to prevail.

Here’s a blog that gives an example of the prevalence of such irrational points of view. It’s called “Reaming Diane Rehm“. During her show on long-term care, Diane Rehm paid most of her attention to a supporter of government paid long-term care. She did not have a single representative of the insurance industry on this show, yet plenty of time was spent smashing and bashing LTCi. I pointed out some of the many false and irrational statements made on this show in a professionally written letter I sent to Diane Rehm by surface mail and email; I never even got an acknowledgement from her or her staff.

Meanwhile, Americans haven’t saved enough to cover their long-term care costs. The private long-term care insurance market can’t cover everybody, but it can cover some of us. The more LTCi policies issued, the less pressure on Medicaid budgets and other entitlement spending in the future.

Sign that I’m Getting Old: I See Actual Evidence of Income Inequality

February 6, 2014 by Honey Leveen Leave a Comment

In my prior blog, www./2014/income-inequality-is-here, I gave irrefutable proof that income inequality is here. Due to the human tendency to deny facts that are unpleasant, it is often difficult for even smart, educated people to acknowledge this.

The email below comes from an informed prospective client who works in the long-term care industry. Every day she sees families in crisis, largely because their loved one does not own long-term care insurance (LTCi). She believes LTCi is the only solution for middle-class people who want to secure their dignity and options, should the probable need for long-term care arise. She sought my help upon the strong recommendation of her friend. We had a good rapport, and I showed her reasonable LTCi premiums. At the point of placing her LTCi application, she froze in fear, like a deer in headlights :

“Honey – Just wanted to touch base with you. I want to be respectful of your time. My week became crazy at work. Things went haywire with individuals quitting and getting laid off. I am going to hold up on my long term care insurance. I will pay the increase when I get the insurance. I may be getting laid off. I will know some time in Feb. I do not want to take on added expense until I know something. Thank you kindness and patience with me. ~ Tracy“

When I began selling LTCi 23 years ago, I did not get many objections like the one above. True enough, there was horrid, incorrect, sometimes scathing media coverage of LTCi in those days. This is not as true nowadays. People were also convinced Medicare would pay for their long-term care or that their kids would care for them. Thankfully, both of these myths have been largely dispelled.

Now we have income inequality replacing the obstacles described above and throwing a wrench into what I believe would be an otherwise thriving LTCi industry.

This is sad to me. With the presence of income inequality, there is a stronger than ever need for LTCi ownership.

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Horrible Story Illustrating Why Medical Insurance and Medicare Supplements Don’t Pay For LTC

Why Staff (Is All That) Matters in Choosing a Nursing Home (Not!)

Sign that I’m Getting Old: I See Actual Evidence of Income Inequality

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