Long Term Care

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mathjak107
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Re: Long Term Care

Post by mathjak107 » Sat Apr 13, 2019 5:25 am

the only question you need to answer if you are married is will my spouse be impoverished if i have to go in a home if i am the lucky one with the extended stay ? it has to be someone so it could always be you .

can she pay for both me and make it financially without a major upset .

if the answer is yes , she would find it very hard to manage then you need to come up with a better plan no matter what you decide .

rolling the dice and hoping it isn't you or your spouse that needs the care is a poor idea . hope is never a strategy . especially because now you have 2 bets and only 1 horse .

if it is only one person that has to escape extended care , well that is one bet , but when you are married you have to both escape it . either one of you can tip the apple cart over . those are 2x greater odds of things not playing out in your favor . .

talk to any busy estate attorney and they will all tell you that the bulk of their clients are those that had no real plan and called it self insuring .

now that reality struck and someone needs care all of a sudden they are scrambling to preserve assets as the community spouse ( stay at home ) goes in to survival mode .

so whatever you decide to do , do it and don't wait until after it is to late .

it isn't about preserving assets as much as the survival of your spouse .

have a meeting with a good elder law attorney and familiarize yourself with the options , laws and tools in your state . then you can make a decision with their guidance . as you see in these discussions most folks have no plan and no clue as to what is a good move and what isn't .

they think because they have a living trust that is a comprehensive plan and they are covered and medicaid can't get to anything . but they fail to realize everything in a revocable trust counts as dollars and that they can't qualify for medicaid with the items in the trust . the old catch 22 gets ya .


some of your options can be :

making medicaid approved family loans

irrevocable trusts

long tern care insurance

hybrid life insurance policy's with long term care links

right of refusal

real- self insuring , not just your general portfolio invested in things that are volatile .

attorney negotiated medicaid rates

and likely a lot more that i am not aware of .

but none except a state partnership plan and LTC cover everything . you can save assets but lose the income for the stay at home spouse so everything else has pitfalls .
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Re: Long Term Care

Post by ochotona » Mon Apr 15, 2019 6:43 pm

Annuity sucks. If I self-fund using the Permanent Portfolio, it will last way past my wife's and my 104th birthday, to a 97.6% probability of success.

See here.

Case closed on annuities, but thanks mathjak, I'm still looking into LTC State Partnership programs....
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Re: Long Term Care

Post by Xan » Mon Apr 15, 2019 7:19 pm

ochotona wrote:
Mon Apr 15, 2019 6:43 pm
Annuity sucks. If I self-fund using the Permanent Portfolio, it will last way past my wife's and my 104th birthday, to a 97.6% probability of success.

See here.

Case closed on annuities, but thanks mathjak, I'm still looking into LTC State Partnership programs....
Are you looking for Texas, ocho? Please let us know what you find out.
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Re: Long Term Care

Post by mathjak107 » Tue Apr 16, 2019 3:14 am

texas is a dollar for dollar state ...they don't offer total asset protection unfortunately .... i found this on texas partnership plans

Income & Asset Protection
An Texas Partnership for Long-Term Care qualified policy provides you, as the purchaser, with the right to apply for Medicaid under modified eligibility rules that include a special feature called an ‘asset disregard’.
This allows you to keep assets that would otherwise not be allowed if you need to apply, and qualify, for Medicaid in order to receive additional long-term care services. The amount of assets Medicaid will disregard is equal to the amount of the benefits you actually receive under your long term care Partnership qualified policy.
Since these policies must include inflation protection, the amount of the benefits you receive can be higher than the amount of insurance protection you originally purchased.
If you have a Partnership-qualified long term care insurance policy and receive $300,000 in benefits, you can apply for Medicaid and, if eligible, retain $300,000 worth of assets over and above the State’s Medicaid asset threshold. In most states the asset threshold is $2,000 for a single person. Asset thresholds for married couples are typically more generous.
Years ago you could protect your assets by creating a trust, but today only an irrevocable trust would be exempt and it would still be subject to the 60-month "look back" period. To be exempt, assets must be transferred 60 months before you apply for Medicaid. (We won't know with 100% certainty what will happen 60 seconds from now let alone 60 months.)
Under a qualified partnership policy, personal assets in the amount of the total benefits paid are disregarded when Medicaid asset eligibility is calculated. For each dollar of benefits paid, one dollar of assets is not counted toward the eligibility limit. This means you get to keep those assets and don't have to spend them before qualifying for Medicaid.
With a Partnership policy it also means that the state will not seek to recover money spent for your care from your estate. Estate recovery means that the state can require repayment from your estate for any costs paid by Medicaid. Thirty states have filial laws that that give the state the right to require your children to reimburse Medicaid for your expenses.
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Re: Long Term Care

Post by WiseOne » Tue Apr 16, 2019 7:20 am

Annuities aren't about getting a great return. I see it as a form of insurance against my getting befuddled in old age and messing up with portfolio management or drawing down.

I suppose if you take care to hire a competent and trustworthy financial manager/accountant, or designate a similarly capable family member with DPOA to handle these things ahead of time, that would work too.
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Re: Long Term Care

Post by ochotona » Tue Apr 16, 2019 8:42 pm

WiseOne wrote:
Tue Apr 16, 2019 7:20 am
Annuities aren't about getting a great return. I see it as a form of insurance against my getting befuddled in old age and messing up with portfolio management or drawing down.

I suppose if you take care to hire a competent and trustworthy financial manager/accountant, or designate a similarly capable family member with DPOA to handle these things ahead of time, that would work too.
By the time we're old and feeble, I think I could instruct my engineer daughter to rebalance annually. Just divide by four!
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Re: Long Term Care

Post by mathjak107 » Wed Apr 17, 2019 3:49 am

the problem is generally not dividing by 4 ...it is the fact those who you leave the money to either to manage for you or to inherit may not understand the investment . they won't rebalance , they will look at the losers and go who wants this junk .
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Re: Long Term Care

Post by WiseOne » Wed Apr 17, 2019 7:25 am

ochotona wrote:
Tue Apr 16, 2019 8:42 pm
WiseOne wrote:
Tue Apr 16, 2019 7:20 am
Annuities aren't about getting a great return. I see it as a form of insurance against my getting befuddled in old age and messing up with portfolio management or drawing down.

I suppose if you take care to hire a competent and trustworthy financial manager/accountant, or designate a similarly capable family member with DPOA to handle these things ahead of time, that would work too.
By the time we're old and feeble, I think I could instruct my engineer daughter to rebalance annually. Just divide by four!
Well, that and keeping the checking account ahead of auto-paid bills, and not falling prey to scammers. That's really more of a concern. Missing rebalances is probably the least of the worries.

I am seeing all this stuff happen with my mother - no matter how often I lecture her about not opening emails from unknown senders and never clicking on links in emails, plus the fact that she's still fairly sharp given her age, it still manages to happen. She was somehow induced by a random email to change her Google password last month, the day before I was headed out on a business trip. I ended up walking her through re-changing her password, verifying identity, and re-entering her new password in all the gzillions of required places over the phone from the airport, because I thought likely that she'd just handed her password to a phishing hacker.
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Re: Long Term Care

Post by jhogue » Wed Apr 17, 2019 9:55 am

WiseOne,

You have put your finger squarely on a dilemma we are all apt to face. I had a similar problem with my 89 year old mother only a few months before she died last year when she somehow got the notion to cancel her Medicare part B coverage out of the blue. It led to a very unpleasant and exasperating argument.

The story may be only anecdotal, but the problem is becoming universal. I have no idea how to even begin to solve it.
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Re: Long Term Care

Post by dualstow » Wed Apr 17, 2019 11:26 am

I’m sorry for your loss, jhogue.
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Re: Long Term Care

Post by WiseOne » Fri Apr 19, 2019 12:02 pm

Same here, and especially sorry that it had to be overlaid with a potentially avoidable financial issue.
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Re: Long Term Care

Post by mathjak107 » Fri Apr 19, 2019 2:43 pm

WiseOne are you in ny ?
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Re: Long Term Care

Post by Mountaineer » Sat Apr 20, 2019 5:43 am

I'm sorry for the loss of your mother, jhogue. It is not easy to lose a close family member, especially a parent.
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Re: Long Term Care

Post by ochotona » Mon Apr 22, 2019 1:40 pm

Two CFPs looked at my plan, and both told me to make no changes... just keep paying LTC premia. If I do that, the impact on my portfolio will be minimal.

One of them did say if I got tired of paying increased premia, I could partially self-fund into accounts only to be used for LTC, not for general retirement income.
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Re: Long Term Care

Post by mathjak107 » Thu May 02, 2019 9:34 am

just keep in mind these hybrid's can end up being the most costliest way to fund long term care
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