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Health and Long Term Care Insurance


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Well it's that time of year again where we fulltimers who are below age 65 have to deal with health care insurance again. I use the Escapees South Dakota address as my full time address. I have very little options on health insurance. I am 64 so have one more year to go till I am elligable for Medicare. I know I will still have to purchase a supplement policy.  My parents both who are in their 80s just went into assisted living. They have a Medicare Supplement policy but still are experiencing high out of pocket costs for their care. So I began to look into a Long Term Care policy for myself. I am finding out that these too are state specific. But I am full time. I don't know what state I may be in if and when I would have a claim for long term care. I know that Medicare is statewide and does not have a network but was Wondering what other full timers do for Medicare supplement and long term care insurance. I've got a year yet but just thinking of it at this time while I'm looking into health insurance again. 

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Medicare supplement policies are sold for residents of specific states, but are applicable to expenses that occur in any state.  We are SD residents and have Humana supplemental policies sold there.  We both have Plan F supplements and have used them all over the US without any issues.  Plan F is the most expensive of the supplements but it covers virtually anything Medicare doesn't pay.  Specific claims have to be for services that Medicare covers, but if a claim is paid, in part by Medicare, then Plan F usually pays anything left over.

Of course, there are physicians who don't accept Medicare reimbursements as payment of their fees.  In those cases I believe Plan F pays up to something like 110% of the Medicare limit and beyond that you may still owe the physician or other provider.  However, in 5 years of being covered by Medicare we have yet to have this occur.  So far this year our out-of-pocket expenses for anything other than prescription drugs has been zero, as it has been for the past 5 years.

As for long term care insurance, we have policies purchased in Maryland more than 15 years ago.  From what I have read, it's my understanding that long term care "partnership" policies are state specific because they tie Medicaid eligibility thresholds to payments received from long term care policies.  But there is little reason for policies that aren't of the partnership type to be restricted to specific states.  We had no problem with our Mutual of Omaha long term care policies changing our domicile to SD.

Unfortunately, buying a long term care policy at age ~65 will be a lot more costly than buying it at a younger age.  Ours were bought when we were ~55 and have had 5% inflation riders since then.  Since inflation has been lower than 5% for quite a few years, this means that our policies pay a significantly higher percentage of expected cost than they would have when we first purchased them.

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Thanks docj. I know my health insurance is only good for SD in network providers except for emergency treatment. I also know that Medicare when I am eligible next year will cover me in any state not just SD as Medicare does not have a network. I'm not sure if the long term policy will require me to be in a long term care facility in SD only. Being full time I probably won't be in SD if and when I need long term care. 

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My mother had a long term care policy and they were a pain to deal with to get the money when she needed it.  They required multiple faxes each month from the assisted living place before they would cut a check.  I asked the assisted living place if there were any companies that were better and they said they were all bad and most were worse than my mother's, since many found ways to pay less through loopholes.  My mother's policy cost her $230 a month and they paid a maximum of $2100 a month for up to two years.    They did pay the full amount for 8 months, and she paid in for over 20 years, so they made money on her.  Made me not believe in long term care policies.  

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Mr. Joyce: That has also been my experience and I don't think I will buy one. When my mother, 83, was in a nursing home in 2001 the cost was $7,000 per month and somehow my father didn't have to pay? She was only there for less then a month before she died. I remember that my father was upset because he didn't make $7,000 per month so that he could pay. By this time, my father, 90, was slowing down so his plan: sell the home in the northeast and the condo in South Florida and give all of the money to his four children. The rest of his money he put into CDs with me as the beneficiary with the understanding that I divide it between the four children. He lived off of his $6,500 per month income which was more then enough at 90. He never spent one day in a nursing home.

 

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From out experience with our mothers (if you want the government to take care of you) the government will leave you with 1 home, 1 car and about $2K in savings.  They will take the rest and THEY will tell you the assisted or nursing home you will live in.  It will no doubt be the least expensive and who knows where it will be located.  If you plan to give your assets to the kids to hide them the government will go back 5 or 10 years to get your assets.  We consulted an attorney in MI several years ago when estate planning our mothers. 

We have been paying for long term care for many years (less expensive when payments start in your 50s) but we can determine the place we'll be or stay in our home and have care come to us.  There is a limit on what they pay and how long which allows us some control over the cost.     Greg  

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The government didn't look to see if or when my father gave us the money. Not all of us will end up is a nursing home of assisted living facility. My mother spent less then one month and my father no at all. I would think that as I lay there dying it will not matter were I am.

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My mother in law spent almost two years in assisted and then dementia living centers, she (the family also) was fully aware of the level and quality of service she was getting.  During the first time hospice was brought in she and us were well aware of the service she was getting.  The second time I will agree that she wasn't aware of what was going on.  Don't assume your time in a living center will be short and your level of service will not matter. 

In MI we were assured the government would check your finances and history.       Greg   

Greg & Judy Bahnmiller
Class of 2007
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Both sold 2/19, settled in Foley, AL after 12 years on the road

http://bahnmilleradventure.blogspot.com/

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5 hours ago, whj469 said:

The government didn't look to see if or when my father gave us the money. Not all of us will end up is a nursing home of assisted living facility. My mother spent less then one month and my father no at all. I would think that as I lay there dying it will not matter were I am.

Did your father start receiving Medicaid for long-term care?  That is when the 'claw-back' would occur.  Since you stated your father never was in a care facility there wouldn't have been a reason for them to scrutinize his finances.   It is only when you have drawn down all assets and ask for Medicaid to help with the care that they look at historical finance records.

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Look back at the time our parents were getting old and unable to manage their affairs was 3 years in PA.   We took  legal actions perfectly legal to protect their assets and to provide them with the best quality care we could. Their  home for example was "purchased" by myself and rented "on paper" to them .By the time they were  unable to manage their affairs  we that is my sisters and myself managed all their affairs. We had no problems with Medicaid or the choice of nursing home facilities. They passed with dignity  and well cared for.

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According to the U.S. Bureau of the Census, slightly over 5 percent of the 65+ population occupy nursing homes, congregate care, assisted living, and board-and-care homes, and about 4.2 percent are in nursing homes at any given time. The rate of nursing home use increases with age from 1.4 percent of the young-old to 24.5 percent of the oldest-old. Almost 50 percent of those 95 and older live in nursing homes.

Today, a senior citizen (65+) has about a one-in-four chance of spending time in a nursing home (skilled care facility).
Currently 5 percent of the older population lives in nursing homes (skilled care facilities), with an average life-expectancy of approximately six months upon entrance into the nursing home.

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Just thinking about some friends, a father-daughter-grand-daughter. I think he is now 92/93.  They have been together for more than 20 years but I wonder if he might have been better to have gone into some group type home when he was still mobile and able to develop friendships there to supplement  his other family. They live in a rural area and the daughter still needs to work and the grand daughter is in a nearby Med. school.  Even though he mostly has his faculties he has limited mobility and has to rest a good bit during the day.   I don't know if I am explaining my thoughts well but maybe you will understand.  It has me rethinkng some of my strategy. 

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Bigjim,   I do understand.  My mother is a very active 95 yr old, but she developed vertigo a few years ago and became afraid of being alone in case she fell.  So 5 yrs ago she moved in with my sister,  just so there would be someone around.   She frequents the senior citizens center in their town, joined their writers group,  and since my sister has retired, they do a lot of things together, but she often mentions that maybe she should have gone to assisted living instead because she is the only elderly (unlike us who are still young) person in the neighborhood.   

Barb & Dave O'Keeffe
2002 Alpine 36 MDDS (Figment II), 2018 Ford C-Max HYBRID
Blog: http://www.barbanddave.net
SPK# 90761 FMCA #F337834

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  • 3 months later...

Hello there! As my father has registered for the Medicare supplement insurance plan, so I know a little bit about it. These Medicare Supplement plans contain different types of Medigap plans. Different plan covers different coverages of Part A and Part B, whereas Plan F covers High Deductible plan and covers all the coverages, which is not covered under original Medicare and plan N pays 100% of Part B coinsurance. Check out here for more detailed information on different Medicare supplement Insurance and long term health care plans.

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This topic is interesting. My parents/ grandparents all lived long lives. On mother and father side also. Unfortunately dementia, Alzheimer does also on mother's side. She spent 10 plus years in nursing homes. She got in bad accident, went up exit ramp head on into traffic. Broke her up badly. Body healed, mind couldn't remember how to walk. She lived to 92 like this. Last five years knew no one. My father at 85 had a brain aneurysm burst. Hospitalized. He shut down. Would not eat or anything. Refused care. Lasted about a month. Didn't want to be Holden to anyone. Died the way he lived. He was perfectly healthy. Was picking watermelons day it happened. At 61 I am in perfect health. 

 

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  • 2 weeks later...

My wife and I are planning to go FT in January 2019.  I will be 61 and my wife will be 57.  We are both in good health presently and live in Utah.  Our plan is to sell our home in UT and domicile in FL which is where we were originally from.  We will need a health policy that will follow us around the country in our travels.  From my research, it appears that Blue Cross offers 2 policy choices but I cannot find out the cost of the policies.  Does anyone know where I can find out what the current premiums are for these policies or give me an idea on how much to budget per month for health insurance from Blue Cross?  I have a consultation call set up for next week to discuss this with the rver insurance exchange but was hoping somebody could give me an idea on how much our premiums per month will run?

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On 3/3/2018 at 5:08 AM, SandraHuston said:

As my father has registered for the Medicare supplement insurance plan, so I know a little bit about it.

You might be surprised how many of the participants in the forums are past the age for Medicare. I suspect that it would be at least 25% of us and likely more than that. But we are happy to see the younger folks moving in to take over. Many of us have been participants in the forums for more than  10 years so it is good that folks like yourself are getting involved.

On 3/3/2018 at 10:39 AM, GlennWest said:

She spent 10 plus years in nursing homes.

My dad lived to just short of 91 and had pretty good health most of the way. Mother was 7 1/2 years younger than dad and lived to be 91 but spent her last 5 years in a full care home due to dementia. So far Pam has outlived both of her parents, as her mother died at 53 of cancer and her dad of a heart attack at 69. With both of us mid 70's, we have some issues to deal with but we do travel by RV but are not fulltime any longer. 

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Fortunately  we both have very good Employer provided Health insurance that we carried over into retirement. We are both over 65   and are  also on Medicare.Our healthcare premiums are not cheap but the coverage is very good. 

 

all of our parents spent time in extended care facilities and in fact died there. There comes a time when the family can no longer provide Adequate care and it is a good move to plan for that.

Helen and I are long timers ..08 F-350 Ford,LB,CC,6.4L,4X4, Dually,4:10 diff dragging around a 2013 Montana 3402 Big Sky

SKP 100137. North Ridgeville, Ohio in the summer, sort of and where ever it is warm in the winter.

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On 3/17/2018 at 5:16 AM, Macky Bailey said:

My wife and I are planning to go FT in January 2019.  I will be 61 and my wife will be 57.  We are both in good health presently and live in Utah.  Our plan is to sell our home in UT and domicile in FL which is where we were originally from.  We will need a health policy that will follow us around the country in our travels.  From my research, it appears that Blue Cross offers 2 policy choices but I cannot find out the cost of the policies.  Does anyone know where I can find out what the current premiums are for these policies or give me an idea on how much to budget per month for health insurance from Blue Cross?  I have a consultation call set up for next week to discuss this with the rver insurance exchange but was hoping somebody could give me an idea on how much our premiums per month will run?

What have you tried so far to get premium information?  It's all readily available at Blue Cross's website (floridablue.com) or at healthsherpa.com.  You don't have to establish a log-in or identify yourself at either site--just enter things like age and sex.

You want an EPO, not an HMO, to get the nationwide network. 

Of course, the current premium may not have anything to do with what the premium will be next year, but nobody can predict next year's premium at this point.  And Blue Cross may not even offer these plans in 2019--they pulled them out of Texas on very short notice.

 

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On 3/17/2018 at 5:16 AM, Macky Bailey said:

My wife and I are planning to go FT in January 2019.  I will be 61 and my wife will be 57.  We are both in good health presently and live in Utah.  Our plan is to sell our home in UT and domicile in FL which is where we were originally from.  We will need a health policy that will follow us around the country in our travels.  From my research, it appears that Blue Cross offers 2 policy choices but I cannot find out the cost of the policies.  Does anyone know where I can find out what the current premiums are for these policies or give me an idea on how much to budget per month for health insurance from Blue Cross?  I have a consultation call set up for next week to discuss this with the rver insurance exchange but was hoping somebody could give me an idea on how much our premiums per month will run?

www.healthsherpa.com or www.healthcare.gov

You'll just need a FL Zip Code.

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