Long Term Care Premiums Going Up Again in PA.

Here is an article that I noticed about LTC(Long Term Care Insurance) premiums going up again in Pennsylvania.  If you are tired of premiums consistently rising, give our office a call.  We may be able to help.  While replacing an existing policy may or may not be advisable, we can look at a couple of options that are available.

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Veterans Aid and Attendance Benefit

We may be able to help veterans of WWII, Korea, Vietnam and other wars qualify for funds that most people don’t know exist. The Veterans need not have participated in these wars but rather just needed to be on active duty within 90 days on either side of these declared wars.

The extra funds could mean the difference between depleting a life savings to pay medical bills and being able to use that savings for retirement or to pass it on to the next generation.

The Veterans Aid and Attendance Benefit can provide around $2,000 a month to pay for all types of medical care, including hospital and doctor care, and also home health assistance.

According to the latest data available from 2007, $3 billion has been allocated by Congress since the law went into effect in 1951 and only 150,000 veterans or spouses of veterans are currently claiming the benefit.

That is only 1% of the 15 million veterans who might qualify. Up to 85% of applicants get rejected on their first application because the process is complicated, but our office can find out if the Veterans qualify and, if so, help them get the funds.

Any veteran who served during the dates of a declared war–including WWII, Korea, Vietnam, Iraq and Afghanistan–is eligible if he or she is 65, received a discharge other than dishonorable, had 90 days of active duty with one day during wartime, and needs help with daily living activities because of health issues.

There are some other minor criteria due to the dates different wars were declared. If a veteran is disabled, the age limit can be lowered. There are income eligibility guidelines, too, but there are techniques, such as setting up an irrevocable trust, that can protect assets while still qualifying for the Veterans Aid and Attendance Benefit.

Monthly benefits range from $2,540 for two married veterans, $1,949 for a veteran with a dependent spouse, $1,644 for a single and $1,056 for a surviving spouse.

Using the available veterans’ benefits can pay for medical expenses or for an assisted living facility and protect the family’s nest egg at the same time, he says.

The Veterans Aid and Attendance Benefit is completely separate from Medicaid. Applications are separate and can be made for either or both, but the two should not be confused.

The Veterans Benefit is described in four pages of a 1,800-page law, so it is not surprising many Veterans do not know about it.

 

Long Term Care Insurance Quiz

Ever wondered if you should have long-term care insurance?

Now, you can answer this question once and for all with the quick quiz below!

LONG-TERM CARE INSURANCE QUIZ:

  1. Would paying $200/day or more for long-term care deplete your savings?
  2. Would you prefer to preserve your assets so that you might pass on an inheritance to loved ones?
  3. Would you like the option of receiving care in your own home instead of going to a facility?
  4. Would your family members have difficulty covering the added expense of your care if your savings was depleted?
  5. Do you have a family history of chronic illness or memory loss?

If you answered “YES” to even one of these questions, you should learn more about your long-term care coverage options. You never know what tomorrow may bring, but one thing is for certain – you’ll feel relieved knowing that you’ll live with dignity, without burdening your loved ones, no matter what happens.

Call me today and I’ll explain your options and help you find an affordable solution.

Warm Regards,

Michael L. Schwartz, RFC, CWS, CFS

215-886-2122, Mike@schwartzfinancial.com

http://www.schwartzfinancial.com

 

P.S.      Isn’t it time to make a wise and caring choice to preserve your dignity and your assets? Wouldn’t it be nice to know you’ll never be a burden to your loved ones? Call me today – you’ll be glad you did –215-886-2122.

Planning For Long Term Care

Long-term care planning has always been a dilemma in my mind. You can look at statistical averages all day long, but in the end it comes down to each person’s individual experience. You’ll either need it or you won’t, and if you do need it you’ll either pay a lot or a little. So the “planning” can range from needing many years of care at a very high cost, to needing no care at all at a cost of zero. It’s equivalent to the possibility of your house burning down. Your house will either burn down, or it won’t. Chances are it won’t. But if it does, it would be devastating financially. So you plan for this possibility by buying fire insurance.

But that’s where the equivalence ends. Fire insurance is affordable, so there is little downside to protecting against an event that probably won’t happen. (In case you’re interested, there is a one in four chance that your house will have a fire large enough to report it to the fire department, according to the National Fire Protection Association.)

Long-term care is a little different. According to a recent Vanguard Mercer study on health care costs, about half of the elderly can expect to pay nothing for long-term care. Another quarter can expect to incur costs of less than $100,000. Fifteen percent can expect costs exceeding one-quarter of a million dollars.

paid long term care costs

Unlike fire insurance, long-term care insurance is expensive and difficult to obtain. Some people can’t qualify for it. Some people can’t afford it. And some people buy it with the best of intentions only to face premium hikes that render it unaffordable after many years of paying on it. While there will always be a certain number of people for whom long-term care insurance is appropriate, there has to be a better way of planning for long-term care.

One way is to refrain from lumping everyone into one big risk pool (like the insurance companies do; that’s their business). Instead, use a more targeted method of estimating the chances of needing long-term care and the costs of such care. Consider the likelihood of needing long-term care in the first place. Look at the type of care that might be needed, and the duration of such care. Then consider the costs of each type of care. While these factors may not be fully predictable, we encourage you to consider them in the context of your own health outlook and life expectancy and family dynamics that can lead to a closer approximation of long-term care costs.

The official definition of long-term care, according to the Health Insurance Portability and Accountability Act (HIPAA), is the need for help with two activities of daily living (ADLs) for a period of 90 days or longer. The ADLs are bathing, dressing, toileting, transferring (getting in and out of a chair or bed), continence, and eating. The definition also includes the need for substantial supervision for safety reasons due to severe cognitive impairment.

Long-term care can be further categorized as temporary or ongoing. Temporary care might include rehabilitation after a hospital stay or recovery from an injury or surgery. In these instances the individual recovers and no longer requires care. Another example is hospice care where the end of life is imminent. Temporary long-term care costs may be covered by Medicare.

In contrast, ongoing long-term care is many months or even years in duration. It may be triggered by cognitive decline, permanent disability, and other chronic conditions. The most common situation leading to ongoing long-term care is dementia. Stroke, Parkinson’s disease, and osteoarthritis are also common reasons for needing long-term care. Once this type of care is started, it usually continues for the rest of a person’s life.

But HIPAA’s definition of long-term care is not the only type of care that needs to be planned for. Long before a person becomes unable to perform two activities of daily living, they may need help with cleaning, cooking, shopping, and getting around town. These homemaker services are not considered formal long-term care (and are not covered by insurance), but their costs should be incorporated into the financial plan to the extent that there is no family member available or willing to help out.

If you remain at home into your 80s and 90s you will need to budget for these services in addition to your regular costs for housing, food, and transportation. The chart below shows an average annual cost of $45,756 ($3,813 per month) for homemaker services. But the actual cost for any one individual will depend on their needs. A person who hires someone to come in for just a few hours a week will spend far less than this. According to Genworth, the national median hourly rate for homemaker services is $21. If the need is 20 hours a week, the monthly cost would be less than $1,800. With all the meal and grocery delivery services cropping up today, the cost can be even less.

The next step, for those who are unable or unwilling to stay in their own homes but who are still relatively healthy, may be a move to an assisted living facility. The chart below shows an average annual cost of $43,656, or $3,638 per month, for assisted living. But this would include housing, food, some transportation, and housekeeping services in the monthly fee, so it may not be as expensive as it first seems.

cost of care

A person who wishes to stay in their own home and who needs more extensive care than simple housekeeping may hire a home health aide. These aides offer “hands-on” personal care, but not medical care. The chart above shows this cost to be $46,332 per year ($3,861 per month), but again, it depends on a person’s needs. The national median hourly rate for a home health aide is $22. If the aide only needs to come in for a few hours a day or week, the cost would be far less.

The last step would be admittance to a skilled nursing home at a median cost of as much as $267 per day for a private room. Now we’re talking some real money: nearly $100,000 per year. In planning, you need to ask yourself: what are the chances I will need this type of care, and for how long? The answer will determine the type of planning you need to do. Some may want to set the funds aside or buy some type of insurance, while others may want to take their chances that they will never need this extreme type of care.

The other thing to remember is that if a client does encounter cognitive or physical decline, whether they stay in their own home or move to some type of assisted living facility, spending in other areas, such as travel and leisure, will decline.

And don’t forget about family members, who may or may not serve as a resource. If you have good relationships with your children you may be able to depend on them for housing and some type of assistance. Those who don’t have children, or who don’t want to burden their children, will want to make sure the financial resources are in place so they can pay for the housing and care they need.

In the end, planning for long-term care should be like any other aspect of financial planning—completely customized for based on preferences, probabilities, and projected costs for the type and duration of care that might be needed. Some will want to insure to the hilt. Others would rather take their chances and hope for the best. Whenever we’re working with uncertainties like this, I believe that falling back on general statistics is the wrong approach. Like life expectancy and other matters that can’t be predicted with certainty but that might have a sense about based on their own health experience, genes, and lifestyle, I think the best way to do long-term care planning is to engage with your planner. Lay out the probabilities, costs, circumstances that might point to a need for long-term care (dementia, etc.), and possible solutions (self-insure, LTC insurance, hybrid policy, Medicaid). Once you are informed and have had a chance to think about it, you may be able to come up with a workable plan.

Please give us a call at 215-886-2122 to start the conversation.

Who Will Need Long-Term Care?

It is difficult to predict how much or what type of long-term care a person might need. Several things increase the risk of needing long-term care.

·        Age. The risk generally increases as people get older.

·        Gender. Women are at higher risk than men, primarily because they often live longer.

·        Marital status. Single people are more likely than married people to need care from a paid provider.

·        Lifestyle. Poor diet and exercise habits can increase a person’s risk.

·        Health and family history. These factors also affect risk.

Source: National Institute on Aging

Two Documents Your Estate Plan Must Have Now!!!

Power of attorney

LegalZoom defines power of attorney (POA) as, “a document you can use to appoint someone to make decisions on your behalf. The person you designate is called an ‘attorney-in-fact.’” There are three main elements for a valid POA: (1) the person signing the document (the principal) must be mentally competent and acting without undue pressure from anyone; (2) the document must contain the date of execution; and (3) the signature must be notarized or be witnessed by two unrelated adults. State laws vary, so see an attorney for advice.

There are several important reasons for having a POA. For one, if there is no designated agent, the state may step in and appoint a guardian, a decision over which the family will have no say. Also, it is critical to have a financial overseer if and when a senior’s mental health declines.

In practice, a POA is very flexible, suiting the needs of each individual family. It can be “special” or “limited,” meaning that authority is granted only for a set period of time or for a particular transaction. No other powers are given. Conversely, a durable power of attorney allows an agent to manage all the affairs of the principal for any length of time, although it does expire at the time of death. A springing POA goes into effect only when a specific, predetermined event occurs, i.e., the principal becomes incapacitated. It can be durable or limited. Also, the agent can be granted as many or as few powers as the principal wants.

Caution needs to be taken when choosing an agent, especially in regard to financial matters. Dishonest agents have used POAs as opportunities to steal from unsuspecting seniors. We encourage you and your loved ones to sign a POA.

In fact, it might be you who is chosen to take on the role of attorney-in-fact. Caring.com, an online resource for caregivers, offers the following tips for preparing to become a POA:

  • Create a caregiving team—people who can advise you and be the resource you need to make good decisions.
  • Consider all ramifications of a decision, not giving in to what others may think or pressure from doctors or professionals. Choose what is best for your family member.
  • Do some research on accounting, medical terminology, and counseling.
  • Give yourself permission to make mistakes.
  • Know the current state of affairs for the person you will be representing, both financially and medically.
  • Establish a cordial relationship with the rest of the family.

Health care directive

A health care directive is also referred to as a medical power of attorney or an advance directive. LegalZoom defines a health care directive as a “document that explains a person’s health care preferences when he or she is unable to make those choice for him or herself.” Some directives may designate a health care agent, a person given the authority to make medical decisions on the principal’s behalf.

A health care directive is not the same as a living will. A living will is limited to situations when the principal is terminally ill or permanently unconscious. It does not apply to any other situations where medical decisions might need to be made. However, a living will can be useful to give some guidance to the health care agent.

WebMD gives these guidelines about choosing, or helping a parent choose, a health care agent:

  • Choose someone you trust, who knows you well and who can handle stress and emotional turmoil.
  • Consider medical issues and your care options, then take the time to put them in an advance directive and/or discuss your values and preferences with the agent.
  • Don’t assume that a child or spouse knows what you want. Talk openly about your wishes.
  • It’s not possible to discuss every situation that would arise, so choose someone who knows what is important to you.
  • Check with your state about required documents. Make sure you complete everything.
  • Tell your family, doctors, and anyone else involved in medical care who your agent is.

We all hope our loved ones remain healthy and capable as long as possible, but the reality is that they will one day become compromised at some level. Be assure that getting your elders to choose now who will make decisions when they cannot is actually the best way to preserve their independence.

Accepting health risks

Health depends on a number of factors – genetics, lifestyle, exposure to unknown toxic substances, and luck. You can live the healthiest lifestyle and still get cancer. A few lucky people can break every lifestyle rule for good health and still live to a ripe old age. Unfortunately, you do not know for sure which hand you are dealt. Currently, most people live in a state of denial with their health risks and this prevents preparation for the likelihood of potentially bad outcomes. Wouldn’t it be better if we accepted our health risks and planned for those outcomes in advance?

Doctors clash frequently with patients over “compliance” – that is, following their recommendations for good health or to restore health. Examples are limitless – the patient with diabetes who refuses to give up sweets, the patient with an early family history of heart attacks who won’t give up smoking, or the patient with hypertension who won’t cut out the salt.

We all do things we know we shouldn’t do and there is always a reason. Lack of willpower in the moment, depression, peer pressure, costs in time or money, or maybe we just don’t care. Sometimes we get back on the program and sometimes we totally give up. We are human.

If you have a health risk or unhealthy lifestyle, and know that you won’t or can’t do anything to change it, take a different road.

  • Let your family and health care providers know what you will or will not do to take care of your health.
  • Make certain you understand the potential outcomes of your actions. For example, if you have diabetes and can’t control your diet, learn about the severe outcomes such as renal failure, heart disease, amputations, and blindness along with the minor problems such as frequent urination, thirst, and skin infections that occur. Ask your doctor specifically, “What are the major and minor problems I will develop and what will my life be like as my disease progresses?”
  • Work with your doctor to determine your attitude towards health care. Do you want to receive as much as doctors can offer to mitigate your lifestyle choices? Or would you prefer to avoid the health care system as much as possible?
  • Get the appropriate insurance in place immediately before you become uninsurable – life, disability, and long term care insurance.
  • Finalize your advance directives by completing a living will, naming a health care surrogate, and documenting the quality of life that is appropriate for you. Share this information with all family members and health care professionals who could potentially have a say in your care.
  • Take care of the rest of your affairs. Complete a will, durable power of attorney, and create a list of who you want to get specific personal items. Plan your memorial service and funeral.

It is important to reassess your attitudes periodically. Maybe previous stress in your life has gone away, and now it is possible to prepare healthier meals. Or you have a new job that allows you to take a 30 minute walking break at lunch. Every little bit of action you take toward your health has the opportunity to improve the outcome or at least make you feel better. Life is not static, and our attitudes are not static either.

By preparing for who you are instead of who you want to be, you can decrease frustration with yourself, your family, and your health care providers. Everyone will be more realistically prepared for the potential outcomes which will save time, heartache, and money. This will help you, your family, and your health care providers have a more harmonious relationship for the rest of your life.