Shaking my Head Today

Jack,

I'm new to insurance and appreciate your point of view. Nonetheless, if the potential client is "not educated", shouldn't the agents job be to educate the client on the product and how it may/may not fit into her needs? She may be in good health, but not want to spend time in a Medicaid facility should she need some form of extended care. Maybe a small short term care product would be suitable, or an annuity? Who knows as it is tough to guess, but I would never recommend someone to dump off 2/3rds of their liquid assets into a product like that.

I would like your input on the idea of bringing in a child. To me, bringing in a child may not always be a great idea. The child may have an ulterior motive for his or her recommendations to the parent and said ideas may not be in the best interest of the parent. A small annuity might be a good fit in this situation, but the child might object to this idea(or any other ideas) not because they are a good alternative, but rather that they could cut into his expectancy of mothers estate. I am hesitant to bring in a third party unless I really think that the third party would be a neutral party.

Nonetheless, my past life has taught me the value of documentation and I absolutely agree that, if one were to sell a product in the situation above, that some form of full disclosure is signed.

I always believe in bringing in adult children to the table, if the relationship between parent and child warrants it. Down the road, the child will manage the claim should it occur. Makes sense to meet them today.

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LTCI is about protecting assets. She has no assets to protect.

If she uses 57% of her income to fund a traditional policy at $2k/m as you suggested (that would

.

Traditional policy would have been 7-10% of income, but even if an adviser keeps premium to 7% of income threshold there is still inflation and rate increase risk to address. At end of day as Arthur stated the client will wind up on Medicaid. Or the policy will lapse.
 
I always thought LTC was stay out of nursing home insurance.

I would be curious to hear actual experiences with regards to quality of care and Medicaid coverage. Recently heard a talk from a lawyer who does Medicaid planning and he said in Westchester, New York he knew of only one home that would not accept Medicaid patients. So for the most part he saw no difference in quality of care. Perhaps it is different in other parts of the country though?
 
I would be curious to hear actual experiences with regards to quality of care and Medicaid coverage. Recently heard a talk from a lawyer who does Medicaid planning and he said in Westchester, New York he knew of only one home that would not accept Medicaid patients. So for the most part he saw no difference in quality of care. Perhaps it is different in other parts of the country though?


Since more than 80% of the people who need long-term care are NOT in nursing homes, the attorney's point is moot.

Most states do not allow Medicaid to pay for care at home.
OR, if they do, there is usually a very long waiting list and the hours of care is extremely limited--(just enough care to keep you out of a nursing home... not enough to keep you comfortable at home.)

A relative of mine needed 6 years of care and eventually had to rely on Medicaid. The nursing home itself was great. The staff were all caring and professional. Since he was on Medicaid he was cramped in a tiny room with a roommate who listened to the television on max all the time. (A semi-private room means NO PRIVACY.)

When we'd visit him there was room for only one chair. One of us would stand, one would get the chair and one would have to sit on the foot of his bed and we all had to clog our ears from the noise of his roommates T.V. If he was private pay he could have had a much better room.

The attorney is full of sh*t.

Bottom line: Relying on Medicaid severely limits your choices for care.

:yes::yes::yes:
 
originally posted by jomeara73

I would be curious to hear actual experiences with regards to quality of care and Medicaid coverage. Recently heard a talk from a lawyer who does Medicaid planning and he said in Westchester, New York he knew of only one home that would not accept Medicaid patients. So for the most part he saw no difference in quality of care. Perhaps it is different in other parts of the country though?

Living & working in Westchester County, I'll try to answer your question.

Contrary to the previous poster, the attorney is not full of s**t. The attorney is correct. 99% of the nursing homes in NYS accept Medicaid. By law (I believe both federal & state) if someone enters a nursing home as a private payer (either their own funds or a LTCi policy) once either their funds are exhausted or their poicy benefits have been exhausted and the patient winds up on Medicaid, if the facility accepts Medicaid that patient cannot be moved.

However, if the patient is already on Medicaid prior to entering the facility, the state has a right to transfer the patient to a Medicaid facility, within 90 miles of their residence.

As far as the quality of care, the aides that attend to patients do not know who is paying the bills. My mother is a prime example. In the mid 90s, she had to enter a nursing home. She entered as a private payer in one of the top nursing homes in NY, with about $50,000 to her name. She used that money to pay for approximately 6 months of care, until her funds were exhausted and she wound up on Medicaid. She stayed in the same room (which was semi-private) and all of the providers who cared for her were the same.

Medicaid will generally not pay for a private room. But, the occupancy rate of nursing homes is much less today than it was 20 years ago. (more people are staying at home or moving into assisted living facilities.) So, if someone starts out as a private payer in a private room and winds up on Medicaid, and there are a number of empty private rooms available in the facility, there is a chance (no guarantee) that the patient can remain in a private room. The difference in cost between semi-private & private is usually about $15-$20/day.
 
originally posted by jomeara73



Living & working in Westchester County, I'll try to answer your question.

Contrary to the previous poster, the attorney is not full of s**t. The attorney is correct. 99% of the nursing homes in NYS accept Medicaid. By law (I believe both federal & state) if someone enters a nursing home as a private payer (either their own funds or a LTCi policy) once either their funds are exhausted or their poicy benefits have been exhausted and the patient winds up on Medicaid, if the facility accepts Medicaid that patient cannot be moved.

However, if the patient is already on Medicaid prior to entering the facility, the state has a right to transfer the patient to a Medicaid facility, within 90 miles of their residence.

As far as the quality of care, the aides that attend to patients do not know who is paying the bills. My mother is a prime example. In the mid 90s, she had to enter a nursing home. She entered as a private payer in one of the top nursing homes in NY, with about $50,000 to her name. She used that money to pay for approximately 6 months of care, until her funds were exhausted and she wound up on Medicaid. She stayed in the same room (which was semi-private) and all of the providers who cared for her were the same.

Medicaid will generally not pay for a private room. But, the occupancy rate of nursing homes is much less today than it was 20 years ago. (more people are staying at home or moving into assisted living facilities.) So, if someone starts out as a private payer in a private room and winds up on Medicaid, and there are a number of empty private rooms available in the facility, there is a chance (no guarantee) that the patient can remain in a private room. The difference in cost between semi-private & private is usually about $15-$20/day.



thank you for proving my point.

:swoon:
 
This could be a big problem down the road. Now, I guess my 60 day bed reservation benefit could allow me to leave the facility from mid August to mid October if the Bucs are playing good ball. Hmmm.....

They have the special senior package.

Your choice of Matlock, Andy Griffith or a The Price is Right/Let's Make a Deal package. The thing is, once you choose you can never change the channel again.

Wheel of Fortune and Jeopardy may or may not be included with The Price is Right.
 
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