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Old 09-10-2017, 10:15 AM
 
Location: Grove City, Ohio
10,138 posts, read 12,398,078 times
Reputation: 13986

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The scenario would be a married couple both in their late 60's, on medicare, retired and not having long term care insurance. What happens if one has to be admitted to a long term care facility with Alzheimer's or other nursing needs?

I know it is a wise thing to have but some people simply can not afford and others, due to existing health issues, can not purchase at any price.

This would not be an issue of being negligent.

Let's put a value on the home of residence at $200k and they do not own any other property.

His social security benefit is $2,600 while the wife receives $1,300 for a combined monthly benefit of $3,900.

They have a combined savings and IRA accounts of $150k with most of this in the IRA accounts.

They have two cars; one is valued at $12,000 the other at $8,000.

The husband develops Alzheimer's and needs full time nursing home care. What happens to the spouse? What happens to his social security benefit? If they take half the total benefit the spouse not needing care can not afford to continue living where they are.

What happens to the IRA and savings account?

Same thing if the wife develops Alzheimer's, what happens?

What effect does having a Plan G or Plan F supplement have on this scenario?

In the long run as I understand it Medicare has to take care of the afflicted but what happens to the spouse that is not afflicted and might live another 20 years?
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Old 09-10-2017, 10:32 AM
 
1,227 posts, read 1,261,865 times
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Nicet4,

I don't know the answers to all of your questions.

Medicare does not provide long-term nursing home care. That would fall to Medicaid.

Gap Insurance pays what Medicare does not pay. However, I don't believe it covers long-term care.

I also think, but am not sure, that the answers to your questions depend upon what state you live in.

Generally, I believe that you and your spouse would be required to spend down to a certain poverty level in order to qualify for Medicaid.
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Old 09-10-2017, 10:56 AM
 
Location: Wisconsin
17,066 posts, read 17,389,275 times
Reputation: 41560
My state has a special program called "Medicaid and the impoverished spouse". The spouse that needs to have nursing home care, under Medicaid, gets that care and the spouse in the community gets to keep some assets (a house -under a certain value, a car, a pre-paid burial fund and a specific limit to savings) plus a certain amount of money each month (from their & their spouses SS/pension checks).

In my state, the spouse in the community can keep $2,300 a month (sometimes a little more) to live on. It may not be a large amount of money, but at least the state does not have to worry about elderly people being homeless and living under bridges so that their spouse receives the nursing home care that they need. Depending on your previous life style and your individual situation, and the COL in your area, this amount of money could be a hardship & very different than your previous life or it could be quite reasonable. I know in some cases, people have to sell their homes as the spouse in the community could not afford the mortgage, property taxes & upkeep on the reduced monthly income and in other cases that is not necessary (and can even be a very bad idea financially for the long run).

Depending on the assets that you start out with you do have to spend down to that specific limit of savings/assets plus there are many, many, many rules. And, of course, there is the five year Medicaid look-back period.

Please contact an elder care attorney and/or your local Counsel of Aging & Disability for more details.

My husband needed to go into a facility when I was diagnosed with Stage IV cancer (as I had been his 24/7 caregiver before that happened). This program was essential to our lives.

Good luck to you.

PS. As LookingatFL mentioned, Medicare does not cover nursing home care (except in very specific cases such as short term rehab after an illness or injury). You would need to qualify for the low income program Medicaid.

Last edited by germaine2626; 09-10-2017 at 11:15 AM..
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Old 09-10-2017, 11:10 AM
 
Location: Grove City, Ohio
10,138 posts, read 12,398,078 times
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Thank you germaine,

Nothing is happening with us, we are both in good health for our age and while I don't see any surprises on the horizon sometimes bad things just happen.
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Old 09-10-2017, 12:03 PM
 
Location: Philadelphia/South Jersey area
2,879 posts, read 1,408,873 times
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So my grandmother who was a widow developed and succumbed to Alzheimer /dementia.
We lived in NYC so we (my parents and her other children) sold her house, we moved her into an apartment and hired two home health care workers between that and her children she was fine.

It was about 4 years from the time she could no longer live by herself until the time she passed.
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Old 09-10-2017, 12:33 PM
 
Location: Wisconsin
17,066 posts, read 17,389,275 times
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Quote:
Originally Posted by nicet4 View Post
Thank you germaine,

Nothing is happening with us, we are both in good health for our age and while I don't see any surprises on the horizon sometimes bad things just happen.
Life can change in an instant. I was working full-time for years after Hubby developed mild dementia and it worked out fine. Then one fall down a flight of stairs and he needed round the clock, full time care due to a traumatic brain injury. Even that worked out well for 18 months until I was diagnosed with Stage IV uterine/ovarian/colon cancer and needed surgery and months and months of chemo-therapy and recovery. BTW, I had zero symptoms and it was only discovered via a fluke.

So, surprises can, and do, happen. It is best to try to be prepared.
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Old 09-10-2017, 12:48 PM
 
Location: Raleigh, NC
3,428 posts, read 9,257,592 times
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Quote:
Originally Posted by LookingatFL View Post
Medicare does not provide long-term nursing home care. That would fall to Medicaid.
Correct. And remember that the state usually decides where the patient will be placed, so don't assume the patient will continue to reside near their spouse.

Quote:
Originally Posted by LookingatFL View Post
Generally, I believe that you and your spouse would be required to spend down to a certain poverty level in order to qualify for Medicaid.
Also Correct.

Also note that, whether a LTC policy is used, or Medicaid is used, by law the level and quality of the care must be exactly the same.
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Old 09-10-2017, 12:53 PM
 
71,759 posts, read 71,853,273 times
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and we all now how that works when it is "by law "

by law a medicare advantage plan is supposed to cover the same things as medicare . guess what ?

each state is different as far as the what if's .
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Old 09-10-2017, 01:41 PM
 
Location: Central Massachusetts
4,800 posts, read 4,853,880 times
Reputation: 6379
Quote:
Originally Posted by nicet4 View Post
The scenario would be a married couple both in their late 60's, on medicare, retired and not having long term care insurance. What happens if one has to be admitted to a long term care facility with Alzheimer's or other nursing needs?

I know it is a wise thing to have but some people simply can not afford and others, due to existing health issues, can not purchase at any price.

This would not be an issue of being negligent.

Let's put a value on the home of residence at $200k and they do not own any other property.

His social security benefit is $2,600 while the wife receives $1,300 for a combined monthly benefit of $3,900.

They have a combined savings and IRA accounts of $150k with most of this in the IRA accounts.

They have two cars; one is valued at $12,000 the other at $8,000.

The husband develops Alzheimer's and needs full time nursing home care. What happens to the spouse? What happens to his social security benefit? If they take half the total benefit the spouse not needing care can not afford to continue living where they are.

What happens to the IRA and savings account?

Same thing if the wife develops Alzheimer's, what happens?

What effect does having a Plan G or Plan F supplement have on this scenario?

In the long run as I understand it Medicare has to take care of the afflicted but what happens to the spouse that is not afflicted and might live another 20 years?

First the easy answer is that the spouse does whatever it takes. If it takes selling the house or something you do it. I don't know exactly how I would do it or how my wife would if it were reversed. Probably the best answer I can give you on the financial aspect of it the most important things as a couple you can do is make sure each of you know how to access accounts and family around for some support.
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Old 09-10-2017, 01:47 PM
 
Location: Southern California
23,785 posts, read 8,301,716 times
Reputation: 15503
Quote:
Originally Posted by nicet4 View Post
Thank you germaine,

Nothing is happening with us, we are both in good health for our age and while I don't see any surprises on the horizon sometimes bad things just happen.
Take some prevention food type supplements for keeping the brain healthy. I do and I'm 79 and no one to lean on or to worry about. Grape Seed Extract is a GREAT support for all prevention of health issues.

There are many sites on Alz and Prevention, here is one on Dementia.

http://www.aplaceformom.com/blog/vitamins-and-dementia/

Some yrs ago I found myself taking .5mg Lorazepam for panic attack issues and along the way a friend was taking a low dose for sleep issues, she deals with CFS and found info on benzos and Alz link, both of us are totally OFF benzo use. There are many other keep "calm" supports.

There is also info on benadryl and alz link.

Last edited by jaminhealth; 09-10-2017 at 02:09 PM..
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