If you're 40 years old and healthy, it is very easy and inexpensive to purchase Long-Term-Care Insurance. All of you should purchase it now. Unfortunately, not all of us are so lucky to 40 and healthy. What are those of us that are in our 50's, 60's, 70's and older to do about long-term-care, especially if we have bad health? LTC Insurance is impossible to purchase if we are too old or too diseased. What are those of us to do about paying for long-term-care, when it becomes necessary? I am in that position and have been forced to learn everything possible about this situation in order to be as prepared as I could be. If you are like me, this may be important too you, too.



My research found dozens of government and private sites trying to explain how to pay for LTC. The following items became obvious and verifiable from those websites.

Many seniors find themselves facing nursing home care costing over $50,000 per year. The costs range from just under $50,000 to over $120,000 in more cosmopolitan areas such as New York City. These costs can be devastating for most senior citizens and their families. It seemed obvious that payment of these amounts was eventually going to lead to some sort of govt. program. How many LTC patients or their families were actually going to have the funds with which to pay? Payments were narrowed down to only four possibilities: 1) The family; 2) Medicaid; 3) Veterans programs; or, 4) Long-Term-Care (LTC) Health insurance. Since very few seniors have LTC Health insurance, virtually all nursing home expenses will be paid by Medicaid and/or the family. Veterans of a time of conflict have a special program available to them. I give two sources of information below that helped me the most with the information necessary for Nursing Home (LTC) Planning.

What is Medicaid? Medicaid (Medi-Cal in California) is an entitlement program created by the Social Security Act, Title XIX. It is the primary provider of long-term-care benefits for senior citizens today. Many seniors believe they can look to Medicare to pay for nursing homes. However, Medicare only pays up to 100 days for particular types of long-term-care. Medicaid is often needed after that period is over. Medicaid benefits have become the premier safety net for most seniors. Financial and estate planners should not overlook Medicaid planning to protect and preserve the assets of their senior clients. Some people think it is improper or unethical to use Medicaid. This is not true. The rich rarely use Medicaid to save money. An April, 2006 report titled ?Medicaid and the Uninsured,? the Kaiser Family Foundation details that the median amount transferred from a Medicaid recipient to anyone else, including spousal transfers, was less than $2,800. Of course, they also reported there were transfers made for amounts over $200,000 albeit only 5 percent of transfers were above $50,000. They concluded that the transfer of assets in order to gain Medicaid eligibility is grossly over-exaggerated.

Everyone is entitled to the Medicaid program under the right circum?stances. Proper advance planning is necessary to assure those ?right? circumstances and preserve your hard earned as?sets. Too much of the following as?sets will keep you from qualifying: cash, stocks, bonds, IRA's, CD's, real estate, cash value life insurance, second homes, etc. A single person is allowed up to $2,000 in cash, a primary residence and per?sonal items. An at-home spouse is allowed a maximum of $101,640 in cash (Effective 1-1-07), a primary residence and personal items. These amounts may differ from state to state. In most states, the at-home spouse may have either considerable or even unlimited income when structured properly.

In order to qualify, many people choose to ?gift? assets away. Assets can?not be given away within 60 months (currently 30 months in California, 36 months in several other states and 60 months as required by The Deficit Reduction Act of 2005) of qualifying for Medicaid. Before ?gifting,? be certain of how the latest changes have affected your State's Medicaid Rules. Please be certain to obtain necessary legal or professional advice.

When either spouse needs long-term-care, assets that need to be protected can be changed in form e.g. from cash to life insurance (with no cash value); and even a business owned by the LTC patient or in some cases rental income in the LTC patient's name. Several of these items are next to impossible due to family structure or individual state's Medicaid provisions.

The in?come paid out to the at-home spouse is unlim?ited in some states and limited in others. In the case of the ?unlimited in?come? states, the con?tri?bution to the long term care facility by the family would be any retirement income paid in the name of the spouse needing the care, such as social security. In the ?limited income? states, when the limit is reached, the remaining income of the at-home spouse, in addition to the income of the spouse needing the care would be the family's contribution to the care facility. Medicaid would pay the difference, thereby conserving your estate for your spouse or your beneficiary. New rules today regarding reimbursement of the State for any Medicaid expenses are now being adopted in several states.

I have found two websites that seem to be the most knowledgeable about Nursing Home Medicaid Planning. The first is Barry Rahm Insurance. You can reach Barry Rahm at www.barryrahm.com or 800-255-1932. After speaking with Mr. Rahm, he may be the best person I have located (and the easiest with whom to get in touch) in order to answer questions and help to get Medicaid qualified the fastest. The second is Medicaid Asset Protection Plan. They can be contacted at www.medicaidhelp.com or 866-334-2243. They are also extremely knowledgeable and charge $342.00 (including postage for overnight shipping) to get you the information needed for Medicaid Qualification.

I must credit both the above sites for much of the language and facts reported here.