Monday, January 16, 2012
Is Insurance the Answer to Long Term Care Planning?
living over the age of 90. According to author Haya El Nasser “The
number of people living to age 90 and beyond has tripled in the past
three decades to almost 2 million and is likely to quadruple by 2050”.
Seniors who live longer generally have some sort of disability or need
help at some level of living. Sandy Markwood, CEO of the National
Association of Area Agencies on Aging, indicates that the focus
needs to be on being able to help these seniors live at home as long
as possible as nursing home cost could rise to average $72,000 a
year.
Long Term Care at any level, in the home, assisted living or nursing
home can add a tremendous cost to seniors and their families.
Government Programs Only Pay For About 16% Of Long Term Care
Government programs such as Medicare, Medicaid and the Veterans
Administration will cover the cost of long-term care under certain
conditions. Medicare will cover rehabilitation from a hospital stay or
limited care at home if there is a skilled (medical) need. The Veterans
Administration will cover the cost of nursing home care indefinitely if
the veteran is at least 70% service-connected disabled. The VA will
also cover other forms of home-based or community-based care if
there is a medical need.
Medicaid will cover both medical and non-medical related long-term
care but in order to qualify for Medicaid an Ohio resident has to have
less than $1,500 in assets and income that is insufficient to pay the
cost of care.
Funding Long Term Care with your Life Insurance Policy
Drawing cash from life insurance or changing a life insurance policy
should only be done after reviewing with an expert advisor. Loss
of the policy and death benefit could prove to be a detriment. If,
however you have accumulated cash in a life insurance policy and no
longer need the coverage you may consider using the cash for long
term care or purchasing a LTC rider to your current policy.
New insurance products are being developed to cover both life
insurance and long term care insurance. ElderLawAnswers reports:
“A new law makes the purchase of products that combine annuities
or insurance policies with long-term care insurance more attractive.
These "hybrid" products are gaining in popularity due to a law that
went into effect January 1, 2010, making distributions from life
insurance and annuities tax-free when used to pay for long-term
care. The same law also allows owners of annuities or life insurance
policies to exchange their old policies for long-term care insurance or
hybrid policies without being taxed.”
Combination sales which include life insurance, annuities and
traditional long-term care coverage are becoming popular with
insurance companies and may prove a method of financing long
term care. Investigate closely, however to find what exactly will be
covered. Some policies do not cover home care costs or complete
costs of nursing homes.
Long Term Care Insurance Funding for All Long Term Care Needs
The first long-term care policies were offered about 40 years ago.
These were primarily nursing home-only policies designed to take
over when Medicare rehabilitation ran out. They were not the
comprehensive benefit policies we see today.
Long Term Care Insurance policies today are greatly diversified in
their coverage. Home care, nursing home costs, adult day care,
physical therapy, skilled and non-skilled nursing care are some of the
services covered. Policies vary in price and what they cover. There
is also a very restricted qualification of physical and mental heath to
get a policy. Purchasing a policy at a younger age makes it easier to
qualify and also provides cheaper premiums. It is best to consult with
a long term care insurance professional about the type of policy that
fits your needs and budget.
Veterans Aid and Attendance Pension Benefit
Though not an insurance policy, the VA Pension Benefit should be
mentioned as a way to pay for long term care needs. A veteran or
spouse of a veteran who served during a period of war can receive
money, up to $2,019 a month, to pay for long term care medical
expenses, home health care, and assisted living cost. A qualified
Veteran Consultant can help you determine if you qualify for this
benefit.
Pre-Need Burial Insurance
One might ask what Pre-need burial insurance has to do with long
term care. The purpose of preneed life insurance is to set aside funds
for your funeral, before the need arises.
It is an insurance policy that covers the cost of the predetermined
expenses of a funeral, cremation or burial. It gives the purchaser the
opportunity to preplan the services and peace of mind in having it
paid for. This is usually an insurance policy that pays at time of death
for these expenses. There are many insurance companies that offer
these packages as well as funeral homes.
NOTE: If a person anticipates needing to apply for Medicaid after
all is said and done, it is unwise to start spending down assets until
having at least a consultation with a Medicaid specialist. In order to
retain the maximum assets for the community spouse, application
needs to be made first.
The saddest cases of long term care needs we hear are:
“Mother can no longer live alone and she has no money to go live in a
care facility.”
“ Is there someone that can come help me take care of my wife? We
live on our Social Security and I can not pay what home care costs.”
“Father died last night and we have no money to bury him, what do
we do?”
It is important to make the necessary arrangements to cover long
term care and end of life costs. There is no government program
that will cover all those needs. The National Care Planning Council at
www.longtermcarelink.net strives to educate people about long term
care services and encourages the planning that needs to be done to
prepare for future costs and needs.
The National Association of Professional Geriatric Care Managers at
www.caremanager.org has lots of good information as well as a list
of professionals around the country who specialize in long term care
planning and follow-through with families.
Debra Roidl, MSW, CMC
Care Manager, Certified
Wednesday, May 11, 2011
Downsizing and accessibility for seniors
May 10, 2011
When Robert and Anne bought their family home thirty years ago, their plan was to live through retirement in this home. They had furnished their home with refurbished antiques acquired from their many trips together. It was one of their cherished antique coffee tables that Robert tripped over, breaking his hip. Now with his return from the hospital in a wheelchair, the overwhelming task of making their home accessible for Robert’s wheelchair and safe for both of them faced Anne.
Remodeling for wheelchair access, organizing home furnishings and daily living items or downsizing and relocating to a smaller living area are monumental tasks that are many times thrust on senior home owners. Sometimes the need to do this is brought on by injury or age related illness. Home and yard maintenance can become a daunting chore for even the healthiest of seniors, requiring them to make a downsizing decision.
There is a large and growing industry of specialists who understand these challenges of elderly homeowners and are ready and willing to help with remodeling, organizing or the sale of the home and with the move to a new location.
A professional organizer provides skills in making the home safe and manageable. Relocating furniture, removing hazards such as electrical cords, throw rugs, heavy objects on shelves that might fall are some of the ways they make a home more senior friendly. They specialize in helping seniors part with items that clutter or have no valued use, so to make rooms less crowded or to make ready for a move to a smaller living space.
Handicap remodeling services and senior safety services offer help in adding wheelchair ramps and widening doorways. Bathrooms are made more accessible and safe, with hand rails, walk-in bath facilities and easier access to toilets.
If moving to a smaller retirement home or care facility is the best solution there is another senior specialty provider to call on called a Seniors Real Estate Specialist.
The Senior Real Estate Specialist concentrates more on a complete service package for the sale of the property and/or the purchase of a new living arrangement. The specialist also arranges for the services of a relocation specialist or Senior Move Manager to provide a complete, stress-free package for the elderly homeowner.
A move often requires downsizing and getting rid of a tremendous number of acquired possessions. The relocation specialist or Senior Move Manager, as they are often called, will typically provide a turnkey operation that includes assessing and identifying items to keep, arranging for auction or other disposal, cleaning the home, moving the belongings and setting up the new residence. The manager may also work closely with a real estate agent to arrange for the sale of the home and may also be involved in the financial transactions necessary to move into a new living arrangement.
All the help available to seniors may in itself be overwhelming. How do seniors choose the right service provider for their needs? How do they know they will hire someone qualified, responsible and honest? Area Agencies on Aging and State Better Business Bureaus are good resources to check out available service providers.
Family, friends and religious leaders can be valuable resources to seniors in referring service providers and helping to manage the hiring and supervision.
The National Care Planning Council’s website www.longtermcarelink.net provides educational articles and information on eldercare providers throughout the nation.
Wednesday, April 20, 2011
Using Your Home Equity for Long Term Care
A reverse mortgage is a way of tapping into home equity without creating monthly payments and without requiring the money to be paid back during a person's lifetime. Instead of making payments the cash flow is reversed and the senior receives payments from the bank. Thus the title "reverse mortgage".
Many seniors are finding they can use a reverse mortgage to pay off an existing conventional mortgage, to create money to pay off debt, make home repairs, or for remodeling.
For those seniors who are in need of long term care and want to stay in their home, a reverse mortgage can create the money needed to pay for in-home personal and medical care. They can also pay for needed medical equipment and handicap adaptation to their home.
There are no income, asset or credit requirements. It is the easiest loan to qualify for. You must be at least 62, own and live in, as a primary residence, a home [1-4 family residence, condominium, co-op, permanent mobile home, or manufactured home] in order to qualify for a reverse mortgage.
A reverse mortgage is similar to a conventional mortgage. As an example:
• The bank does not own the home but owns a lien on the property just as with any other mortgage
• You continue to hold title to the property as with any other mortgage
• The bank has no recourse to demand payment from any family member if there is not enough equity to cover paying off the loan
• There is no penalty to pay off the mortgage early
• The proceeds from a reverse mortgage are tax-free and can be used for any legal purpose you wish
False Beliefs Regarding Reverse Mortgages
• "The lender could take my house." The homeowner retains full ownership. The Reverse Mortgage is just like any other mortgage; you own the title and the bank holds a lien. You can pay it off anytime you like.
• "I can be thrown out of my own home." Homeowners can stay in the home as long as they live, with no payment requirement.
• "I could end up owing more than my house is worth." The homeowner can never owe more than the value of the home at the time the loan is due.
• "My heirs will be against it." Experience demonstrates heirs are in favor of Reverse Mortgages.
There are some things to be aware of when thinking of using a reverse mortgage. According to Walter Updegrave, a senior editor at MONEY Magazine and author of "Investing for the Financially Challenged," closing costs and other fees can run into thousands of dollars. If the borrower remains in their home for many years after taking the reverse mortgage, and uses the money to stay independent by paying for caregivers, for example, then the costs may be worth the risk. If, however, the borrower dies or has to move to a more protected environment within a few years, the fees may not be worth it. (http://money.cnn.com/2004/03/30/pf/expert/ask_expert/)
The amount of reverse mortgage benefit for which you may qualify, will depend on
• your age at the time you apply for the loan
• the reverse mortgage program you choose
• the value of your home
• current interest rates
• and for some products, where you live
As a general rule, the older you are and the greater your equity, the larger the reverse mortgage benefit will be (up to certain limits, in some cases). The reverse mortgage must pay off any outstanding liens against your property before you can withdraw additional funds.
The loan is not due and payable until the borrower or borrowers no longer occupy the home as a principal residence (i.e. the borrower sells, moves out permanently or passes away). At that time, the balance of borrowed funds is due and payable, all additional equity in the property belongs to the owners or their beneficiaries.
Other considerations regarding reverse mortgages are that interest rates and fees can vary widely among reverse mortgage lenders. Mr. Updegrave states, “… it can be very difficult to compare the true costs of different loans from different lenders. The best way to do that is to compare each loan's ‘TALC,’ or total annual loan cost.
This figure, which reverse mortgage lenders are required to disclose by federal truth-in-lending laws, takes all loan costs into account as well as the timing on the payments you're projected to receive.”
( NEW YORK (CNN/Money) - What are your feelings pro and con about reverse mortgages?
-- Josephine Amato, Wyckoff, New Jersey) (http://money.cnn.com/2004/03/30/pf/expert/ask_expert/)
The most popular reverse mortgages are the so-called HECM loans. HECM loans require that the applicant meet with a government approved counseling agency to be sure the applicant understands the reverse mortgage process.
The Federal Trade Commission states:
“Before applying for a HECM, you must meet with a counselor from an independent government-approved housing counseling agency. Some lenders offering proprietary reverse mortgages also require counseling. The counselor is required to explain the loan’s costs and financial implications, and possible alternatives to a HECM, like government and nonprofit programs or a single-purpose or proprietary reverse mortgage. The counselor also should be able to help you compare the costs of different types of reverse mortgages and tell you how different payment options, fees, and other costs affect the total cost of the loan over time. Most counseling agencies charge around $125 for their services. The fee can be paid from the loan proceeds, but you cannot be turned away if you can’t afford the fee.”
A Reverse Mortgage Specialist in your area can answer your questions, calculate the amount of loan you can receive and advise the type of loan for your needs. The National Care Planning Council (http://longtermcarelink.net/a7reversemortgage.htm) has a list of Reverse Mortgage Specialists in your area. Also, the AARP website has a section on reverse mortgages at http://www.aarp.org/money/credit-loans-debt/reverse_mortgages/. Do your homework and make sure that you also consult with your own financial advisor about whether a reverse mortgage is the best way for you to utilize the equity in your home.
Sunday, February 13, 2011
Planning Ahead for ElderCare
Take a look around. Talk with your friends and neighbors. Notice how many people are engrossed in the task of caregiving. Tell them there is hope. There are resources. And there are experts in the field that can guide and assist them through their journey.
Make sure you are educating yourself about what your parents need, what they have, and what they do not have. Where are their finances? Who are their doctors? What hospital do they prefer? What legal documents have they updated (healthcare Powers of Attorney, financial POAs, Trusts, Living Wills, etc.).
Don't wait for the crisis. Plan ahead. You will be much more prepared and experience less stress if you take your head out of the sand and look around to prepare.
Thursday, October 7, 2010
Phobias
People love their phobias. Withn the anxiety and the trepidation, there is something that makes us hold on to them.
For example, just now, thinking about really trying to desensitize myself with regard to my arachnophobia, I actually felt kind of … sad. Like I would miss the drama, the attention that I make to myself of this inordinate fear of spiders. I would actually miss the fear?
Or am I just talking myself out of trying to desensitize myself.
I truly am afraid of spiders. No reason, really. No memory of a traumatic event. Maybe it’s a past-life thing. Actually, yes, come to think of it, there is an early memory of being in bed, waking up sleepily, and with every stuffed animal I owned having a sleepover that night. A spider. Small but large to my young eyes (4 year old, maybe? 6?), crawling relentlessly, and rapidly – startlingly – across my bed, and under my bunny rabbit. I could not save my bunny rabbit. Stuffing 12 other beloved toy animals in my two little arms, screaming bloody murder for my other - is my next memory. And my mother, so calm, so comforting. I will always admire mama for her lack of fear and the chivalry of her nestling it into a tissue to set it free outdoors.
Today, they get in my house, they're dead. Sorry. Outside, i avoid you, spider. Inside, you weren't invited and you scare me!
Spiders are always running, rapidly, startlingly, across one’s vision. Often towards me, it seems. Coming right at me. Relentless. Purposeful. Driven. Because it knows I’m afraid of it and is coming to scare me.
I really don’t think they’ll bite me – unless I provoke them, of course, the spiders “are just afraid of you as you are of them” (yeah, right). It’s just that they startle me, and they seem to do it on purpose. "BAH". “I am in front of your face you stupid human and you didn’t see me coming and I might TOUCH you.”. Their tickling touch – ick!
Okay, I’m changing the subject now. Thanks for listening.
Rantings of an aging baby boomer.
Happy Halloween, everyone.
Wednesday, December 9, 2009
2009 -- it was a very good year
oh, and i'm married again. Yes, again. But this time, three's a charm, right? Martin Roidl and I have known each other through Taoist Tai Chi(r) for over 8 years. We were both married to others when we first met. Things happen for a reason, and at the right time, and we married on August 15th in Columbus at the Columbus Tai Chi Center. We honeymooned in the Upper Peninsula and now know what a Yooper is.
I've broadened my interests, focused my energies, and found that what does not kill me actually does make me stronger. Just call me Wonder Woman.
Saturday, January 3, 2009
Aging Parents of Adult Children
Yes, I know; the topic is usually the other way around: how aging Baby Boomers are dealing with their aging parents.
But think about it from your parents’ perspective. Just for a minute. Look at your own child to whom you gave birth a mere 10 to to 20 or even 30 years go, and imagine having THEM in charge of YOUR life.
No matter the mental age of a person in winter life stage, their children are still their children.
However, the mental age of a person in winter life DOES have to do with how much they can understand and/or retain of what they need to know to remain independent. They begin leaning on you, calling you, guilt-tripping you into taking them to their physician appointments; regardless of your being in trouble with the boss already in this job-risky economy.
And you DO want to do those things for your parents. Even if they have been less than perfect parents (show me a perfect parent, I’ll show you a Ph.D. study topic). Society expects, and we expect of ourselves, that we will care for our aging parents whether we are good at it or not.
Let’s face it. Some of us are not good at taking care of our own parents. And the long term options, bureaucracy, and lack of continuity make it a more than part-time hobby. Surgeons do not operate on their relatives; counselors cannot counsel their own relatives, so what makes people think they’re obligated to become sudden experts in the face of audacious and meandering system of unrelenting menu choices on a doctor's office's or insurance company's telephone service.
So, we need to flesh out several topics from the above:
*No matter the mental age of a person in winter life stage, their children are still their children.
*The mental age of a person in winter life DOES have to do with how much they can understand and/or retain of what they need to know to remain independent.
*Some of us are not good at taking care of our own parents. And the long term options, bureaucracy, and lack of continuity make it a more than part-time hobby.
*Just who IS going to take care of US? And who do we want helping us take better care of our oldest generation?