Why You Should Consider Long Term Care Insurance in Your Retirement Planning

If you haven’t already done so, now is an excellent time to consider adding long term care insurance to your retirement portfolio. Because uninsured long term care expenses can pose a significant risk to the assets you’ve worked a lifetime to accumulate, long term care insurance should be considered as part of a complete financial plan.
 
As former Senator told the United States Senate Special Committee on Aging, “Although the need for health insurance to cover a patient’s medical expenses in case of catastrophic illness is widely recognized, few people are insured against the costs of providing long term support services for that same person. This lack of insurance coverage jeopardizes the financial security of families and diminishes the economic security of the country.”
 
The likelihood that you may need long term care is significant.  Some 70% of Americans who reach the age of 70 can expect to utilize some type of long-term care during the remainder of their lives.  And while long term care includes a broad range of services, from in-home care to nursing home care, each comes at a cost.  Those costs could be substantial, and could have a significant adverse effect on your retirement portfolio.
 
Why? Most forms of health insurance focus on medical expenses, not the custodial care and nonmedical expenses associated with long term care. Medicare only covers nursing home care after a related three-day inpatient hospital stay and even then for only 20 days before a daily co-payment is assessed and Medicare only covers a total of 100 days.

Medicaid doesn’t kick in until one has spent down a significant portion of their assets (spend-down to $2,000*).  Therefore, if either you or your spouse needs long term care, you may have to pay for that care out of your accumulated assets … unless you have long term care insurance.

genworth-nursing-cost-2016The average cost of a private room in a nursing home met or exceeded $80,000 annually.  If one partner needs such care, the cost could quickly and substantially erode the assets acquired over a lifetime.
 
Let’s use a hypothetical couple living off the interest of $500,000 of invested assets to illustrate how serious an impact long term care expenses could have.

For the sake of this discussion, assume the couples’ investments are earning approximately eight percent annually, generating about $40,000 per year in income.  Let’s also presume this couple needs all of this income to support them while they’re living together in their home.
 
Based on an $80,000 annual cost for nursing home care, it may appear that this couple has enough for a little more than six years of care. However, that basic calculation does not consider the living expenses of the spouse who remains in the community.  

If this couple is using all of their investment income to provide for their living expenses, they will soon need to start withdrawing from the principle for a portion of those living expenses as well as for the long term care expenses of the partner who needs care.
 
In circumstances like these, it’s easy to see how the assets accumulated over a lifetime could soon be completely exhausted.
 
Long term care insurance can help provide the funds to pay for the care you may need, while simultaneously protecting the assets you’ve worked a lifetime to accumulate. Long term care insurance may also help preserve financial independence, choice, and dignity, and those can be priceless.
 
It’s never too early to consider insurance because your health can change at any time, meaning you may be uninsurable and end up paying out-of-pocket.

The Partnership Asset Protection program is available in most states. This will protect your home and assets to the limit as was paid by a qualified policy.

Some people have too many assets to benefit from the Partnership. They may prefer an annuity or life insurance with a long term care rider. You can use an existing whole/universal life policy or existing annuity to fund a new policy with long term care coverage. The Pension Protection Act allows this transfer without having to pay capital gains.

Feel free to contact us for more information or for an updated quote.

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.* States can differ on spend-down.

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Caregivers At Risk.

It is not easy to talk about our parents or even ourselves getting older and some day needing help with very basic things. Here is information designed to educate the public about these issues.

Finding the words to begin a long term care conversation. (Genworth)

Beyond Dollars Infographic exposing the true costs of a long term care event. (pdf)

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LongTermCare.gov – Basic information about what is covered by Medicare and Medicaid.

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There are different ways to fund long term care: self-insure, long term care insurance*, life insurance or annuity with a long term care rider*, life insurance with a chronic illness rider*, Medicaid.
* Insurance is medical underwritten. Insuring locks in age and health.
27% of applicants ages 60-69 are declined because of health.

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Millennials are most aware about long term care insurance

Only 20% of Americans have taken steps towards financing long term care, including even researching the costs. Millennials, who have long known that Social Security may not exist by the time they retire, are the generation most likely to have taken action on long term care insurance, according to Genworth Life Insurance Company, a long term care insurer since 1974.

Of people age 65 and older, 70% will need long term care at some point. However, only 52% of baby boomers believe they will need care. Millennials and members of Generation X are more realistic; 64% of Millennials (age 34 and younger) and 65% of Generation X (age 35-50) expect they may need long term care in the future.

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Most Americans (66%) mistakenly believe government programs will cover the costs of long term care. But Medicare only pays for skilled services or rehabilitative care, not for non-skilled assistance with activities of daily living, which is the bulk of long term care services.

Here are the 2016 national average costs for long term care in the United States (costs vary by state): $225/day or $6,844/month for a semi-private room in a nursing home; $253/day or $7,698/month for a private room in a nursing home; $119/day or $3,628/month for a one-bedroom space in an assisted living facility; $20.50/hour for a health aide; $20/hour for homemaker services; $68/day in an adult day health care center.

For those who are not prepared financially to handle their care costs, the burden will fall on their families and communities. It’s important for people who are growing older to talk with their families about their possible future needs and develop a plan — including how they will pay for care if needed.

Other facts the Genworth study showed Americans were uninformed about: 52% did not know that long term care insurance can cover help in their homes; 61% did not know that long term care can be personalized and that the insurer can help them find good care providers.

Insurers say people are never too young to begin planning for long term care costs, which can be a major expense and quickly use up retirement savings. To find out about long term care insurance, see the Guide To Long Term Care

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Want to live longer? Take care of someone

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Seniors who take care of others live longer than those who do not.

This observation comes from an international research project in which scientists analyzed data from the Berlin Aging Study that followed 500 adults over the age of 69 from 1990 to 2009. About half of the subjects took care of friends, children, or grandchildren; these caregivers were still alive 10 years after their first interview in 1990.

For those who took care of non-family members, half were still alive seven years after the first interview. For those seniors who did not take care of anyone, 50 percent had died within four years of the first interview.

However, moderation in caregiving is essential. Other studies have shown that too much caregiving responsibility is stressful and can endanger one’s health.

Long term care insurance can help pay for needed care at home or in an institution. Some companies offer a cash benefit that can be used to pay a friend or family member for care. Get more information here: GuideToLongTermCare.com

 

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Eye Scan for Alzheimer’s

Scanning the eyes is a new way to detect Alzheimer’s disease.

Researchers at Cedars-Sinai Medical Center in California say Alzheimer’s affects the retina, in the back of the eye, in a similar way to how it affects the brain. A high-definition eye scan can show the buildup of toxic proteins that indicate Alzheimer’s.

The plaque showing in the retina matches the plaque in a corresponding part of the brain. Through repeated scans of the retina over time, doctors will be able monitor the progression of the disease.

At one time, the only way to diagnose Alzheimer’s was by examining the brain after a person died. Now doctors can use brain scans to diagnose the disease in living patients, but these scans are expensive and invasive. The non-invasive eye scans will help doctors to detect the disease earlier, making it possible to intervene with medications and lifestyle changes before more symptoms appear.

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If you do not plan for your long term care who will? See the Guide To Long Term Care for more information on Alzheimer’s and how to prepare for long term care needs.

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Dying at Home

Most people (70%) want to die at home, in a familiar place surrounded by loved ones. However, only about 25% do. Nearly 50% of Americans die in a hospital, and another 20% die in a nursing home or long-term care facility.

The trend is for more people to die at home, with a 29.5 percent increase from 2000 to 2014, according to the Centers for Disease Control and Prevention. During the same time period, the percentage of deaths in hospitals, nursing homes and long-term care facilities has dropped.

Seven out of ten Americans die from chronic disease, and more than 90 million Americans are living with at least one chronic disease. The Centers for Disease Control (2007) listed the ten leading causes of death in America (in order):
1.
heart disease
2.
cancer
3.
stroke
4.
chronic lower respiratory disease
5.
accidents
6.
Alzheimer’s
7. diabetes
8.
influenza
9.
pneumonia
10.
kidney disease and sepsis.

Almost a third of Americans see ten or more physicians in the last six months of their life. And almost 30% of Medicare’s budget each year is spent on patients who are in the last 12 months of their lives.

According to LongTermCare.gov about 70% of Americans over age 65 will require long-term care. If a person has an extended illness requiring long-term care, long-term care insurance will help cover those expenses whether in a hospital or at home. Studies show that those with long-term care insurance stay at home longer because the insurance provides more money for care. This includes extra money for home modifications like a wheel-chair ramp, a medical alert system and a stair lift.

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It is often the lack of money that prevents people from staying at home when they need care. Who pays for long-term care? In some cases they will spend all their savings and now are forced to rely on Medicaid (welfare health care). With a Partnership asset-protection insurance policy you will be exempt from the Medicaid spend-down requirement, the exemption is based on the total benefits your policy has paid out for care.

More than 80% of patients with chronic diseases say they want to avoid being in a hospital or intensive care unit when they are dying. While dying at home is usually preferred by the patient, it can be difficult for the caregiver. Hospice services can help.

Hospice care is for those in the last six months of their lives. More than 88% of hospice patients are Medicare beneficiaries.

Traditionally, for a patient to qualify for Medicare-supported hospice, a doctor must certify that the patient has: a home, a diagnosis of six months or less to live, a full-time caregiver, and a willingness to give up curative care and receive only palliative care.

In 2016 the Medicare Care Choices Model began offering some patients “concurrent care”: the choice of continuing curative care while starting palliative care and hospice care. An evaluation of concurrent hospice in non-elderly patients showed this plan improves quality of life and reduces costs.

The Medicare hospice benefit emphasizes home care, with almost 60% of patients receiving their care at home as of 2014. Medicare coverage is limited, additional care would be paid for out-of-pocket. Do you really want to spend-down your hard-earned savings and investments leaving open the option that Medicaid will require your estate to repay Medicaid for your care costs? There are 30 states with a filial responsibility law that could require your family to reimburse Medicaid.

Home care is much less expensive. Inpatient hospice services are used when the patient’s pain and symptoms must be closely monitored in order to be controlled, when medical intervention is required to control pain or symptoms, or when the family needs a rest from the stress of care giving.

A hospice team arranges for doctors, nursing care, medical equipment like wheelchairs and walkers, medical supplies, prescription drugs, hospice aide and homemaker services, physical and occupational therapy, speech-language pathology services, social workers, dietary counseling, grief and loss counseling for the patient and family, short-term inpatient care, and short-term respite care.

After evaluation by a doctor, a patient can enroll in hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit extensions. A patient can decide to stop hospice care at any time.

A recently proposed bill, The Patient Choice and Quality Care Act of 2017 (H.R. 2797), aims to give patients and families living with advanced and life-limiting illnesses the information and services they need.

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Deaths from Alzheimer’s disease rising

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From 1999 to 2014, United States deaths from Alzheimer’s disease rose by 54.5 percent. According to the U.S. Centers for Disease Control and Prevention (CDC), the Alzheimer’s death rate rose during those 15 years from 16.5 to 25.4 deaths per 100,000 people. In 2014, 93,541 people died from Alzheimer’s.

Alzheimer’s, the leading cause of dementia and the sixth-leading cause of death in the United States, caused 3.6 percent of deaths in 2014.

Researchers expect rates will continue to rise as life expectancy increases. About 5.5 million Americans are living with the disease. That number is expected to rise to 16 million by 2050.

There is a trend for more people with Alzheimer’s to die at home rather than a medical facility. The number of Alzheimer’s patients dying at home increased from 13.9 percent to 24.9 percent from 2009 to 2014. During the same time period, the number of who died from Alzheimer’s in medical facilities fell from 14.7 percent in 1999 to 6.6 percent in 2014.

The disease mainly affects people over the age of 65. The rise in Alzheimer’s cases is attributed to the increasing numbers of older people, as medical improvements have led to fewer deaths from conditions such as heart disease. However, some of the increase may be the result of more accurate reporting by doctors.

At this time there is no cure for Alzheimer’s. It is the leading cause of long term care insurance claims. To plan for possible long term care needs in the future, see the Guide To Long Term Care.

Planning to buy long term care insurance at some point? Remember you must buy before the diagnosis. There are many conditions like Alzheimer’s that are uninsurable, here is a partial list: Are You Insurable?

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