Articles Tagged with Long-Term Care Planning

8.15.16The cost of long-term care can take a huge bite out of retirement savings, exhaust family resources and create strain on relationships. Don’t count on Medicare, but do plan in advance.

At least seven out of ten Americans age 65 and over will need long-term care at some point. Most people simply underestimate the cost of long-term care, or they think that Medicaid will cover the costs. Your best defense against long-term care costs: advance planning with professional help.

The Memphis Daily News article, “Long-Term Care – Not for Everyone,” says that Medicare does little for these costs and only for a short time period. Medicaid doesn’t apply until the assets of an estate are spent down, so many people must pay for these costs out-of-pocket. The article says that there are only two ways to address these expenses: with your investment/retirement portfolio and with long-term care insurance. Most people review the cost of long-term care insurance and elect to roll the dice, but when that first round of expenses hits, they probably will wish they’d bought it long ago. Now it’s usually too late to buy it. If you can afford to self-insure, you can save your estate and yourself some serious money.

Old man on bench 5.4.2016Houston families with an Alzheimer's patient must address the issue of financial planning as well as care and treatment. A number of planning tools should be discussed once a diagnosis has been made.

Any family faced with helping a loved one who has been diagnosed with Alzheimer's disease has a number of challenges ahead. In The Wall Street Journal's "Voices: Consider Trusteed IRAs for Clients With Alzheimer's," the article suggests that frank discussions must begin to address a number of concerns for the present and the future. Issues include care and treatment, wishes for care when the person can no longer speak for themselves, determining who will manage finances, estate planning and how a spouse will be supported during the loved one's illness—however long it may last.

Many of those with an Alzheimer's diagnosis really are concerned with not becoming a financial or practical burden on their family. Loved ones can encourage them to see an elder law attorney to help them organize and designate their assets early, so that they will ensure appropriate distribution before they're not able to manage their money directly.

Bigstock-Couple-running-bookshop-13904324As with the rest of America, Hawaiians are coping with a growing population of citizens over age 65 diagnosed with Alzheimer's, approximately 25,000 in total. Advocates, including members of a dementia task force under the Executive Office on Aging and members of the local Alzheimer's Association, are focusing on preparing professionals and caregivers to address the often complex needs of individuals with dementia.

A recent article in KHON, titled "Task force aims to help seniors living with dementia" recently reported on this.

James Pietsch, the director of the University of Hawaii Elder Law Program, told KHON that there are multiple tasks under this task force, one of which is supportive research to determine whether professionals are qualified or capable of handling these type of cases. Professionals like doctors, social workers, nurses, and lawyers need to be better prepared to handle issues involving dementia.

Hand with cashNursing home and other long-term care expenses can be a financial burden for most families. And although long-term care insurance policies can help offset those expenses, LTC premiums are on the rise and can be quite costly. It can take careful planning to determine if LTC premiums can be paid for, without dipping into retirement funds.

When people purchased their policies 10 to 15 years ago, nursing home costs were about $150 or $200 a day. In some parts of the county, today’s costs can exceed $400 a day, or $12,000 per month for higher levels of care.

The expense incurred by the insured going on claim has caused the long-term care insurance industry to downsize. Those companies still offering policies are bumping up the premiums amid the rising cost of long-term care.

Older couple with documentAs a direct result of complex relationships between Social Security and Medicare and a number of other unforeseen issues, 2016 will be an expensive year for some seniors, according to Forbes' recent article, "Untangling the Medicare Premium Mess — And What It Means For You." Medicare laws require it to increase premiums annually to cover increases in per capita costs. This would typically be about $16, which most seniors can manage.

Except that 2016 will not be a normal year. Most retirees have their Medicare premiums deducted from their Social Security benefits, but because inflation was so low this year, there won't be a cost-of-living increase in 2016 for Social Security. And the law says that if Social Security benefits don't rise—you guessed it—neither can the Medicare premiums.

That means about 70% of Medicare beneficiaries won't see the premium hike. However, that leaves the entire burden of this year's Medicare cost increases on the remaining 30%. Those guys are going to be hit with 50% premium hikes.

Road in forest free useDo you have a plan for long term care?  It can be costly and prohibitive for many families, especially for dementia care.  Several key points about long term care are clarified in a recent article from The Arizona Daily Star, “Costs pile up fast for dementia care.” 

Don’t count on Medicare. The median annual cost for a private room in a skilled nursing facility in Tucson last year was more than $90,896. Assisted living costs about $45,000. In a 2015 annual Cost of Care survey, results showed that Americans paid approximately $16,060 more per year in 2015 for a nursing home than they paid in 2010.

Remember that Medicare doesn’t pay for long-term care, including home care, aside from 100 days of skilled services or rehabilitative care. After that, it’s up to the family to figure out how to pay. The options include long-term care insurance, public assistance through Medicaid programs for people over 65, Veterans Aid, or private pay. On average, an American turning 65 today will incur $138,000 in future long-term services. This cost could be financed by setting aside $70,000 today.

Hands in agreementThe Huffington Post published an interesting article on the ethical and legal issues posed by two related legal practice areas, “Some Legal Issues at the Intersection of Elder Law and Estate Planning.” There are legal and ethical issues that arise when determining courses of action in both areas.

One is whether to dispose of assets through pre-need planning to qualify for means-tested government programs such as Medicaid that might pay, for example, the cost of long term nursing home care. This is very complicated, and you should work with a qualified elder law attorney.

If you want to maximize eligibility for means-tested governmental benefits, a common income reduction technique is to create a Qualified Income Trust (QIT), also called a “Miller Trust.” There are also other types of "special needs trusts" that can be created without reducing government benefits. Again, this is a highly complex area that requires help from an elder law attorney.

Military man saluting flagA survey conducted by the National Association of Area Agencies on Aging, National Council on Aging and UnitedHealthcare reveals a frightening statistic in the United States of Aging survey. 97% of professionals supporting people 60 and older believe that seniors will not be able to afford their health care costs as they age. Only 3% are very confident older Americans will be able to manage health care costs. Not a pretty picture.

The high and ever-increasing cost of long-term care is the leading reason that professionals do not believe that seniors will be able to afford their health care. The median price of a private room in a nursing home now costs about $91,000 – an increase of 4% from last year. The survey on aging, reported on in an article in Forbes, offers a glimmer of hope with a look at a little-known program from the VA:  "The VA Program That Pays For Long-Term Care for Vets."

About half of us will someday use nursing home care, and many others will need long-term care in assisted living facilities or at home.

MP900407501Can you imagine not being notified if your parent had been injured, fell ill or had even passed away? With a recently increasing occurrence across the country, state representatives are proposing changes to ensure children have visitation rights to ailing parents.

Fox News shared Catherine Falk’s story in an article titled“'Columbo' daughter pushes for bill that protects the right to visit sick parents.” The daughter of Peter Falk, a five-time Emmy Award winner as Lt. Columbo, laughs as she recalls memories about her funny father, like forgetting about Christmas presents they had given him after he had put them in the trunk of his car, only to find them all there still the next year. But when he got sick, it was no laughing matter. Catherine claims she was kept out of the details of her father’s condition, including being able to see or talk to him. Thousands of adult children in America are finding themselves going through a similar experience.

In Falk’s case, she and her stepmother were locked in a court battle over conservatorship and access to Peter for years. In 2008, he became completely incapacitated from his advanced dementia. Catherine then decided to create the Catherine Falk Organization, which advocates for the rights of adult children to see their sick parents.

Bigstock-Elder-Couple-With-Bills-3557267"If you get a claim denial, always contact your doctor or hospital to see if they can help you through the appeal," said Shirley Whitenack, president of the National Academy of Elder Law Attorneys and a partner with law firm Schenck, Price, Smith & King.

Larry Tocco retired last year from a job in the collections department of a credit union. After some medical treatment, he started receiving past-due notices from health care providers after his claims on a Medicare plan weren't paid. After several frustrating phone calls, Larry learned he was still on the active employee roll of the health insurance plan covering his former employer. As a result, his Medicare plan was considered secondary coverage.

A benefits manager from the credit union told him they sent the retirement paperwork, but the representatives with the Medicare provider said they didn't get it.

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