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Gifting assets to a family member can have terrible tax consequences. In order to gift a 401(k) or any other type of Retirement Account, you'd have to pay tax on ALL of it. If you've got $500K in a retirement account and you "gift" it to a trusted family member, you'll have to pay almost $200K in federal income taxes (plus state income taxes). Gifting real estate has similar consequences.
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A lot of GREAT answers here. For those who have LTC insurance, it would be so very helpful if you would provide real life examples of the pricing (premiums, increases, cost of care, etc.) if you feel comfortable doing so. Hey, we're all anonymous, right?

OP, you might want to do some research now on what care would look like without LTC insurance. Tour facilities you could see yourself being willing to use, set up an appointment with the admissions and financial person and ask them to be straight with you.

When my mother went into a facility, she was already on community medicaid. Because she had medicaid already in place, and not "pending" as a private pay person would, she jumped to the head of the line. They just wanted to guarantee payment. A person on Medicaid is more of a guarantee than a private pay person whose funds have run out. Just a different way of looking at things.

As for the type of facility she got into, it is nicer than 90% of the facilities in our area (Long Island, NY). She has a private room since the dementia unit is all private rooms. It is not by any means the best of the best. The staff to patient ratio is just average. The cream of the crop facilities would not even look at us once I mentioned Medicaid (I think there were 3 of those) but by and large, there were a handful of very decent facilities that accepted a Medicaid person without a private pay period.

It's worth mentioning that there are relatively few outstanding facilities, period. I contacted about 26, almost every facility in my county and a number of facilities in neighboring counties. I did a LOT of tours, some twice. There were only 3 that I would consider a dream facility, and they weren't that big, so even if you have the money, what are the chances of getting into one of those?

I applied to 5 facilities. The others I don't think I would send a dog there. (There are a LOT of bad facilities.) One accepted her, and it's quite nice, comparatively. It doesn't hurt that it's in one of the most expensive neighborhoods in NY. I've heard "the nicer the neighborhood, the nicer the nursing home," but you'd have to test that in your own state.

When you talk about nursing homes, you're talking about quality of care. We have some outstanding aides, who I wish I could clone, and also some lousy ones we have to complain about and get removed from my mom's care. Mom is fortunate to have me, her "helicopter daughter" right on top of things. That's how we make this work. We MAKE it work.

But what about those of us who have no kids? We NEED to be in those top notch facilities, and we need a strategy to get there, which may or may not include LTC insurance. Do lots of research. Ask questions. Talk to people who've been there, and plan for yourself.

Great question!
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As mentioned here, you can apply for Medicaid but only if you're eligible and have limited resources and very little money. If you're ineligible, then it's either get long-term care insurance or drain your savings paying for your own care and have nothing for your heirs or your funeral/disposition
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My mom is 92. She is very healthy. My dad (before he passed) insisted she get LTC. I recently read the contract and was shocked at how little she will get! She's put well over 100,000 over the last 15 years. I am a CNA, I plan to take care of her. LTC WILL NOT PAY ME!!! They require she get an aid from an agency! I worked for agencies before starting my own business, I would NEVER have someone from an agency take care of her. I wish I would have intercepted the LTC before she put so much money into it.
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There are some LTCi policies that can pay a family member to provide care. If your mom is 92 and she's had her policy for 15 years, I assume she was age 77 when she purchased the policy. Nowadays it usually does not make sense for someone that age to buy long-term care insurance because the premiums are so high at that age. For someone age 75+, it usually makes more sense to buy an annuity with a long-term care "multiplier". It would only make sense to buy this annuity if  the person had at least $500K net worth because they'd have to put about $100K into the annuity to make it worthwhile.
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To answer Christine's question, my wife and I share a long-term care policy that has $870,000 of benefits. It pays $7,250 per month per person, if we need care. We bought it in our forties so our premium is about $60 each per month. We don't have any inflation benefit on it. I am comfortable using our own assets/income to cover the cost of care that exceeds $7,250 per month. I am in my 50's now and we are both still healthy, so we might buy another policy to supplement our current policy.
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My relative bought her LTCi policy 10 years ago when she was in her mid-sixties. She bought a policy with a "graduating" premium, meaning that the premium increased each year as the benefits increased. Most policies don't work that way, but in her case, it was the best policy for her and she was comfortable paying the increases each year. Over the past 10 years she's paid about $30,000 in premiums. She's on claim now and her premium has stopped. Her policy has a little less than $400,000 in total benefits. Her monthly benefit is a little less than $10,000. She only needs about $7,000 per month right now for her care. The unused $3,000 remains in the policy. Her policy should last about 5 years.
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@DigitalBAnker- Pre-paying for your funeral/final disposition is an allowable Medicaid "spend down" expense. It won't count against you.

It sometimes seems like there's just no good solution. Healthcare is expensive. Unjustifiably expensive. Prohibitively expensive.

My facility is $14,000 a month. The other day, I saw an aide sleeping in the dining room when she was supposed to be making sure people didn't choke to death. I can't imagine anywhere how a share room (in most cases), 15-20 minutes of a CNA's time per day (who makes $16 an hour), 3 cafeteria style meals plus snacks, and the *presence of an LPN ( a friend who's an LPN told me that means "low-paid nurse") merits $14,000 a month!

But when you add to the mix the fact that many of these people have no other option, it becomes supply and demand and the price skyrockets. The same reason some cancer drugs cost so much. Certainly, the ingredients and production are not much more expensive than many other reasonably priced drugs (I used to work in the pharmaceutical industry), but when you factor people's desperation to live to the equation, you get away with murder!

And sure, the facility needs to keep the lights on and pay the social workers and the financial people and buy supplies, etc, etc, but, for a 30-resident unit, they are pulling in (and this is assuming everyone is on Medicaid paying $8000 a month instead of $14,000) $240,000 A MONTH. And most of these places smell like urine. Are ya kidding me?
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Thanks LTC Shop! Just curious, what companies are these LTC policies with?
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It's been my observation that the policies offered and the companies offering them change all the time. A policy issued 10 years ago is no longer even offered, or a good company no longer offers LTC at all, etc. And prices and benefits vary greatly.
Our advisor pitches one to us about every year. Actually, they seem to be more attractive than what was available 2 or 3 years ago; and we almost applied this year, then backed out.
I think you just need to do some comparison shopping for available plans, considering your own personal plans. If you think you will have a family member care for you at home, obviously, make sure the policy you buy will pay for that.
Another consideration: There will probably be a physical required, and you will have to be in good health to be accepted.
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With the coming tax cuts and ballooning government deficit, you can be sure that major government cutbacks are looming. Without insurance, anyone with means could easily be wiped out financially.
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@Christine73,
My policy is with Allianz.
My relative's policy is underwritten by John Hancock.
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@Agingmyself,
I'm not sure why you would say that good companies don't offer long-term care insurance anymore. Some of the biggest and strongest insurance companies in the country sell long-term care insurance: Massachusetts Mutual, Mutual of Omaha, New York Life, Northwestern Mutual, State Farm, Thrivent, Transamerica, all sell long-term care insurance and they are all very large and very strong companies.

Once a company sells a policy they can't cancel your policy (unless you don't pay your premium on time.) If a company stops selling new policies, they still have to honor all of the policies they've already sold. My relative's policy is with John Hancock. They've stopped selling new policies, but they have to honor all claims of all the policies they've sold previously.
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My policy is with The State Life Insurance Company, a OneAmerica company
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Thank you @LTCShop! Much appreciated.
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Thank you @superstring!!
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Long Term Care Insurance is a valuable part of an estate plan for people who have substantial assets, savings and income. If you do not have substantial assets and income to fund the premiums, consider other long term care planning methods.

The National Association of Insurance Commissioners publishes a Shopper’s Guide that outlines what to look for in a LTC Insurance policy. Compare policy offerings and consider:

What are the policy's limitations on home care? Are Home Care Costs Covered at all? How may days per week? What Services are Covered?
Does the policy pay family members for care giving?
Does the policy pay for 24 hour a day home care? (most do not)
What level of physical and mental impairment does it take to get the policy to pay benefits? Eligibility for coverage is based on whether or not a person can perform Activities of Daily Living. Make sure you understand the policy’s definition of ADL's. People who are unable to perform these Activities of Daily Living, and who can't obtain adequate nutrition, usually require a caregiver to support them from 12 to 24 hours each day. ADL's include: Dressing
Bathing
Toileting
Eating
Walking
Shoppers Guide is at:
https://www.ltcfeds.com/epAssets/documents/NAIC_Shoppers_Guide.pdf

(Don't confuse ADL's with Independent ADL's, which are the activities that enable a person to live independently in a house or apartment, such as: preparing meals, performing housework, taking medication, going on errands, managing finances, and using a telephone.)

My state, Massachusetts, is unique because it has a Long Term Care Insurance incentive program that exempts an elder’s home from Medicaid liens, and protects the home from estate recovery. No other state in the union has this protection. three important features that must be found in the policy: 1) coverage for at least two years of long term care, and 2) a daily benefit dollar amount of $125 and 3) elimination period (days on which services are provided to an insured before the policy begins to pay benefits) not longer than 365 days in a nursing facility or a deductible of no more than $54,750.

Because the Massachusetts law measures these requirements at the time the policy is purchased, elders can use the qualifying insurance policy to pay for community-based home care before they enter a nursing home, without fear of being disqualified by the two year requirement. The purpose of the law is to protect elders who use their long term care insurance for community-based care, so they can remain in their homes as long as possible.
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Just be aware: Long Term care seems like a great plan, but know the statistics. Only approximately 50% of claims get approved.
More and more companies are raising premiums and " re-interpreting contracts " to lower their claim exposure, thus raising profits. Meaning people who planned on those benefits for retirement care, are not getting them. It's a constantly changing dynamic.
Litigation against Long Term care companies
Have double since 2012, as more people attempt to start claims and get denied.
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LTCShop,
Sorry if my earlier post seemed to imply that no good companies offered LTC. As you say, that's not the case.
I was just opining that the offerings change so often that it is hard to make comparisons; and you can't base your own decision on the experience of someone else, because the coverage they collected on probably is not available today, not from another company or even the same one.
My relative's experience with John Hancock is an example--good company, paid as promised--but, as you said, they don't offer LTC now.

Mr. Roberts, Indiana also has an asset-protection approved plan similar to what you described. I'm going to check out the Shoppers Guide you mentioned.

Thank you both for your informative posts.
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A little off topic, though WizerOne did mention it-- My sister-in-law's family insurance policy (ACA) soared to the tune of an $840 PER MONTH increase in 2018. e.g. premium will cost $2,600 per month! Who can afford that also with high deductible?
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Only a knowledgeable agent can answer your question. Hybrid polcies (combinantion life/LTC, and life/annuity) are outselling straight LTC policies at this time. Not necessarily because they are better, but because many people are reluctant to place their money into any instrument without a guaraneed ROI. The underwriting is generally less stringent than straight LTC policies.
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There are 44 states that have Long-Term Care Partnership Programs. I'm not sure why Mr. Roberts thinks Massachusetts is the only one. Other states LTC Partnership Programs have the flexibility of protecting any type of asset (not just your home) from Medicaid liens.
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Badandy, do you have a source for your statistics? According to study done by the Dept. of Health & Human Services only 4% of LTCi claims are denied and the denial rate decreases to 2.4% within 12 months.

Here's a link to the chart
twitter.com/LTCShop/status/942606001768873984

Here's a link to the entire study published by Dept. of HHS:
ltcfacts.org/wp-content/uploads/2015/04/ltci-claims-audit

Last year 254,910 people received benefits from their LTC insurance policies. In that same year, there were 50 lawsuits filed against LTC insurance companies. For every 5,000 claims paid there was just 1 lawsuit filed.

The LTC policies that have had disputes over claims have mostly been policies that did not meet the federal guidelines for LTC insurance.

The most important policy terms (e.g. how to know if you qualify for benefits) have been standardized by the federal gov’t. The policies that meet those guidelines are very clear in terms of when you qualify for benefits.
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Thank you, Agingmyself, for your explanation. That was very kind of you.

You're 100% correct that LTC insurance offerings have changed from what was sold 15 years ago. However, the changes have not been for the worse, but for the better.

15 years ago, most states did not have LTC Partnership Programs. If your policy ran out of benefits you were out of luck. Today, 44 states have these programs. Consumer can protect most, if not all, of their assets if they buy a policy that has an amount of benefits equal to (or near) their net worth.

Badandy's concerns about rate increases would be correct if long-term care insurance companies were allowed to price their new policies, available for sale today, the same way they priced their policies 15 years ago.

Fortunately, insurance regulators do NOT allow any policy purchased today to use the old pricing assumptions. Also, 41 states have passed very strict pricing regulations for any policy purchased today. These new regulations have removed any profit incentive from rate increases.

Now that’s good news and that’s bad news. The bad news is that a policy purchased today costs more than a similar policy that was purchased 15 years ago.

The good news is that because of the new regulations and because today’s policies are priced more conservatively, any policy purchased today has a very low chance of having a large premium increase.
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Hi LTC shop! I will dig up my statistics. I am not referring to rate increases, although very common to go up over 40% . I am referring to unethical denials .
Reference the Class Action Lawsuit of
Gwen B Daluge vs
CNA Financial Corporation.
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Do all LTC policy premiums go up when one turns 64? I'm heading toward 64 in less than a month and have been dilly-dallying about a LTC policy. It has definitely helped my mom (now 87), as much as a pain as it was to work with the company. There seem to be several knowledgeable folks on this thread. I was planning to be out of town for most of the next few weeks (with Mom, of course) -- should I try to rush to get a policy before my birthday? Thanks for your help!
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superstring Dec 2018
I don't know the answer, but in my case the (single premium) was to go up on my birthday. I don't think it was necessarily because it was my 64th birthday. Also, I didn't have to "rush", I'd been studying it for quite a while and just hadn't signed the final paperwork so I used the fact of my upcoming birthday to motivate myself to stop agonizing and get it done.
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Yes and you should get a policy before your birthday.
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I have been holding my tongue to see what others have to say about LTC. Now, let give you my 2 cents.

My husband had LTC through my work five years ago, and that was three years before his Alz diagnosis. On the one hand, he was lucky that he got in just in time, because now he would not be qualified to enroll. On the other hand, we didn't know he would get sick so soon, so he only signed up for a 3-yr policy. We now wish he had signed up for the "indefinite" policy with the highest daily benefit amount ($450/day). We would have been financially stable if he had done so, even having to pay a much higher monthly premium. Here's why:

Several months ago, my husband had a crisis that caught me off-guard. That was the first time I had first-hand experience what delusions looked like. Wow, it was scary and heart-breaking. I put him in memory care while I worked out a better care option for him. The monthly cost in memory care was $9,000 a month! He stayed there for two months and we were $18,000 poorer. His LTC policy only paid half, which helped a bit. But if he had purchased the "indefinite" policy with the maximum DBA, we would not have to pay a dime. And once you have been approved for claims, LTC stops collecting your premium and anything you paid after the approved date would be refunded to you. So, even if my husband had paid $1500/mon in premium, it would still have been cheaper than $9000 a month.

I do not know what I will do after the 3-yr policy is gone. Right now, I can only focus on one day at a time.

I think if you are super rich like Trump, Gates, and other billionaires, there is no reason to by an LTC policy - for obvious reasons. But if you are a normal person like most of us, an LTC policy is a good idea, because the cost of caregiving is VERY expensive, and it gets more expensive as more care is needed later.

Not sure if my post helps, but everyone's situation if different.
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@Teri4077,

Long-term care insurance premiums are based upon your age (and health) at the time that you apply. The older you are when you apply for a policy, the higher the premium.
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@badandy,
Can you share some specifics about the suit? I couldn't find anything about it online.
According to the annual reports published by the NAIC, in 2015, CNA incurred $824,492,319 in claims. In 2014, CNA incurred $694,455,842 in claims. In 2013 CNA incurred $650,624,104 in claims. 
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