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Old 01-05-2016, 06:08 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,956,950 times
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Quote:
Originally Posted by golfingduo View Post
In some ways they are but if we are talking late 50's and early 60's LTC takes precedence. One they are more likely to be unemployed or underemployed (working part time). Two it is in the late 50's that insurance becomes more expensive and jumps drastically in the mid to upper 60's if you can even get it.
Really depends on the individual. Since my husband and I are lawyers - most of our friends are lawyers - or upper middle class people in other professions - like medicine. They are/were at peak earnings in their 50's and often their 60's. Often at peak spending too. Many had kids in college - and/or were helping elderly parents financially (sandwich generation stuff).

We know 2 people - one a lawyer and one a dentist - who were forced to retire as a result of disabilities in their 50's. Curiously - both as a result of golf accidents. They would have been up the proverbial "sh** creek" without disability insurance. We don't know anyone under 80 who has been in an ALF or SNF (and those people were/are in our parents' generation). Even some neighbors with dementia (they either died at home or are still alive at home). Robyn
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Old 01-05-2016, 06:21 AM
 
Location: Central Massachusetts
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Quote:
Originally Posted by Robyn55 View Post
Really depends on the individual. Since my husband and I are lawyers - most of our friends are lawyers - or upper middle class people in other professions - like medicine. They are/were at peak earnings in their 50's and often their 60's. Often at peak spending too. Many had kids in college - and/or were helping elderly parents financially (sandwich generation stuff).

We know 2 people - one a lawyer and one a dentist - who were forced to retire as a result of disabilities in their 50's. Curiously - both as a result of golf accidents. They would have been up the proverbial "sh** creek" without disability insurance. We don't know anyone under 80 who has been in an ALF or SNF (and those people were/are in our parents' generation). Even some neighbors with dementia (they either died at home or are still alive at home). Robyn

Understood, we come at this from two ends of the candle. I don't know any lawyers. All of our friends are just above minimum wage folks. In particular my friends are soldiers or were soldiers. If they have made it to 60 without getting disabled then they will be senile in a few years. Okay maybe not that bad but my meaning is that the folk I know are in nearer my shoes than they are to Johnnie Cochran and Robert Shapiro.

Don't get me wrong because I can honestly see that as well.
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Old 01-05-2016, 06:42 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,956,950 times
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Quote:
Originally Posted by organic_donna View Post
My sister lives in AZ and she told me Mayo Clinic doesn't take Medicare, is that true?
I'm in Florida. Don't know if Florida Mayo works the same as Arizona Mayo. It's a little complicated here. When it comes to Medicare Part B services - Mayo accepts Medicare patients - but does not "accept" Medicare. It bills patients directly for services. At approximately Medicare rates + 15% (the exact formula is kind of complicated). The patient is responsible for paying the bills. Mayo tells Medicare and your Medigap insurer what the charges are. And - if Medicare covers the work - you'll get checks from Medicare and your Medigap insurer which pretty much add up to the amount Mayo has billed you. Assuming your Medigap policy covers the 15% (most Medigap policies don't - but ours do).

Most services are covered by Medicare. But - if Mayo thinks the services might not be covered - it will give you an ABN (advance beneficiary notice) before services are rendered. Telling you how much you might have to pay out of pocket.

When it comes to Medicare Part A (hospitalization and similar - Mayo has a hospital here) - Mayo does "accept" Medicare. I think you'd be responsible for "the 20% Medicare doesn't cover" if you didn't have a Medigap policy (don't know - we all have Medigap policies).

Mayo here is not accepting new Medicare patients in its primary care practice here. Therefore - if you want a Mayo primary care doctor - you have to join the concierge practice. Which my husband and I and my father did. We get about 95% of our medical care at Mayo. Everything except things like routine skin cancer screenings - routine eye exams and the like. We are for the most part very happy with the care we get.

I do know that Mayo in Rochester Minnesota works differently than Mayo here. It has departments we don't have - like pediatrics. And it even accepts some local Medicaid patients. Which Mayo here doesn't. I think that's because Mayo is basically the only show in town in Rochester for locals. It's far from the only show in town here.

BTW - I really don't know any doctors here who "accept Medicare" in the old-fashioned sense. I.e., that they accept whatever Medicare pays and don't worry about collecting the 20% or so that Medicare doesn't pay. If you don't have a Medigap policy to cover the 20% - you'll have to pay it out of your own pocket. Robyn
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Old 01-05-2016, 06:51 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,956,950 times
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Quote:
Originally Posted by Loriact View Post
They take Medicare, but don't accept the Medicare-assigned rates and may charge up to 15% more than Medicare will pay. The patient would be responsible to May for the overage.
That extra 15% or so - only applicable to Part B services - is covered by some Medigap policies. Like my husband's (Plan J - now discontinued) - and Plan F (which my father and I have). I think the coverage is called "excess Medicare reimbursement" or similar. Robyn
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Old 01-05-2016, 07:16 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,956,950 times
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Quote:
Originally Posted by borninsac View Post
Well I'm not one of those obsessing about long term care and I don't have a LTC policy but yes I do have an umbrella liability policy and I agree with you. I do have a good disability income policy that is very specific to my profession. I understand these policies are hard to come by these days.

I've bumped up deductibles on auto policies and home properties (both residence and rentals) to achieve lower premium costs because I'm willing to assume the risk. Ditto for health insurance policy. I have a high-deductible one because I'm willing to assume the risk in exchange for a lower premium which is still a lot of money at age 60.

And for the record, I don't buy extended warranties on major purchases. That's worthy of a separate topic discussion here.
I've heard the same about disability policies these days.

When it comes to health insurance - that is a big one in terms of necessity and cost. Good coverage was never cheap (except perhaps 30+ years ago). But - judging from articles I read and discussions on the Health Insurance forum - it is becoming a disaster area for people in their 50's and pre-Medicare early 60's who don't qualify for ACA subsidies/aren't on large employer group plans. In terms of the kinds of plans that are available and what they cost. In doing financial planning - I think it's really important for people to get a handle on insurance costs like this. Others as well.

FWIW - even Medicare is no bargain these days. Many younger people are under the impression that it is "free" - and it is anything but free. Robyn
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Old 01-05-2016, 07:31 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,956,950 times
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Quote:
Originally Posted by mathjak107 View Post
...What does this partnership mean to you?
If you're asking me - well I don't have an opinion. And couldn't/wouldn't form one on the basis of a summary and some second-hand information from a lawyer in New York. I'd have to do a lot of work to analyze the thing properly (which I always feel obligated to do when I'm saying anything that even approaches being a legal opinion). And I'm not going to do that - simply because I don't live in New York. Ain't got no dog in that fight . Robyn
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Old 01-05-2016, 07:42 AM
 
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ha ha ha ha, no , that was the FAQ question on the plan website that gives the summary of the plan . "what does this partnership mean to you ? "

Last edited by mathjak107; 01-05-2016 at 07:54 AM..
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Old 01-05-2016, 07:45 AM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,956,950 times
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Quote:
Originally Posted by mathjak107 View Post
...they are just giving you back your own money for 15 or 16 years...
Is that standard these days? Or is that 15/16 years with regard to a particular product/kind of product? With my father's annuities - he got all his own money back after about 13 years. The reason that's important for many people is that although the amount of money you're getting from a single premium immediate annuity stays the same - the amount that's taxable goes up from about 1/3 of the payments (IIRC) to 100%. Which - at least in my father's case - increased his MAGI enough so he has to pay Medicare Part B and D surcharges (not to mention a fair amount more in income taxes). People should take a look at these things in terms of the taxable income they can/will generate down the road - and the consequences of that taxable income.

BTW - when it comes to Medicare surcharges - they kick in at $170k of MAGI for couples - but only $85k for single people. And I wouldn't be surprised if these income limits are decreased in the future as Medicare faces more and more funding difficulties. Robyn
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Old 01-05-2016, 07:51 AM
 
71,896 posts, read 71,942,576 times
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basically you give the annuity company a sum of money . they hand it back to you at an agreed draw so the time frame is based on how fast they give it back to you .

you don't have a penny of roi , despite what the irs likes to imply so they can tax you in advance , until the day after you get all your money back .

the irs can assume you live to some age on a chart and assume you got a certain amount of interest each year but the reality is nooooo you have gained nothing in return on capital spent until you go on their dime .

different types of annuity's are taxed differently but that does not mean you made a penny with some types until you get back what you gave them . . .

basically you are buying a pension .

Last edited by mathjak107; 01-05-2016 at 08:31 AM..
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Old 01-06-2016, 11:43 PM
 
662 posts, read 481,369 times
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I haven't read the whole thread yet, but I'm tired and wanted to get this up. If what I've said below has already been covered, well, then this is just another story like it.

I've never read anything supportive of reverse mortgages from a source I respect.

And while I have little first hand knowledge of recipients of medicaid (and only one case in which a lawyer fixed things so the wife could keep the house), what I have seen isn't the sort of care I want for myself. I (and everyone) deserves much better. Something along the lines of dignity. My friend's father seemed to get about the same sub-standard care in the early 2000's that my grandmother got in the 1960s. My friend still can't talk about it.

I also don't like the idea of my home being confiscated for my care. And, as a sub-55 year old, I think medical advances may very well get me in and out of a facility in a much shorter time frame then the current model. Thus, I want a home to come home to. (I should note that while I do have an adult child, he will inherit 7 figures from his father, so I feel no need to save anything for him.) Plus, I'm searching high and low with no success, for a reputable (that's the key) and recent source of the top 10 reasons for admittance into NHs, ALFs, etc, as I have no family history of alzheimer's, dementia, stroke, or cancer on any side of my extended family. Heart attacks do run on one side of my family, but in people with HBP; I am an anomaly on that front in my family, as I have very low blood pressure. So I'm trying to figure that all in. Tricky business, to be sure.

Also, I've been debating putting my house into a family trust to protect it from medicaid (care? I need to clear my head on the distinctions) should my planning not work out. (I've yet to make a decision about ltci, and am leaning towards self-insuring, thus, the idea of the trust). I'm not sure how others who have no one to add to a trust would work this out. ie: can a couple of friends set up a trust, or can only blood relatives? If so, can you do it with a cousin who is also single? Both of you save your homes that way? (It might be a good idea to call that cousin you haven't spoken to in years, if they're your age and single. They might welcome the call.)

Another idea that grew from that is renting out the house while I'm in a facility (again, all based upon whether I can do the trust, and how, and so forth...I'm in the very beginning stages of looking at the very end). But I would have my son set some of that up - such as if I'm in a facility for two months and it looks like it may last a while, he could empty my house and put my things into storage.

Although I would think someone could do this without a relative. Pre-plan and find a good, responsible, respected property manager to handle it all. (Overseen, hopefully, by your attorney.) Their take is usually a 10% cut of the monthly rent - frankly an outrageous sum for a home in a good area: property managers do hardly anything unless a tenant is a nightmare. But it is what it is. Even if I go this route myself, I would use a property manger, but have my son oversee him/her, jftr, and, honestly, just because I do have him. I should also note that it's not in the common job description for a property manager to put things into storage...that would be extra.

So, if I could manage it, putting it into a trust, and renting it out while I'm unable to care for myself, using my son to empty it and set up a property manger, ..well...seems possible. Cover the taxes, upkeep and so forth.

As to your last point, I don't need annuities, as I have a defined benefit plan.

Last edited by crusinsusan; 01-06-2016 at 11:45 PM.. Reason: because i'm too dang tired and making mistakes! lol
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