Transcript LTC Slide Show

The Rights and
Benefits of
Medicare
and
Medicaid
Medicare 2012
Part - A (Hospital)
`$1,156.00
$ 0. 00
$289.00 per day
$578.00 per Day
Deductible
1st Through 60th Day
61st Through 90th Day
91st Through 150th Day
Medicare 2011
Part - B (Doctors)
80% of Medicare Approved Charges - Annual Deductible 162.00.
Immunosuppressive Drugs for 1st Year After Organ Transplant.
Injections for Broken Bones for Individuals Who Have a Diagnosis
of Post-Menopausal Osteoporosis.
Mammography Screening for Women over 65 Every 23 Months.
Medicare 2011
Skilled Nursing Home
100% of the Cost for First 20 Days.
All but $141.50 Per Day from 21st - 100th Day.
Three Day Prior Hospital Stay Required.
Must Be a Medicare Approved Facility.
Custodial Care NOT Included.
Medicare 2011
Home Health Care
Medically Necessary
Part Time or Intermittent
* Physical Therapy *
* Skilled Care *
* No Hospital Stay Required *
* Custodial Care NOT Included *
What is Long Term Care?
The Assistance or Supervision
given to a person who has a
Physical or Mental Disorder
which causes that person to no
longer Function Independently.
This can be due to Injury, Illness,
or the Normal Aging Process.
Is Long Term Care Only
Used in Nursing Facilities?
NO!
Long Term Care can be provided in the
privacy of your own home, An Adult Day
Care Facility, and other types of facilities.
Why Medicare Does Not Pay
for Long Term Care
 Care
Provided in a Skilled Nursing Facility Only
 Must be Medicare Approved
 Three Day Prior Hospital Stay
 “Restorative” in Nature
Questions To Ask Yourself

Do you know where the money will come from if You
need care in a Nursing Facility or At Home?
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How long will your money last?
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Does it make sense to use your interest on principal
to protect your assets to pay for Long Term Care?

Can You count on family to be able to help you?

Can you count on the Government to design a plan
that is right for your needs?
Who Pays For
Long Term Care Services?
 Private
Insurance
 Medicare
 Medicaid
 Self and Family
6.5% (and growing)
11.8%
37.9%
43.8%
OBRA 1993 - RECOVER FROM YOUR ESTATE
Requires States to Recover Nursing Home Medicaid
Expenses From the Estates of Deceased Recipients.
 States can go against any real or personal property,
including the home you held in your own name.
 The State may even recover from assets you gave
away or otherwise disposed of prior to death,
property you held jointly with another.

No recovery is made from Long Term Care
Insurance Payments.
Spend Down Quick Reference
(Welfare)
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Home
Regardless of income. Some States protect the
home for a period of up to six months, if single.
Automobile
Up to $4,500 value, no limit if used to go to work
or used to receive medical care.
Personal
Household goods, personal items up to $2,000.
Wedding Ring
One wedding ring and one engagement ring.
Property
Up to $6,000 equity in personal and real property,
if essential for support.
Life Insurance
Cash Surrender value of $1,600.
Assets
Approximately $2,000.
Burial Costs
Funeral and burial plots up to $2,500.
Personal Needs
Allowance is $35 to $70 per month, monies spent
for personal expenses not covered by Medicaid.
Home Maintenance Allowance of approximately $2,000 per month.
N Y State Partnership
Plan
Protects Your Assets
Does NOT Protect Your
Income
The Partnership Plan is a Covenant
between YOU and the
STATE OF NEW YORK.
N Y State Partnership Plan
Protects Your Assets
Does NOT Protect Your Income
YOU promise to purchase Long Term Care
with at least the following Minimum Benefits:
 $208/Day Nursing Home Benefit

50% Home Health Care Benefit

3 Year Benefit Period

5% Compound Inflation Rider
 Plus Other Benefits
N Y State Partnership Plan
Protects Your Assets
Does NOT Protect Your Income
The State of New York Promises:
When Your Long Term Care Benefits are
Exhausted.
You will be able to Qualify for Medicaid and
We Will Not Take Your Assets.
You will however be required to contribute
most of your Income.
N Y State Partnership Plan
Protects Your Assets
Does NOT Protect Your Income
May Not Be Suitable:
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If You are Planning to Leave New York
If You have a lot of Income
If You have Few Assets to Protect
If You Can Afford Longer Term Benefits
Why the Need for
Long Term Care
Six out of Seven Families
would be financially devastated by the
cost of Long Term Care
Why the Need for
Long Term Care
It is estimated that one third of the
Nursing Home Population is under 65
years of age.
Why the Need for
Long Term Care
Every year, roughly half a million people
deplete their life savings for
Long Term Care
and then have to go onto Medicaid.
Why the Need for
Long Term Care
More than 1/2 of the women
and 1/3 of the men
turning 65 this year will spend some time
in a nursing home before they die.
Long Term Care Insurance
It’s all about keeping
you OUT of a
Nursing Home
Do You really want to end up
in a Nursing Home?
With good reason we frequently hear:
I’ll
put a bullet in my brain first!
I want my privacy, my dignity!
Nursing Homes are unsafe, smelly places with
lousy food, filled with over-medicated zombies
in diapers and wheelchairs receiving little or
very poor care.
Why do so many end up in
Nursing Homes?
Crisis
An
unexpected medical crisis such as a Fall
from a Broken Hip, Stroke, Alzheimer's, or
Over-Medication can be overwhelming.
It is just too easy to listen to well intended
advice from health care professionals and
wind up in a Nursing Home.
Why do so many end up in
Nursing Homes?
Burnout
Can
you really expect your Spouse or Children
to give up their lives to care for you?
Are they physically or financially up to It?
How long can they keep it up before their own
health is jeopardized?
Why do so many end up in
Nursing Homes?
Savings Depletion
No matter how much you are worth:
Long
Term Care can wipe you out and quickly.
After your life’s savings are gone, you have to
apply for Medicaid (Welfare), and Medicaid
pays for very little outside of a Nursing Home.
If you should need Long Term Care
Where would you like to be cared for:
A Nursing Home
An Assisted Living Facility
At Home
Do nothing and you will be guaranteed
to enter a Nursing Home in case of need!
Long Term Care Insurance
is
Expensive!
of course it is
but that’s only because
Long Term Care
is so very Costly.
The Most Expensive Mistake
that you can make:
To Need Long Term Care
and not have
Long Term Care
Insurance
You Purchased
Long Term Care Insurance
Ten Years Ago.
Now you Need the Benefits.
How Long Before You
Collect More in Benefits
Than All of Your Premiums?
Answer:
In Most Cases
Less Than Four
Months!
January 1, 1997
KENNEDY - KASSEBAUM
Qualified Long Term Care
Insurance Becomes
Tax Deductible!
If You Itemize and Exceed 7.5% of
Adjusted Gross Income You May
Deduct the Premiums Paid.
Amounts you may
Deduct:
Age 40 or Less
Ages 41 - 50
Ages 51 - 60
Ages 61 - 70
Age 71 and older
$320
$600
$1,190
$3,180
$3,980
Benefits Received from
Qualified Long Term Care
Insurance
are largely
Income Tax Free.
Your Long Term Care Choices:

Take Your Chances.

Give Away Your Assets.
(But Don’t Get Caught)

Consider Long Term Care Insurance.
Most Important Reasons to
Purchase Long Term Care
 Choice
and Remaining Independent
 Protection of Assets
 Avoid Emotional Burden on Family
 Guarantee Affordability of Services
 Avoid Physical Dependence on Family
 Quality of Care
 Peace of Mind
The Greatest
Problem
DENIAL
LONG TERM CARE
 Living
 Total
Benefits to Preserve Lifestyle
Protection
 Choice
and Independence
LONG TERM CARE
The Choice is yours
POVERTY OR PROSPERITY
DIGNITY OR DESPAIR