Cost of Long Term Care


A lot of people incorrectly assume that health insurance and Medicare will cover long term care. They cover medically necessary care for up to 100 days, or until you stop improving or stablize. After that, you’re on your own.

The majority of Americans over 60 do not have long term care insurance yet 70% will need care. So, why do people not buy insurance?

Most will say the cost of the policy. An average policy, depending on age, health and benefits chosen, will cost $1,000-$3,000 per year per person.

But what about the fact that the same people who say they will “self-insure” for long term care will never “self-insure” a parking meter… they always put money in the meter, even though they could easily afford and “self-insure” the parking fine.

We make decisions based mostly on emotion. That’s what causes people to buy stocks when they are high and sell when it crashes, the opposite of what seasoned investors do.

What if you “self-insure” for long term care, how much will it cost you? The national average for nursing home care is $89,000/year with some areas over $140,000/year. Home care and assisted living average $50,000/year. See how much care cost in your state: download the Cost of Care brochure.

For every $1,000 of monthly retirement income you want to generate from your own savings, you will need about $230,000 in assets, according to the Schwab Center for Investment Research. For example, if you want only $3,000 a month, or $36,000 a year, you would need savings of $690,000. That’s a conservative estimate, assuming that you earn 5.2% on your investments and live off the earnings without dipping into the principal.

If you cannot afford a long term care insurance policy, how are you going to afford paying out of pocket? The other option is spending all your cash for your care. This includes anything of cash value: savings, investments like stocks, bonds, life insurance, annuities. Medicaid allows you can keep only $2,000.

There are 30 states with filial laws that allow the state to make your children repay Medicaid for your care expenses, although this is rarely done. Fifteen years ago the #1 reason people bought long term care insurance was they did not want to be a burden on their family. Today, the #1 reason is people do not want to outlive their money (and end up on Medicaid-Welfare Health Care).

Some people will buy long term care insurance for asset protection. Most states have a Partnership program that will protect assets from Medicaid if you own a Partnership long term care insurance policy.

You have five options to pay for long term care:

1. Self-insure.

2. Long term care insurance and Partnership.

3. Life insurance with long term care rider.

4. Annuity with long term care rider.

5. Medicaid.

The life insurance and annuity do not qualify for the Partnership (neither do group LTC policies). The life/LTC or annuity/LTC are often bought because: the person’s health will not qualify for traditional LTC insurance, or the person has too many cash assets and they’d never spend down to qualify for Medicaid. An old life policy or old annuity can be converted to one with long term care benefits without paying capital gains.

You can continue down the same road, uninsured, until either a diagnosis or a serious change of health, like a stroke, will disqualify you from insuring. Then you will only qualify for state assistance. At that point you would have to have used, sold or given away your assets 5 years before applying for Medicaid. Who has the ability to see 5 years into the future?

*  The best age to insure: the age your health will still insure you.
*  The best benefits to get: enough to cover what you cannot afford to pay out of pocket.

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30 States Have Laws Requiring Children to Repay Medicaid for Parents Care



Filial responsibility laws date back to 17th century English law requiring children to financially support their parents when they couldn’t support themselves.

Because of age, or maybe an illness like Alzheimer’s, millions of Americans are no longer able to take care of themselves.

Spending one’s own money for care can wipe out a life’s savings in a short time. It could be someone in your family.

What happens when the money runs out? Out of love, you may feel a moral obligation to help. In some states, however, you may be legally responsible for paying your parents’ long-term care.

In these days of economic uncertainty it is essential that people have a sense of security in terms of their future. Long term care insurance is a way to preserve that.

Like car insurance, the prices for long term care insurance will vary by company. The premium will depend on your age, health and the benefits you want.
The LTC Partnership Program provides asset protection in most states.

Since care cost differs by type and location it is important to get the right information to make an informed decision.

Other than transferring your assets to an irrevocable trust five years before you apply for Medicaid, the only way to protect your estate from Medicaid is with a Partnership long term care policy.


Be Prepared: Get Long Term Care Insurance Quotes





Promising New Research May Lead To Reversal of Alzheimer’s Dementia


Scientists have recently discovered a possible new way to reverse Alzheimer’s disease.

A new study found that amyloid protein plaques, associated with Alzheimer’s disease, were eliminated when researchers removed a naturally occurring enzyme called BACE1 from the brains of mice.

Riqiang Yan and his team at the Cleveland Clinic studied mice that were genetically engineered to have a rodent form of Alzheimer’s disease. BACE1, known as beta-secretase, clings to the amyloid precursor protein, resulting in the production and buildup of plaques.

When the BACE1 enzyme was removed from the mouse brains, formation of amyloid plaques stopped, and plaque already in the brains of the mice disintegrated. Removal of the enzyme also improved learning and memory in the mice.

In the study, the scientists gradually removed BACE1 from the mice as they aged. By the time the mice were 10 months old (equivalent to the human age of 50 years) they no longer had any amyloid plaque in their brains.

Reducing BACE1 levels in the offspring mice also reversed other conditions found in Alzheimer’s disease, such as microglial cell activation and the formation of abnormal neuronal processes.

Yan published some of his discoveries about BACE1 in 1999 in the journal Nature. This recent study, published in the Journal of Experimental Medicine, is the first one in which researchers have seen a dramatic reversal of amyloid deposits in the brains of mice. It may lead to new therapies that could reverse Alzheimer’s disease. The next step will be to see if human brains react the same way.

Find out about the care of people with Alzheimer’s disease at the Guide To Long Term Care.


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Diabetes drug doing double duty as Alzheimer’s therapy

A drug developed for treating diabetes now shows promise for Alzheimer’s patients, according to scientists at England’s Lancaster University. The drug is described as a triple receptor agonist, or TA. It combines hormones glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and Glucagon, activating these three receptors at the same time. The new study is published in the journal Brain Research.

A group of mice with Alzheimer’s-related symptoms were tested in a spatial water maze. The TA drug was injected once a day for two months. The mice who were treated with the drug remembered their path better than the control group.


In addition to the memory improvement, other symptoms were improved: the accumulation of plaque in the brain was reduced; brain nerve cells were protected from deterioration and loss; and chronic nerve inflammation was reduced, as well as oxidative stress in the cortex and hippocampus. Increased levels of synaptophysin indicated protection from synaptic loss that occurs in Alzheimer’s. An increase of doublecortin positive cells showed improved neurogenesis.

Other diabetes drugs have shown promise for Alzheimer’s patients. The two diseases are known to be related, and type 2 diabetes increases the risk of Alzheimer’s disease. Clinical trials are proceeding to investigate the neuroprotective effects of extendin-4 and liraglutide.

Alzheimer’s cases are expected to triple in the next forty years, requiring more long term care. The increase in patients will bring financial challenges as well as medical ones. For more information on supporting Alzheimer’s and dementia patients, see the Alzheimer’s Section on Guide To Long Term Care.


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Insomnia increases Alzheimer’s risk

Just one night without enough sleep can cause harmful proteins to build up in the brain, increasing the risk of Alzheimer’s disease, according to a new study.

Past studies already linked insufficient sleep to increased risk of Alzheimer’s and other chronic diseases — but this recent study from Washington University,published in the Annals of Neurology, discovered what insomnia actually does to the brain.


One of the functions of sleep is to clear the brain of waste, including amyloid beta proteins which can bond with each other and form plaques on nerve cells. These plaques build up in the brains of people with Alzheimer’s disease.

People with a genetic tendency for Alzheimer’s disease have higher than normal levels of beta amyloid proteins, even before they develop symptoms. After a night without sleep, these higher levels appeared in the healthy study participants.

Inadequate sleep has been linked to a 1.5 fold increase in the odds of developing Alzheimer’s. It’s not surprising, therefore, that research shows that sleep disorders such as sleep apnea increase the risk.

In the study, eight participants with no previous sleep or memory problems were instructed to either stay awake all night, get a normal night’s rest, or use the drug sodium oxybate to help them sleep. The sleep aid is supposed to increase the period of deep, dreamless sleep when the brain is thought to restore itself.

The scientists tested the cerebrospinal fluid surrounding each participant’s brain for amyloid proteins. Measurements were taken before the night of the test, and then every 2 hours the next day, to show how the night of sleep or no sleep affected the accumulation of these proteins in the brain.

Study participants who went without sleep for just one night had a 25-30% increase in the beta-amyloid proteins in their cerebrospinal fluid, bringing the levels to what researchers would expect to see in people who have genes for Alzheimer’s disease. Before the test, the participants all had normal levels. The pills designed to promote the deep sleep did not affect the levels of amyloid protein.

In a healthy person, normal sleep eliminates waste and restores the brain each night. But repeated nights of insufficient rest may overwhelm the brain’s recovery system, allowing amyloid proteins to build up and form plaques which interfere with the brain’s functioning.

For information on Alzheimer’s and also long term care insurance, see Alzheimer’s Section on the Guide To Long Term Care.


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