# Is long term Care a smart decision?



## needshave

I have a father-in-law that is in poor condition. As I help him in doctor visits, emergency room visits, hospital stays and rehab I start to consider my own situation. Should I investigate Long term Care? I will be 70 in November and with my father in laws problems and experiences it has been an Eye Opener. I have talked to a few people with mixed opinions. One has long term care Insurance, he has had it for 12 years. He does not know what its going to be like when He needs it, he fears it may have been a loss of funds. SO far he feels the only thing they have done for them has cashed his checks.

So is there anyone that has done all the research an is willing to share there thoughts? I have been trying to research and there is a ton of information out there, how much do you believe. Many I have found are self financing a 40 hours health care professional to visit the home when that time comes, rather than pay a premium for care in a very expensive nursing home somewhere.  Its all very difficult and hard to sort out. If you have thoughts or experiences, I would love to hear them.


----------



## Keesha

Yes it is. The reason I say this is because you never know what can happen. A mini stroke can cause dementia and fast. If this happens and you have no plans in place , then your health is up to anyone’s guess.

Most countries have free or subsidized services that are available to you in the comfort of your own home.

Here in Canada nursing homes are subsidized. The government will pay 50% if you can afford it and 100% if you can’t. You cannot  get kicked out, except If you are overly violent to other residents.

Once you need healthcare 24/7 it’s actually much cheaper to go into a nursing home with full services than trying to deal with and pay for services at home especially if your mind is going or gone.


----------



## ClassicRockr

I worked for a senior healthcare company for 4 1/2 years. We had passenger vans that would pickup patients, take them to a Center where they would get medical and dental exams/attention, a nice lunch, play some games and then be taken home by the same van. It cost, but not as much as a living facility would.


----------



## needshave

Keesha said:


> Yes it is. The reason I say this is because you never know what can happen. A mini stroke can cause dementia and fast. If this happens and you have no plans in place , then your health is up to anyone’s guess.
> 
> Most countries have free or subsidized services that are available to you in the comfort of your own home.
> 
> Here in Canada nursing homes are subsidized. The government will pay 50% if you can afford it and 100% if you can’t. You cannot  get kicked out, except If you are overly violent to other residents.
> 
> Once you need healthcare 24/7 it’s actually much cheaper to go into a nursing home with full services than trying to deal with and pay for services at home especially if your mind is going or gone.


----------



## needshave

Yes, My father in law is receiving care at home, which includes a LPN that is in every week, a Physical therapist that try to work with him, although unless a family member is there he refuses to do it. They get meals delivered to them for lunch each day and now dr care if needed or if X-rays, or testing is done they will actually come to the house to do it. He is almost 91. However he is very weak and that has become a problem for him to get around unless he is a rehab center with someone to care for him. But he now only has 6 days left of rehab care left before insurance runs out. (He has to be out of rest home, hospital, rehab center for 100 days before funding will kick back in for rehab) So because of his weakened state that how the long term care insura


----------



## needshave

-nce concerns came about. Yet, I'm not even sure that would cover his care. To stay in the current facility, they would be required to pay 175.00 per day, out of pocket, to maintain current location and service including all meals, but they refuse to pay it.


----------



## Don M.

LTC insurance is similar to most insurance....it's a waste of money Until/Unless you need it.  We took out a policy with Bankers Life, decades ago, and it has built up to the point where the wife and I are covered for $250K each....and that amount increases every year....and so do the premiums.  The problem you may find is that at your age, approaching 70, the premiums may be Very Large.


----------



## Don M.

duplicate post....hit the wrong key


----------



## needshave

Don M. said:


> LTC insurance is similar to most insurance....it's a waste of money Until/Unless you need it.  We took out a policy with Bankers Life, decades ago, and it has built up to the point where the wife and I are covered for $250K each....and that amount increases every year....and so do the premiums.  The problem you may find is that at your age, approaching 70, the premiums may be Very Large.



Thanks Don,

What happens when you reach 250K? How is that handled if you are in a state of disrepair yet functional?

I have asked for quotations, nothing yet.

Here is some data for my area:

Skilled Nursing Facilities Private Room Annual Rate: *$102,382.50*
Skilled Nursing Facilities Semi-Private Room Annual Rate: *$88,764.35*
Assisted Living Facility Monthly Rate (2 bedroom): *$6,145.28 (73.7+)*
Assisted Living Facility Monthly Rate (1 bedroom): *$5,294.79 (63.5+*


----------



## Keesha

needshave said:


> Thanks Don,
> 
> What happens when you reach 250K? How is that handled if you are in a state of disrepair yet functional?
> 
> I have asked for quotations, nothing yet.
> 
> Here is some data for my area:
> 
> Skilled Nursing Facilities Private Room Annual Rate: *$102,382.50*
> Skilled Nursing Facilities Semi-Private Room Annual Rate: *$88,764.35*
> Assisted Living Facility Monthly Rate (2 bedroom): *$6,145.28 (73.7+)*
> Assisted Living Facility Monthly Rate (1 bedroom): *$5,294.79 (63.5+*


What????
Oh goodness. Basic accommodation here is about $1,890 a month. Private I think is $2400
It includes room cleaned daily, laundry done once a week, name sewed in all garments, 3 meals a day, 2 snacks, 2 baths or showers per week, help with medication, help with mobility, help with toiletries, entertainment, daily activities, crafts etc.

The only thing it doesn’t cover is nail care and hair cutting & styling. Some cover physiotherapy and some dont

I wish you the best


----------



## Don M.

needshave said:


> Thanks Don,
> 
> What happens when you reach 250K? How is that handled if you are in a state of disrepair yet functional?



IF/When we reach the LTC limits, I suppose the options would be something like a Reverse Mortgage, or begin to bleed down the bank accounts and investments.  At the rate our policy is increasing, and if we live as long as our parents did, our policy should be at least $350K each....enough to last 2 or 3 years, I would hope.  Beyond that, if we are in such bad shape, we probably won't care much about what happens to us.  We have stipulated in our Wills, Powers of Attorney,etc., that there will be no extraordinary measures taken if we are diagnosed with a major health issue....just pump us up with morphine, and let nature take its course.  The kids are on board with our wishes, and hopefully we can leave them something rather that giving our life's work to the doctors/hospitals/caregivers. 

We recently had a meeting with the Ins. Co. rep, and he said that there are fewer and fewer companies offering LTC insurance, so you can bet that the ones still making those policies will be charging higher and higher rates.  If you are nearing 70, be prepared for some serious "sticker shock" on the price of these policies....if any of these Insurance companies even respond...they may not even want to make a quote at your age.


----------



## needshave

Keesha said:


> What????
> Oh goodness. Basic accommodation here is about $1,890 a month. Private I think is $2400
> It includes room cleaned daily, laundry done once a week, name sewed in all garments, 3 meals a day, 2 snacks, 2 baths or showers per week, help with medication, help with mobility, help with toiletries, entertainment, daily activities, crafts etc.
> 
> The only thing it doesn’t cover is nail care and hair cutting & styling. Some cover physiotherapy and some dont
> 
> I wish you the best


----------



## needshave

Thanks...Maybe I should Move back to Mississuaga!


----------



## Keesha

needshave said:


> Thanks...Maybe I should Move back to Mississuaga!


Geez! Have more to say but best not. 
Only you can make that choice.


----------



## needshave

Keesha said:


> Geez! Have more to say but best not.
> Only you can make that choice.


go ahead, say it. you're thinking it so your half way there.


----------



## Keesha

needshave said:


> go ahead, say it. you're thinking it so your half way there.


Nope!


----------



## needshave

ClassicRockr said:


> I worked for a senior healthcare company for 4 1/2 years. We had passenger vans that would pickup patients, take them to a Center where they would get medical and dental exams/attention, a nice lunch, play some games and then be taken home by the same van. It cost, but not as much as a living facility would.


rocker, We  have a very nice senior center that does much the same. It even has exercise, water aerobics, etc. Cost of lunch is minimal I think 2.50. Many evening programs, movies, trips. etc. Very nice program.


----------



## Aunt Bea

I guess the question should be what are you trying to protect/insure against.

I don't bother with it because I'm single and am not concerned about using my assets to pay for my end of life care.

If the money runs out before I do then I will have to rely on Medicaid and the kindness of strangers for my care.


----------



## needshave

Since I'm married and the concern for long range care is 2fold, we are trying to look out for each other that monies are available for the care of each other.
It's impossible to predict


----------



## mathjak107

needshave said:


> Thanks Don,
> 
> What happens when you reach 250K? How is that handled if you are in a state of disrepair yet functional?
> 
> I have asked for quotations, nothing yet.
> 
> Here is some data for my area:
> 
> Skilled Nursing Facilities Private Room Annual Rate: *$102,382.50*
> Skilled Nursing Facilities Semi-Private Room Annual Rate: *$88,764.35*
> Assisted Living Facility Monthly Rate (2 bedroom): *$6,145.28 (73.7+)*
> Assisted Living Facility Monthly Rate (1 bedroom): *$5,294.79 (63.5+*


Here in Long Island in ny my buddy is on medicaid now as all his assets are gone and it is 112k a year....Parkinson’s did him in  and he can’t function on his own ....


----------



## needshave

mathjak107 said:


> Here in Long Island in ny my buddy is on medicaid now as all his assets are gone and it is 112k a month ....Parkinson’s did him in  and he can’t function on his own ....


$112,000 A month? or year?  Is this in a full service facility?


----------



## mathjak107

needshave said:


> $112,000 A month? or year?  Is this in a full service facility?


Oops ,it is a year ...


----------



## needshave

Whew! That's a relieve, sort of. thanks.


----------



## Aunt Bea

needshave said:


> Since I'm married and the concern for long range care is 2fold, we are trying to look out for each other that monies are available for the care of each other.
> It's impossible to predict


Start doing your homework and keep an eye on changes to Medicaid each year.

https://www.familyassets.com/nursing-homes/resources/medicaid/ohio

Good luck to you and your family!


----------



## mathjak107

needshave said:


> Since I'm married and the concern for long range care is 2fold, we are trying to look out for each other that monies are available for the care of each other.
> It's impossible to predict



one of the biggest problems our attorney  sees  are the so called self insurers ...

they call it self insuring because they hope they don't need to spend money on care but other than in name , nothing else was done ...

then trouble strikes and the stay at home spouse goes in to panic mode as they realize they can be impoverished and the money they counted on is the same money counted on to generate the income for the stay at home spouse .

to really self insure means you have to act like an insurance company .. that means a big pool of money segragated from the income generating pool , in safe low yielding investments .

anything else is not self insuring ,  it is trying to rule out bad things from really happening rather than planning and allowing for it .

we opted for a ny partnership plan for long term care .. we can leave all the assets invested working efficiently , and just a small portion of that return pays for our policy .

our policy protects all our assets once the 3 years insurance runs out .. it also has no cap on the stay at home spouses income  and a special version of medicaid called MEC  pays the bills with our partnership plan . we have no look back , no spendown , no recovery , all assets are protected .


----------



## treeguy64

Not if you prefer death, to living like a vegetable, or an infant, again.

I'll never understand those who want to hang onto life at (literally) all costs.........


----------



## mathjak107

because by the time you realize `something happened to you it is to late for you to have choices .

my dad had a paralyzing stroke that left him like a vegetable in a second . he spent 6 years in a home whether he wanted to or not .

it impoverished his wife .

these discussions are not about us hanging on longer  , it is about our stay at home spouse not being impoverished and continuing with their life. your view of this is from the wrong spouse. it is not about the spouse needing care . it is about the spouse that still has a life to live and is fine .


----------



## needshave

MathJak,

Thanks for your response. I have to agree with all you have stated. The one person that I know of that is self insuring his medical future, has done pretty much what you have defined and sold his rental properties and put all those monies in a bucket account. All of the properties were sold but one, that property is a rental and feeds his medical bucket account on a monthly basis. This bucket is a stand alone account and is to be used only for medical purposes. He is on medicare so preventive maintenance is handled and not affecting or subtracting from this account. 
 I dont know what a partnership plan is! It may be something available in NY but not in Ohio, where I reside. I hope to be able to investigate to see if it is available, it sounds like a great plan and you have it well though out.

Thanks for your feed back. If you have any info on the partnership plan, please let me know.


----------



## Don M.

mathjak107 said:


> these discussions are not about us hanging on longer  , it is about our stay at home spouse not being impoverished and continuing with their life. your view of this is from the wrong spouse. it is not about the spouse needing care . it is about the spouse that still has a life to live and is fine .



That's right.  An elderly spouse having to take care of his/her mate can quickly put both of them in a precarious position.


----------



## needshave

Don M. said:


> That's right.  An elderly spouse having to take care of his/her mate can quickly put both of them in a precarious position.


Don, You are so right. So very True. My in-laws are experiencing  that very problem right now. My father law fell just this morning. He also fell a few months ago on my mother in law and broke her arm. A perfect example of what you were saying.


----------



## oldmontana

*Is long term Care a smart decision?

I think it is.  If you want to protect your assets if you need LTC.  If you have, like 5 million in liquid assets you can self insure. *

LTC is insurance that you hope you will not need, like home insurance.


----------



## Lethe200

Honestly, if the OP is 70, LTCi is going to be *way beyond his affordability.*

As another member posted, there are fewer companies in the market. When we bought our LTCi policies there were over 100 companies selling this product. There are now.....

*12 - in the entire U.S.*

It is simply not that profitable. Don't forget you AND the insurance company are guessing as to IF you will need care and if so, HOW MUCH care you will need and for HOW LONG. 

Their viability as an ongoing carrier depends on them guessing correctly. Genworth did not, and as a result GE Corp. has had to transfer millions of $$$$$ into their funding to handle claims.

The sweet spot for LTCi policies is now *under 50 yrs of age when applying. *And you need to be in very good health, with good genetics, on few prescriptives.

As for "wasting money", even with premium increases, my spouse and I (separate policies) have spent approx. $60K on premiums over 21 yrs. Is that a lot of $$$$$? Yes.

But Skilled Care Nursing facilities are minimum $10K/month where we live, and go as high as $17K now. Home care, priced on a per hour basis, is _more costly _than SCN. It is, in fact, the healthcare segment that has seen the fastest rise in costs over the last six years.

Our policies each pay for $120K/yr, with 5% compounded inflation increase annually and unlimited period. They are older policies and no longer sold. Needless to say, we would not give them up readily!

I have never understood people who claim "if I just save the money I'd spend on an LTCi policy and invest it, it'll come out the same". Because that simply isn't true. You are assuming you will not need care until 20, 25, or 30 yrs down the road. 

When 25% of people receiving Social Security disability are under age 60, that should tell you that if you are part of a couple, you need to seriously consider what to do if something happens to one of you. 

Death is easy, compared to long term disability/chronic illness.


----------



## mathjak107

needshave said:


> MathJak,
> 
> Thanks for your response. I have to agree with all you have stated. The one person that I know of that is self insuring his medical future, has done pretty much what you have defined and sold his rental properties and put all those monies in a bucket account. All of the properties were sold but one, that property is a rental and feeds his medical bucket account on a monthly basis. This bucket is a stand alone account and is to be used only for medical purposes. He is on medicare so preventive maintenance is handled and not affecting or subtracting from this account.
> I dont know what a partnership plan is! It may be something available in NY but not in Ohio, where I reside. I hope to be able to investigate to see if it is available, it sounds like a great plan and you have it well though out.
> 
> Thanks for your feed back. If you have any info on the partnership plan, please let me know.


Ohio has partnership plans ..they have a dollar for a dollar plans not total asset...for every dollar medicaid spends on your care after the insurance runs out , a dollar in assets is preserved.


Income & Asset Protection ohio

An Ohio 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.



https://www.partnershipforlongtermcare.com/ohio-partnership/index.html


----------



## mathjak107

Lethe200 said:


> Honestly, if the OP is 70, LTCi is going to be *way beyond his affordability.*
> 
> As another member posted, there are fewer companies in the market. When we bought our LTCi policies there were over 100 companies selling this product. There are now.....
> 
> *12 - in the entire U.S.*
> 
> It is simply not that profitable. Don't forget you AND the insurance company are guessing as to IF you will need care and if so, HOW MUCH care you will need and for HOW LONG.
> 
> Their viability as an ongoing carrier depends on them guessing correctly. Genworth did not, and as a result GE Corp. has had to transfer millions of $$$$$ into their funding to handle claims.
> 
> The sweet spot for LTCi policies is now *under 50 yrs of age when applying. *And you need to be in very good health, with good genetics, on few prescriptives.
> 
> As for "wasting money", even with premium increases, my spouse and I (separate policies) have spent approx. $60K on premiums over 21 yrs. Is that a lot of $$$$$? Yes.
> 
> But Skilled Care Nursing facilities are minimum $10K/month where we live, and go as high as $17K now. Home care, priced on a per hour basis, is _more costly _than SCN. It is, in fact, the healthcare segment that has seen the fastest rise in costs over the last six years.
> 
> Our policies each pay for $120K/yr, with 5% compounded inflation increase annually and unlimited period. They are older policies and no longer sold. Needless to say, we would not give them up readily!
> 
> I have never understood people who claim "if I just save the money I'd spend on an LTCi policy and invest it, it'll come out the same". Because that simply isn't true. You are assuming you will not need care until 20, 25, or 30 yrs down the road.
> 
> When 25% of people receiving Social Security disability are under age 60, that should tell you that if you are part of a couple, you need to seriously consider what to do if something happens to one of you.
> 
> Death is easy, compared to long term disability/chronic illness.



The policies are priced so you paying in future dollars about one years cost of care by the time you each the sweet spot ...

You are right , care can be needed at anytime ...my co-worker at age 55 was painting .. he fell off the ladder and broke his hip and wrist ...he had a stroke during hip surgery ....he was paralyzed and needed care ...his family was devastated financially


----------



## Liberty

needshave said:


> Since I'm married and the concern for long range care is 2fold, we are trying to look out for each other that monies are available for the care of each other.
> It's impossible to predict


Needshave...have had a recent, personal happening with respect to a good friend and her family in Ohio.  There are a couple of things that might be very valuable for you to know...since state laws vary.  If you'd like to PM me (start a conversation), I'd be happy to share what I learned while being a sounding board for my friend & family.   Don't want to take up space here on the general forum when others probably wouldn't care about Ohio issues.


----------



## Fyrefox

I have a long term care plan in place.  It's not cheap, but both of my parents died slow deaths of progressive incapacitation, and I'm found to have a one in three chance of winding up as they did.  My mother's care alone ran $7,000 a month in New Jersey, and that was years ago.  It's all a gamble, and while I don't hope for death on the installment plan, I found it prudent in light of my history to prepare through insurance for that contingency.


----------



## mathjak107

insurers can tell us how many people a year will die , they can tell us how many will need long term care .

but they can't tell us who . so while statistics mean something to insurers and data banks we can only have two outcomes .

it is either us or it isn't ....  someone has to have the misfortune of being the unlucky one . we just don't know if it is us .

i worked to hard and spent a life time accumulating what we did so i don't leave those things that can be devastating to us if it is us on the unlucky side by leaving things unplanned and unmitigated


----------



## StarSong

Lethe200 said:


> *When 25% of people receiving Social Security disability are under age 60,* that should tell you that if you are part of a couple, you need to seriously consider what to do if something happens to one of you.
> 
> Death is easy, compared to long term disability/chronic illness.



To be fair, a lot of SSDI recipients are scammers who've hired shady TV-advertising attorneys that have figured out how to win their cases.
There's also no way to know how SSDI recipients need or get caregiver assistance.


----------



## mathjak107

StarSong said:


> To be fair, a lot of SSDI recipients are scammers who've hired shady TV-advertising attorneys that have figured out how to win their cases.
> There's also no way to know how SSDI recipients need or get caregiver assistance.


Boy is that true about fraud ....ssdi became the new unemployment insurance.....it is filled with fraud ...just one person Eric conn and a fraudulent judge put through 1/2 billion in claims for people already denied ......money had to be pulled from ss retirement to fund Ssdi which went broke


----------



## Butterfly

StarSong said:


> To be fair, a lot of SSDI recipients are scammers who've hired shady TV-advertising attorneys that have figured out how to win their cases.
> There's also no way to know how SSDI recipients need or get caregiver assistance.



And a lot of people, like my sister, are genuinely disabled and deserve all the help they can get.  She got SSDI (which BTW took her forever to get through the process) from age about 60 through 65, when Social Security kicked in.  My niece got SSDI benefits in the last months before she died.  Hers was a shortened process because she was certified as terminally ill with no chance of recovery.

With respect, I believe the idea of scammers and shady lawyers is pretty much a false and outdated belief.  The process of qualifying is a long (can take years from application to approval) and onerous one and nowdays, no matter how shady a lawyer is, he/she can't get around the truth or falsity of verified medical records and certified independent medical exams and rehabilitation and evaluation records.


----------



## mathjak107

Butterfly said:


> And a lot of people, like my sister, are genuinely disabled and deserve all the help they can get.  She got SSDI (which BTW took her forever to get through the process) from age about 60 through 65, when Social Security kicked in.  My niece got SSDI benefits in the last months before she died.  Hers was a shortened process because she was certified as terminally ill with no chance of recovery.
> 
> With respect, I believe the idea of scammers and shady lawyers is pretty much a false and outdated belief.  The process of qualifying is a long (can take years from application to approval) and onerous one and nowdays, no matter how shady a lawyer is, he/she can't get around the truth or falsity of verified medical records and certified independent medical exams and rehabilitation and evaluation records.


I think last year they busted over 100 here in ny involved in fraudulent Ssdi claims  Either working for ss or doctors ,lawyers ,etc and they said that is the tip of the iceberg


----------



## Liberty

Butterfly said:


> And a lot of people, like my sister, are genuinely disabled and deserve all the help they can get.  She got SSDI (which BTW took her forever to get through the process) from age about 60 through 65, when Social Security kicked in.  My niece got SSDI benefits in the last months before she died.  Hers was a shortened process because she was certified as terminally ill with no chance of recovery.
> 
> With respect, I believe the idea of scammers and shady lawyers is pretty much a false and outdated belief.  The process of qualifying is a long (can take years from application to approval) and onerous one and nowdays, no matter how shady a lawyer is, he/she can't get around the truth or falsity of verified medical records and certified independent medical exams and rehabilitation and evaluation records.


So true, Star...have 2 I know that got denied and then hired the attorneys.  One has now got it and the other is still pending after a couple years I think.  They also re-evaluate those now that get disability early.  Have a friend that got it for both SS and VA and SS will re-evaluate her in a couple years, because she was so young.  With the VA its 8 years I think.


----------



## mathjak107

The problem is the corrupt people on the inside that are helping others commit fraud . When they do it usually involves lots of dollars going out..

About 3.5 Million of the 10.1 Million on Disability have mental disorders. Of those, 1.5 Million have "Mood Disorders" and the rest are autistic, mentally disabled, have congenital brain defects, head injuries, or are schizophrenic.

Social Security doesn't require the 1.5 Million with "Mood Disorders" to be involved in any treatment program, but they should. They should be required to attend weekly treatment sessions, and if they fail to do so, they need to be terminated.


----------



## StarSong

Butterfly said:


> And a lot of people, like my sister, are genuinely disabled and deserve all the help they can get.  She got SSDI (which BTW took her forever to get through the process) from age about 60 through 65, when Social Security kicked in.  My niece got SSDI benefits in the last months before she died.  Hers was a shortened process because she was certified as terminally ill with no chance of recovery.
> *
> With respect, I believe the idea of scammers and shady lawyers is pretty much a false and outdated belief.  *The process of qualifying is a long (can take years from application to approval) and onerous one and nowdays, no matter how shady a lawyer is, he/she can't get around the truth or falsity of verified medical records and certified independent medical exams and rehabilitation and evaluation records.


I wish that were true.  Turn on daytime TV sometime and see how many lawyers are pitching their services to people who were turned down for SSDI.  They wouldn't be doing that unless there was plenty of money to be made and a reasonably good success rate.


----------



## Liberty

StarSong said:


> I wish that were true.  Turn on daytime TV sometime and see how many lawyers are pitching their services to people who were turned down for SSDI.  They wouldn't be doing that unless there was plenty of money to be made and a reasonably good success rate.


Both of the cases I've been familiar with lately HAD to get lawyers because they were turned down.  I know of the physical issues with both of these people.  One had worked for our company for years and than was my housekeeper for many more years.  As far as I know, it was about the proper form explanations regarding the doctor interfaces and so forth.  The lawyers seem to know how to do that...the legitimate ones, too.  As far as I know there are only a couple lawyers - good ones - specializing in this around the area.


----------



## Lethe200

StarSong said:


> To be fair, a lot of SSDI recipients are scammers who've hired shady TV-advertising attorneys that have figured out how to win their cases.
> There's also no way to know how SSDI recipients need or get caregiver assistance.



Actually, applying for SSDI will get you an almost automatic turn-down. On average it takes 12-18 months to receive benefits. With the elimination of the SS budget surplus, it will get even harder to receive SSDI.

I used that stat not to imply any direct correlation to LTCi, so I apologize if my post gave that impression. What I AM saying is that as mathjak points out above, nobody EVER knows what may happen to them in the future. To not even try to estimate your future financial risks does no favors to you, your family, or your partner.

I worked in the insurance industry for 15 yrs and in financial services for 20 yrs. We purchased LTCi plans because I estimated that we had *average mortality* but *above-average morbidity risks.* 

When we "ran the numbers", it was clear that the disability/long-term illness of one spouse would have a severe negative impact on the other spouse. We are not wealthy, but we have enough assets that there is absolutely no financial assistance available unless the other spouse is forced to seriously reduce their lifestyle.

YMMV.


----------



## mathjak107

The problems with the Ssdi fraud is everyone involves big numbers ....a side from Eric conn doing a half a billion for people who  should never have been signed off on via his corrupt judge buddy we just has a nypd cop get 638k fraudulently.

https://oig.ssa.gov/audits-and-investigations/investigations/april15-nyc-disability-fraud

another ny woman just got 14 months in prison for fraud

https://oig.ssa.gov/audits-and-investigations/investigations/jan31-ny-fraud

so far 138 have been caught in Ssdi fraud here in nyc including insiders who work for ssa

https://oig.ssa.gov/audits-and-investigations/investigations/feb25-nyc

over 100 nyc cops and fireman busted in Ssdi fraud
https://www.newsmax.com/economy/new-york-social-security-fraud-disability/2014/01/07/id/545716/

This is just a smidgeon of what goes on and this is one city ....Ssdi was drained and went bust ....they had to divert money from ss retirement funds to keep paying the huge amount of claims ....what is scary is all of those who aren’t caught.

It is  a system where those who really deserve it have a hard time but fraud runs rampant ..there are always people internally ready to take payoffs to enrich themselves


----------



## StarSong

In response to the rampant fraud, SSDI has tried to make it more difficult to receive benefits.  

@Liberty, I don't know how it is in your area, but in So Cal you'll be bombarded by SSDI lawyer commercials if you happen to tune into Judge Judy, Dr. Phil, or other daytime TV shows favored by seniors.


----------



## Liberty

StarSong said:


> In response to the rampant fraud, SSDI has tried to make it more difficult to receive benefits.
> 
> @Liberty, I don't know how it is in your area, but in So Cal you'll be bombarded by SSDI lawyer commercials if you happen to tune into Judge Judy, Dr. Phil, or other daytime TV shows favored by seniors.


Hmmm...well Star, I don't watch tv in the daytime at all so it could be its that way here too, but I've heard there are only a couple good lawyers that seem to specialize in this.  They get 25% of what the recipient would have got from the date of their first claim being approved.  That's not a bundle usually, so guess they have to have a batch of clients, and a good secretary, to make it work for them.  

The people I know of tried to file a claim and then it was denied (due to lack of some info or whatever).  They then got a lawyer and the lawyer got the doc paperwork right and took it to court. The court dates usually take about a year or so, from what I've heard.  The judge will say he or she is  rendering a verdict in 6 weeks and usually within a month they are approved.  Of course I only know of the legitimate ones...lol.


----------



## StarSong

Liberty said:


> Hmmm...well Star, I don't watch tv in the daytime at all so it could be its that way here too, but I've heard there are only a couple good lawyers that seem to specialize in this.  They get 25% of what the recipient would have got from the date of their first claim being approved.  That's not a bundle usually, so guess they have to have a batch of clients, and a good secretary, to make it work for them.
> 
> The people I know of tried to file a claim and then it was denied (due to lack of some info or whatever).  They then got a lawyer and the lawyer got the doc paperwork right and took it to court. The court dates usually take about a year or so, from what I've heard.  The judge will say he or she is  rendering a verdict in 6 weeks and usually within a month they are approved.  Of course I only know of the legitimate ones...lol.


Do an internet search for disability attorneys with your city or county name to get a bead on how many are out there.  Lots of bottom feeders along with a few legit ones.


----------



## Butterfly

Liberty said:


> Both of the cases I've been familiar with lately HAD to get lawyers because they were turned down.  I know of the physical issues with both of these people.  One had worked for our company for years and than was my housekeeper for many more years.  As far as I know, it was about the proper form explanations regarding the doctor interfaces and so forth.  The lawyers seem to know how to do that...the legitimate ones, too.  As far as I know there are only a couple lawyers - good ones - specializing in this around the area.



Very true.  The process has gotten so long and intricately complicated that just about everyone who applies without a lawyer is turned down, even my friend who has a debilitating (and probably fatal in the future) heart condition,  complications of diabetes, and who is legally blind was turned down the first time.  She hired  an attorney experienced in the field and finally was approved, but it took two and a half years.

And of course, SSDI stops when you reach fra (full retirement age).


----------



## Floridatennisplayer

A friend in another state has his mother in law in a facility. No LTC policy, upper middle class with no way to qualify for Medicaid. 

He met with the facility told them the situation.  Give me a fair price and I’ll pay you a check monthly. They came to a fairly reasonable price for him. Told him that they fight daily with insurance companies over ever single itemized bill. Then the bill is delayed payment while they argue and negotiate. Payments are always 69-90 days behind with tons of paperwork.

He is happy and so are they.


----------



## StarSong

Floridatennisplayer said:


> A friend in another state has his mother in law in a facility. No LTC policy, upper middle class with no way to qualify for Medicaid.
> 
> He met with the facility told them the situation.  Give me a fair price and I’ll pay you a check monthly. They came to a fairly reasonable price for him. Told him that they fight daily with insurance companies over ever single itemized bill. Then the bill is delayed payment while they argue and negotiate. Payments are always 69-90 days behind with tons of paperwork.
> 
> He is happy and so are they.


His MIL still has enough assets that Medicaid won't kick in?

Good to know about the possibility of negotiating with nursing homes.


----------



## Floridatennisplayer

StarSong said:


> His MIL still has enough assets that Medicaid won't kick in?
> 
> Good to know about the possibility of negotiating with nursing homes.



oh yes, way beyond Medicaid to qualify.


----------



## StarSong

Floridatennisplayer said:


> oh yes, way beyond Medicaid to qualify.


Got it.  Glad that her SIL stepped in to negotiate this.  

On a side note, although I've heard many, many "hate your mother-in-law" jokes and comments in this lifetime, the people I know (hubby and myself included) became as close or closer to our in-laws than to our own parents. Loved, cared and watched out for them, and they for us.


----------



## Floridatennisplayer

StarSong said:


> Got it.  Glad that her SIL stepped in to negotiate this.
> 
> On a side note, although I've heard many, many "hate your mother-in-law" jokes and comments in this lifetime, the people I know (hubby and myself included) became as close or closer to our in-laws than to our own parents. Loved, cared and watched out for them, and they for us.



Me too.  I loved my MIL..  Passed away in 2018.  What a wonderful woman.


----------



## Ladybj

Keesha said:


> What????
> Oh goodness. Basic accommodation here is about $1,890 a month. Private I think is $2400
> It includes room cleaned daily, laundry done once a week, name sewed in all garments, 3 meals a day, 2 snacks, 2 baths or showers per week, help with medication, help with mobility, help with toiletries, entertainment, daily activities, crafts etc.
> 
> The only thing it doesn’t cover is nail care and hair cutting & styling. Some cover physiotherapy and some dont
> 
> I wish you the best


$1890 sounds ideal...  I could definitely handle that..  Room cleaned, laundry done, 3 meals, 2 snacks.. of course I will have my own snacks in my room but OH YES!!!


----------



## StarSong

Ladybj said:


> $1890 sounds ideal...  I could definitely handle that..  Room cleaned, laundry done, 3 meals, 2 snacks.. of course I will have my own snacks in my room but OH YES!!!


Not to burst your bubble, but Keesha lives in Canada.  The government helps with the cost.


----------



## OneEyedDiva

When I was researching LTC policies, some features of the plans, as well as pricing, which could continue to rise, were off putting. Wound up being a moot point because I was denied coverage from our retiree group plan and a private plan due to certain health conditions. The older you are, the more policies cost. If I could get a policy it would have to be a company that is large and well established


----------



## Liberty

OneEyedDiva said:


> When I was researching LTC policies, some features of the plans, as well as pricing, which could continue to rise, were off putting. Wound up being a moot point because I was denied coverage from our retiree group plan and a private plan due to certain health conditions. The older you are, the more policies cost. If I could get a policy it would have to be a company that is large and well established


Yes, and also heard there are quite a bit of complaints from some of them also.  That's what I want to do...pay for it for years and then when you want it get a "gee, no you don't meet the requirements - lol.


----------



## mathjak107

Liberty said:


> Yes, and also heard there are quite a bit of complaints from some of them also.  That's what I want to do...pay for it for years and then when you want it get a "gee, no you don't meet the requirements - lol.


i hope to never qualify .... i just want to pay premiums like i would term life or health insurance ..i don't want to use it or qualify for it


----------



## Liberty

Yeah, when do you ever win with insurance?  Its a money pit any way you look at it.


----------



## Lethe200

_>>...insurance? Its a money pit any way you look at it. >>_

So is a car. So are your clothes.  

*Insurance is for risk mitigation.* Most people vastly underestimate how much risk they take on with their financial decisions as they go through life. 

Get injured by an uninsured driver and decide how much of a "money pit" health and auto insurance is to you.

Not everyone needs LTCi. If you can genuinely self-insure - not just "hoping nothing bad happens" - excellent! If you can assure me you'll die a week *before *you suffer a debilitating stroke or fall in the bathtub and break your pelvis in three places - that's even better. 

Unfortunately for my life and my spouse's, our crystal ball just ain't working right now. Gotta get it fixed ASAP, lol.

We've visited the Medicaid nursing facilities in our area. Worth it to us to make sure we NEVER have to risk one of us - let alone both! - ever having to use one of them. Nearby are two top-rated convalescent facilities which handle both short- and long-term patients. Neither one takes Medicaid patients.


----------



## StarSong

@mathjak107
We each have our own way of looking at this.  You choose to rent your home.  Like many here, my husband and I decided to buy.  

 Between the value of our fully shielded house and other assets not countable by Medicaid, the surviving spouse would not be wiped out.  

It's good that you're comfortable with your plan. Please respect that others have also thought this through and made decisions that work for their specific circumstances.


----------



## Floridatennisplayer

Amazing how many people try to hide, bend, fake, lie, spend down, jump through hoops to try to qualify for Medicaid, which is designed and designated for poverty level people, so they can be put in a nasty sub standard Medicaid accepting facility In a nasty area of town you wouldn’t think of driving through normally.


----------



## mathjak107

Liberty said:


> Yeah, when do you ever win with insurance?  Its a money pit any way you look at it.


the problem is as humans unlike insurers where statistics matter , we can only have two outcomes to things . it is us it happened to , or it isn't ..

since all the things we insure against have a very low risk of happening to us  we cherry pick what we feel would be a disaster if it was us it happened to . it has to happen to many on the wrong side of the statistic so it can just as easily be us .


----------



## mathjak107

Floridatennisplayer said:


> Amazing how many people try to hide, bend, fake, lie, spend down, jump through hoops to try to qualify for Medicaid, which is designed and designated for poverty level people, so they can be put in a nasty sub standard Medicaid accepting facility In a nasty area of town you wouldn’t think of driving through normally.



most places have no specific medicaid homes ... there are a certain number of beds in private facilities .
here in new york and ,long island we have mostly private homes if not all private ones . ...  that is why the partnership plans here are wonderful .

if you are a paying customer for three years  and have a partnership plan , then you stay right where your and a special version of medicaid called mec takes over the payments .  that is why the plans cost so much .


----------



## mathjak107

StarSong said:


> @mathjak107
> We each have our own way of looking at this.  You choose to rent your home.  Like many here, my husband and I decided to buy.
> 
> Between the value of our fully shielded house and other assets not countable by Medicaid, the surviving spouse would not be wiped out.
> 
> It's good that you're comfortable with your plan. Please respect that others have also thought this through and made decisions that work for their specific circumstances.



my comments do not have a thing to do with anyone's individual choice ... they merely point out what is going on , what the pitfalls are of taking certain routes and what the options are other then "words" like oh , i am self insuring .

nothing throws fear in to a stay at home spouse , as much as realizing they can easily be impoverished when it happens ...

our estate attorney is one of the most well known in the tristate area and he sees the lions share of cases .... most are all the self insurers with no real plan other than a cross of the fingers and hoping they have enough ..  but now when  bad things happen they panic as they realize at 120k a year they can easily be impoverished  since they do not segrate the self insuring money from the income generation money .... it ends up killing the goose laying the golden eggs as it diminishes for that stay at home spouse , possibly with decades to live  ....

that is not to say some can't self insure , but it does mean for most , there really is no plan to do so other than to say that is what we do . .


----------



## StarSong

Floridatennisplayer said:


> Amazing how many people try to hide, bend, fake, lie, spend down, jump through hoops to try to qualify for Medicaid, which is designed and designated for poverty level people, so they can be put in a nasty sub standard Medicaid accepting facility In a nasty area of town you wouldn’t think of driving through normally.


As @mathjak107 said, in CA there are not "Medicaid" homes, only payment assistance through Medicaid.  Not looking to dodge paying for care, just trying to ensure that the surviving spouse isn't left completely impoverished. 

US policies force long-term nursing care, even when there's zero hope of recovery from severe vascular dementia or Alzheimer's. Our laws demand that people are kept alive with expensive medical support, despite disastrous diagnoses, prognoses, family wishes or person's specified advanced directives. 

I understand the complexities of enacting legislation that can address all of these issues, but what we've got now isn't working well. 

My BIL suffered a brain aneurysm a month ago. He's now four surgeries into them trying to help him, and he's almost never conscious. Can barely respond to the simplest requests by the neurological testing team. His family is equally terrified about what might happen if he doesn't survive as they are about if he does. We are praying that a lot of his cognitive ability will come back, but there are no guarantees. 

The possible nightmare of him living semi-consciously in a nursing home for years on end has crossed the minds of all of us. His wife is being very careful about what kinds of supportive devices to allow (surgically installed feeding tubes, for instance) because once done, they're difficult to legally undo.


----------



## Liberty

Lethe200 said:


> _>>...insurance? Its a money pit any way you look at it. >>_
> 
> So is a car. So are your clothes.
> 
> *Insurance is for risk mitigation.* Most people vastly underestimate how much risk they take on with their financial decisions as they go through life.
> 
> Get injured by an uninsured driver and decide how much of a "money pit" health and auto insurance is to you.
> 
> Not everyone needs LTCi. If you can genuinely self-insure - not just "hoping nothing bad happens" - excellent! If you can assure me you'll die a week *before *you suffer a debilitating stroke or fall in the bathtub and break your pelvis in three places - that's even better.
> 
> Unfortunately for my life and my spouse's, our crystal ball just ain't working right now. Gotta get it fixed ASAP, lol.
> 
> We've visited the Medicaid nursing facilities in our area. Worth it to us to make sure we NEVER have to risk one of us - let alone both! - ever having to use one of them. Nearby are two top-rated convalescent facilities which handle both short- and long-term patients. Neither one takes Medicaid patients.


Think states  and regional areas are different where nursing home facilities are concerned.  I learned a lot when a friend of mine's mother went into a facility for a few months.  In areas around here and where she went in out of state there are many nice nursing homes and SNF that accept medicare and medicaid patients. Learned a lot.  As my husband says, you still usually never win with insurance although  of course you do need to have it.   By the way, we have a car right now that's been appreciating...lol.  Have a friend that only buys cars that he knows will greatly appreciate in value.  Then he sells them and restocks!


----------



## Lethe200

Liberty said:


> .... By the way, we have a car right now that's been appreciating...lol.  Have a friend that only buys cars that he knows will greatly appreciate in value.  Then he sells them and restocks!



That is very nice for you and your friend. However, I think you will acknowledge that is NOT the normal for 99.9% of autos ever built or bought.

An item is worth only what it is to someone who wants it. No different than a house, or a Le Creuset stock pot. 

If I don't want it, it's worth nothing to me. Smash your car up in an accident, and who's going to buy it? Smash yourself up with it, and who pays for the 24/7 care?

You are absolutely correct that there are differences in facilities depending on where one lives. I'm glad for you that you live somewhere where you can count on county or state facilities. That's a rare thing in America, so you're very fortunate.

I love where I live, but Medicaid (Medicare has nothing to do with nursing home costs) facilities are not good where we are. Thus, it's worth the cost for us to protect our assets, because although we live very comfortably, we would be risking too much to be solely dependent upon only those assets. 

Therefore, we "spread the risk" because the expenditure in premiums is minor compared to the cost if one or both of us needs SCN - or home healthcare and Asst. Living, if we choose it.

I like having options. That's a worthwhile safety net in my mind.


----------



## Liberty

Lethe200 said:


> That is very nice for you and your friend. However, I think you will acknowledge that is NOT the normal for 99.9% of autos ever built or bought.
> 
> An item is worth only what it is to someone who wants it. No different than a house, or a Le Creuset stock pot.
> 
> If I don't want it, it's worth nothing to me. Smash your car up in an accident, and who's going to buy it? Smash yourself up with it, and who pays for the 24/7 care?
> 
> You are absolutely correct that there are differences in facilities depending on where one lives. I'm glad for you that you live somewhere where you can count on county or state facilities. That's a rare thing in America, so you're very fortunate.
> 
> I love where I live, but Medicaid (Medicare has nothing to do with nursing home costs) facilities are not good where we are. Thus, it's worth the cost for us to protect our assets, because although we live very comfortably, we would be risking too much to be solely dependent upon only those assets.
> 
> Therefore, we "spread the risk" because the expenditure in premiums is minor compared to the cost if one or both of us needs SCN - or home healthcare and Asst. Living, if we choose it.
> 
> I like having options. That's a worthwhile safety net in my mind.


Medicare did pay for my friend's mom's very nice SNH for 3 months.  She lives in another state and is thankfully back home now.  She sure got "value received".


----------



## mathjak107

keep in mind most states make Medicaid divorces near impossible .

two very powerful laws here in ny have been upheld and according to our estate attorney who is one of the biggest in ny there are very very few medicaid divorces .

all court actions are now pretty much based on right of refusal .

our two laws that pretty much killed off medicaid divorce are :

(1) Section 5-311 of the General Obligation Law which provides that except as provided in Section 236 of the Domestic Relations Law, a husband and wife cannot contract to relieve either his or her liability to support the other in such a manner that he or she will become incapable of self support, and therefore likely to become a public charge; and

(2) Family Court Act Section 415 which provides that the spouse or parent of a recipient of public assistance or care, or of a person liable to become in need thereof, or a patient in an institution in the department of mental hygiene if of sufficient ability, is responsible for the support of such a person. The Court has the discretion to require any such person to contribute a fair and reasonable sum for such support (child up to 21 years of age).

also if it is eventually determined that a divorce is to be pursued, the divorce needs to satisfy all of the requirements of the Domestic Relations Law, such as establishing one of the requisite grounds for a divorce. This may be difficult to accomplish because of the illness or disability of one spouse


----------



## Lethe200

Liberty said:


> Medicare did pay for my friend's mom's very nice SNH for 3 months.  She lives in another state and is thankfully back home now.  She sure got "value received".



Yes, 120 days is the MAXIMUM Medicare allows, and there are strict rules:

You must have stayed at least 3 days ("observation only" stays do not count) in the hospital.
You require a "skilled" level of care in the nursing facility that cannot be provided at home or on an outpatient basis, on the order of a doctor
Also, as soon as the nursing facility determines that a patient is no longer receiving a skilled level of care, the Medicare coverage ends. And, *beginning on day 21 of the nursing home stay, there is a significant copayment equal to one-eighth of the initial hospital deductible ($176 a day in 2020).* This copayment will usually be covered by a Medigap insurance policy, provided the patient has one.

On the good side the restrictions are *per incident. *If you were discharged and have not used SCN for at least 60 days, a recurrence will qualify for another 120-day admittance. The copay still applies.

Full article: Medicare's Limited Nursing Home Coverage
=====

Nobody gets a "free ride".


----------



## macgeek

Dave Ramsey says its good, I trust him. 

https://www.daveramsey.com/blog/who-needs-long-term-care-insurance


----------



## Lethe200

>>Medicare did pay for my friend's mom's very nice SNH for 3 months. She lives in another state and is thankfully back home now. She sure got "value received". >>

Yes, but again, this has nothing to do with Medicaid and the spend-down of assets. 

What many people don't realize is that seniorcare facilities make their own individual decisions as to whether to subsidize residents who have 'run out of money' and must go on Medicaid.

We have found that for-profit facilities - which are the majority in the U.S. and are busy buying up non-profits whenever they can find one willing to sell - are generally not willing to subsidize Medicaid patients. If you run out of money.....you leave. 

The ONLY reason they will let you stay is because by state law they can't "dump" you on the street, IF there are no Medicaid beds available within a reasonable radius (which can be over 50+ miles, depending on area density). But once a bed is available - out you go. 

This happened to one of those "friend of a friend". He was single and had a fair amount of savings in his 50's. But he became permanently disabled in an auto accident. His savings paid for a very good SNH.....for a while. When the money ran out, he was eventually transferred to a facility that accepted Medicaid. 

We're familiar with this facility, in fact - it's less than a mile from our home. *With Medicaid, you don't get a choice*. Once you're in, you're there until you walk out or get carried out. It's not the worst facility in the world, but it's definitely depressing compared to the quality of the better facilities. It's crowded, the air always smells stale, the staff is there only to "do their job" and no more.

The friend is mentally alert but physically unable to live without full-time help. He's in a room with 3 other "residents". It's a rotten situation to be in. He hates it, but there's nothing he can do since there's no $$$$ to pay for something better.

We are thankful we're able to pay for the LTCi which will avoid being stuck in such an unpleasant situation.


----------



## J-Kat

Being a single person with no children and little extended family left that I thought would assume the task, I decided long ago that it would be up to me to put things in place for my care when the time came if I needed it.  I worked for a state agency and the state employment system offered excellent insurance (health, life, accident, etc.) paying the entire premium for the employee.  There were other options that the employee could select and pay a group rate premium.  On one occasion they offered LTC insurance and I immediately enrolled.  I hope I don't need it but it's there if I do.  I guess you just have to give some serious thought about what would happen if you became demented or physically incapacitated and plan accordingly.  Mathjac107 mentioned "partnership policies".  Texas has such a program and I expect other states do as well since it seems to help states conserve their Medicaid funds.  The original poster might check with her state's Department of Insurance to see what they might offer regarding LTC assistance.


----------



## Aneeda72

Butterfly said:


> Very true.  The process has gotten so long and intricately complicated that just about everyone who applies without a lawyer is turned down, even my friend who has a debilitating (and probably fatal in the future) heart condition,  complications of diabetes, and who is legally blind was turned down the first time.  She hired  an attorney experienced in the field and finally was approved, but it took two and a half years.
> 
> And of course, SSDI stops when you reach fra (full retirement age).


It’s hard to fake Down’s syndrome or other birth defects.  People with these issues are usually not turned down for SSDI.  Of course, if the parents are rich they will not get money until they are 18.  My grandson had to hire an attorney to get SSDI.


----------



## mathjak107

Lethe200 said:


> >>Medicare did pay for my friend's mom's very nice SNH for 3 months. She lives in another state and is thankfully back home now. She sure got "value received". >>
> 
> Yes, but again, this has nothing to do with Medicaid and the spend-down of assets.
> 
> What many people don't realize is that seniorcare facilities make their own individual decisions as to whether to subsidize residents who have 'run out of money' and must go on Medicaid.
> 
> We have found that for-profit facilities - which are the majority in the U.S. and are busy buying up non-profits whenever they can find one willing to sell - are generally not willing to subsidize Medicaid patients. If you run out of money.....you leave.
> 
> The ONLY reason they will let you stay is because by state law they can't "dump" you on the street, IF there are no Medicaid beds available within a reasonable radius (which can be over 50+ miles, depending on area density). But once a bed is available - out you go.
> 
> This happened to one of those "friend of a friend". He was single and had a fair amount of savings in his 50's. But he became permanently disabled in an auto accident. His savings paid for a very good SNH.....for a while. When the money ran out, he was eventually transferred to a facility that accepted Medicaid.
> 
> We're familiar with this facility, in fact - it's less than a mile from our home. *With Medicaid, you don't get a choice*. Once you're in, you're there until you walk out or get carried out. It's not the worst facility in the world, but it's definitely depressing compared to the quality of the better facilities. It's crowded, the air always smells stale, the staff is there only to "do their job" and no more.
> 
> The friend is mentally alert but physically unable to live without full-time help. He's in a room with 3 other "residents". It's a rotten situation to be in. He hates it, but there's nothing he can do since there's no $$$$ to pay for something better.
> 
> We are thankful we're able to pay for the LTCi which will avoid being stuck in such an unpleasant situation.




here in ny we have no medicaid specific homes .. all private homes  have a certain amount of beds for medicaid patients . however  that is for new medicaid patients .

just about all take medicaid assignment  once you have been a paying customer for 2-3 years using either your own money or a state partnershp plan which provides 3 years payments .


----------

