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Saving Mom & Dad...and You 2012 Edition

 
9780974955742: Saving Mom & Dad...and You 2012 Edition

Inhaltsangabe

When facing a health care crisis, consumers want assurance that their access to health care services is secured. They want answers to worst-case scenarios: "Will I be left to die if my health insurance runs out?" "Must I spend myself into poverty to get help for my Alzheimer’s -afflicted spouse?"

This book grew out of my work assisting families through health care crises with their disabled and elderly members. Often this work requires helping individuals become eligible for government-subsidized health care, known as Medi-Cal in California and Medicaid in the other 49 states.

This book provides a new paradigm to understand eligibility rules for Medi-Cal that will aid consumers and professional advisors – financial advisors, bankers, tax preparers, attorneys, social workers, nurses, caregivers – who serve disabled and elderly individuals.

For people whose health and finances give them options, this book also provides guidance on avoiding Medi-Cal. Tightening federal and state budgets mean likely cuts in Medicaid/Medi-Cal funding for the large group of Baby Boomers entering retirement. This book helps this large group examine alternative long-term care funding options.

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Über die Autorin bzw. den Autor

Robert J Cullen, CFP, is a writer, speaker and financial consultant with a gift for making complex issues understandable. He is the president of Cullen Financial Services, Inc., a full-range financial planning firm with special focus on the needs of elderly clients and their families. His work, coupled with experience as a reporter and financial journalist, propelled him to become an expert on the Medi-Cal system and the financial needs of seniors and baby boomers. In the process he developed a new paradigm for understanding Medi-Cal eligibility rules and became a sought-after consultant on Medi-Cal to seniors and their advisors. Bob gained national prominence through articles in the Los Angeles Times, Medical Economics, Financial Planning Magazine and other publications.

Aus dem Klappentext

The cost of unexpected surgery, hospitalization or extended long-term care can decimate your life savings and turn you into a pauper. Even people with high incomes and multimillion-dollar insurance caps have found themselves staring at financial ruin. Can it happen to your parents? Can it happen to you?

Robert J Cullen, CFP, introduces a new paradigm to understand eligibility rules for Medi-Cal, the California government-funded health care program. His Put it in a Box(tm) diagrams wonderfully simplify Medi-Cal eligibility rules for consumers and professionals--attorneys, financial advisors,bankers, tax preparers, social workers, nurses, caregivers, in-home support personnel--who serve disabled and elderly individuals.

For people with good health and comfortable finances, Robert provides expert guidance to avoid Medi-Cal. This direction especially applies to baby boomers, who increasingly recognize that shrinking government budgets make long-term health care planning vitally necessary.

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Great Uncle Pat: Our four choices for long-term care

Great Uncle Pat was a tall, slender man who worked daily on the family farm in Northwest Iowa. He did not concern himself about long-term care issues or bad living habits. He drank whisky and beer, smoked cigars and cigarettes, and regularly ate beef and potatoes swimming in gravy. Whole milk and butter were also staples of his diet.

Great Uncle Pat was 92 years old when one November morning he complained of a terrible headache to Andy, his 88-year-old brother. In uncharacteristic fashion, Pat went back to bed instead of tending to the cattle in the barnyard.

Pat died that day. No hospitals. No emergency rooms. No nursing homes. Pat lived as he wanted, then passed on without fuss.

Great Uncle Pat s death epitomizes a good death, a lucky fate shared by 10% of the American population. Unless we count suicide as an option, we mortal beings face four long-term choices as we contemplate the last years of our lives: 1) Get lucky 2) Enjoy your success 3) Let someone else worry 4) Let someone else pay.

Get lucky was Great Uncle Pat s long-term care strategy. His planning can be summed in two words: Do nothing. The more hedonistic among us may label this as the "Eat drink and be merry" strategy or its close cousin "Let tomorrow take care of itself."

Since this works for only 10% of the population, we have to ask ourselves: Do we feel lucky? Viewed realistically, we have nine-in-ten chances of needing some level of long-term care assistance during our lives.

Cultural factors play a role in long-term care planning. Caring for the elderly at home until they die is expected in some cultures. For these families, long-term care means unrelenting stress and backbreaking work for the next generation, usually a daughter or daughter-in-law.

Denial also plays a role in long-term care planning for many seniors. They know their time on earth is limited; they know many people spend time in nursing homes; they know they should get their affairs in order. Yet many stubbornly ignore their children s and friends entreaties to plan beforehand. Perhaps these seniors refuse to acknowledge their mortality because they fear such thinking will hasten their demise. Besides, didn t their great uncle drop dead one day without ever seeing the inside of a hospital or nursing home?

That you are reading this book is indication that Do Nothing is not a comfortable choice for you.

For the fortunate few who enjoy great financial success, planning for long-term care is simply deciding which assets and/or income will be diverted to pay for necessary care when the need arises. To use an insurance industry description, these individuals may self insure their risks of needing long-term care.

Interestingly, some wealthy people who can afford to self-insure purchase long-term care insurance. Anecdotal accounts from insurance sources indicate a desire by people of significant economic means to protect their asset base from potentially massive costs of extended long-term care.

If Do Nothing does not work for you and Enjoy Your Success seems unlikely in this lifetime, then letting someone else worry for you may be your best choice.

You can transfer your long-term care worries from your shoulders onto the backs of insurance companies by purchasing stay-at-home-longer and protect-our-assets insurance. More commonly called long-term care insurance, this coverage provides income so you can stay home longer and protect your assets when serious medical conditions take away your ability to care for yourself or your spouse.

Obtaining this peace-of-mind coverage requires two critical ingredients: Reasonably healthy medical condition plus the financial wherewithal to pay for the insurance.

Reasonably healthy medical condition means you must qualify medically for coverage. Medical underwriting when an insurance company examines your medical records varies significantly among long-term care insurers. For example, where one company will reject automatically all applicants with any type of diabetes, another company will underwrite (provide coverage) for applicants with certain mild cases of diabetes.

Here is a commonsense rule of thumb: If you do not consider long-term care insurance until your doctor tells you about your serious illness, then you will likely not qualify for coverage. In other words, when you recognize that you REALLY need long-term coverage, you will likely NOT qualify to buy it.

If you qualify medically for this coverage, then you must consider if you qualify financially to pay for it. You need either surplus assets or surplus income to pay for this coverage. (A detailed discussion of long-term care insurance is featured later in this book in Peace of Mind Insurance. )

Ideally, everyone should make provisions for paying for long-term care, whether through self-insurance or purchased LTC coverage. Currently, Medicaid (Medi-Cal in California) pays for 60% of nursing home care in America. One needs only to consider the large numbers of Baby Boomers nearing their retirement years to recognize the improbability of our federal and state treasuries continuing to pay 60% of nursing home care indefinitely.

Medi-Cal is the payer of last resort for individuals who lack means to pay privately for medical care. Medi-Cal is a means-tested program, which means an individual or a couple must meet certain asset requirements to qualify for benefits. Additionally, the individual may be required to pay some or most of his/her monthly income to the nursing home as his/her designated co-payment or share of cost.

The following chapters simplify Medi-Cal long-term care so consumers and their advisors better understand available programs. We begin with a simple case where we seek benefits for an elderly Grandmother.

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