Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I'd like to gently tippy toe into a sensitive area that is relevant to this discussion. Has anybody thought about avoiding a long nursing home stay by moving to a state that has laws that give patients the right to die with dignity? Currently Vermont, Oregon, and Washington state have such laws. In order to be eligible for these programs you need to establish residency. As a practical matter, this may be so difficult that this is not a viable option.
Personally, I have no desire to live in a severely diminished capacity for a long time in a nursing home. I respect the fact that others may feel differently. I'm not trying to suggest this is an option others should adopt. For those of you who have thought about it, have you researched the viability of this option?
Last edited by HopHillers; 10-17-2015 at 06:38 PM..
Has anybody thought about avoiding a long nursing home stay by moving to a state that has laws that give patients the right to die with dignity? Currently Vermont, Oregon, and Washington state have such laws. In order to be eligible for these programs you need to establish residency. As a practical matter, this may be so difficult that this is not a viable option.
Personally, I have no desire to live in a severely diminished capacity for a long time in a nursing home. I respect the fact that others may feel differently. I'm not trying to suggest this is an option others should adopt. For those of you who have thought about it, have you researched the viability of this option?
Absolutely! We list having a 'death with dignity' law as one of the criteria in choosing a relocation place.
Regarding the residency requirement, I found this link:
Eligibility:
Terminally-ill patients who wish to obtain a prescription under the Oregon, Washington, or Vermont law must be a resident of one of the three states and follow a series of steps in order to be certified.
Among other requirements, a patient must be:
18 years of age or older,
a resident of Oregon, Washington, or Vermont;
capable of making and communicating health care decisions for him/herself;
and diagnosed with a terminal illness that will lead to death within six months.
Two physicians must determine whether these criteria have been met.
How does a patient establish residency?
A patient must provide the attending physician proof of residency according to the states' laws. There isn't a timetable associated with establishing residency. Proof can include a state issued ID such as a driver's license, documents showing the patient rents or owns property in the state, state voter registration, or a recent state tax return. The attending physician must decide whether the patient has adequately established residency.
How long does it take to establish residency? There is no minimum residency requirement. A patient must simply be able to prove he or she is a current, bona fide resident of Oregon, Washington, or Vermont.
Can a non-resident move to Oregon, Washington, or Vermont to use the law?
The law doesn't prevent anyone from moving to Oregon, Washington, or Vermont. However, reports show few—if any—patients have moved to Oregon, Washington, or Vermont to use the law.
I just got back home from visiting my 89 years old mother who lives 2.5hrs drive away. She is generally in good health and still puttering around in her garden in spite of being diabetic, has several broken bones which did not heal properly and with deteriorating eyesight due to glaucoma. She does not have LTCi and knowing her wishes and strong will, I am certain that if something happens, her stay in the nursing home would be quite short (if we could even get her there in the first place!).
Anyway, the talk about LTCi, cost and whether it is appropriate to consider insurance as an investment with ROI etc prompted me to open Excel program for some calculations for a hypothetical LTCi cost and payoff for my husband and myself based on our family health history (my PILs suffered multiple mini strokes in their late 70s/early 80s and ended their lives in nursing homes - 1.5 year for PIL and 3 mos for MIL; my father died suddenly of a heart attack few months before his 84 birthday and my mother's health as discussed earlier).
Instead of searching the web, finding some online calculator and punching in numbers, I decided to use the LTCi cost provided by mathjak since we also live in NY. I have been able to maintain my pre-diabetic condition with the family history, however it's likely that my LTCi cost will be similar to what mathjak is paying.
So, here are the numbers which go into my spreadsheet:
1. mathjak's annual premium of $6900 substract $1600 'rebate' from NY state for an annual cost of $5300. I keep the annual premium constant and the payout of $350/day constant and not adjusting for any hypothetical inflation value (assuming that they rise at the same rate).
2. I assume 19 years of payment (starting the insurance at 62 and needing LTC at 80, receiving the benefit at 80 but still pay for the premium while receiving the benefit). The 80-years-old start date is based on my PIL's history.
3. I assume a 10-month stay (based on the average of my PIL and the average 10 months for a male in the study cited in my earlier post).
4. The total premium for 19 years is $106,000. The total benefit received in 10 months is $106,458. So this pretty much breaks even.
If instead of paying the annual premium, I can put it in one of my portfolios which has been gaining 10% per year in the last 20 years. However, considering the current economic downward trend and assuming that I want to be more conservative for this particular pot of money, I use 5% annual return, at the end of 19 years, this portfolio is worth $175,250. After spending $106,458 in LTC (same cost as the benefit in 4), I will have $68,791 left.
Anyway, all of these calculations are just for fun. Some will argue that 10 months stay is the average and what if one needs to stay longer? Based on mathjak's information, the max benefit is for 3 years for the total amount of $383,250. So for this max out scenario, the LTCi seems like a good deal. Both my husband and I are pretty definite about not wanting to prolong our life living in poor condition so it is very unlikely that either one of us want to last that long in a nursing home.
I don't mind being repetitive in restating that "to each his or her own". If you are happy with your choice, good for you. There is absolutely no need to denigrate, challenge or ridicule other people's decision - unless you are not quite sure or have regrets about yours and try to defense it by attacking the opposite's choice ;-)
I don't know anyone buying LTCi that is trying to cover the "average" stay. Most are looking to cover 3-5 years. With three years most feel that they can cover another 2 out of pocket and make arrangements to protect the spouse past the 5 year Medicaid look back
Others realize that most statistics don't count all the home care that was provided by family in the past that they can't count on or choose not to put their family thru.
In your example you have no "coverage" for most of the early years. Your benefit 18 years later is also pretty insignificant. My insurance will be paying over $100,000 a year for home care and over $200,000 for SNF care.
These are just FACTS. Nothing to get upset about. If you know your need and when needed it sure makes sense to not worry about it. If it's TOO expensive or not important to you don't worry about it. If you don't trust insurance companies don't worry about it. I'm ecstatic with my LTCi. And even though I can self fund at this point the policy is so cheap for what it offers and it will allow me to have the very best care at home or in a facility that I would be silly to drop it at this time.
Now if there is a better way to provide that benefit then I am all ears. That is why I participate on these threads. That and to offer my experience with LTC and LTCi.
I'd like to gently tippy toe into a sensitive area that is relevant to this discussion. Has anybody thought about avoiding a long nursing home stay by moving to a state that has laws that give patients the right to die with dignity? Currently Vermont, Oregon, and Washington state have such laws. In order to be eligible for these programs you need to establish residency. As a practical matter, this may be so difficult that this is not a viable option.
Personally, I have no desire to live in a severely diminished capacity for a long time in a nursing home. I respect the fact that others may feel differently. I'm not trying to suggest this is an option others should adopt. For those of you who have thought about it, have you researched the viability of this option?
My understanding is that those laws only apply to terminally ill people, not folks with dementia, blindness, paralysis, etc. Is that right?
Regardless, I have no intention of retiring to a state because it has a right to die with dignity law. I have the plan and the means to take care of this at home. My friend is also a good friend of my physician and we are of the opinion he would certify that I died of a heart attack or some other natural cause..but I can't ask him directly about that, of course. Or could I?
My understanding is that those laws only apply to terminally ill people, not folks with dementia, blindness, paralysis, etc.
Yes, even in the few states that have legislation, the definition of "terminal" is extremely limited. The conditions that (imo) we seniors worry most about - Alzheimers, Parkinson's, etc. - don't apply.
Nor do pneumonia or most cardiac conditions.
Last month a friend lost her elderly dad to pneumonia. The doc said they could give him antibiotics or not. The dad and family opted not. For the elderly, medical directives and powers of attorney can achieve in all states what death with dignity laws in a few states cannot.
Thank you for your insights. This was exactly the kind of information I was trying to learn. In particular, I did not realize that dementia, Parkinson's, blindness, and certain other awful conditions were not considered terminal.
May seem like opening a can of worms here but think when (not if because we all know it is coming) changes are made to Social Security it is time for the USA to look at some sort of national long term care scheme. This instead of shifting what limited LTC provisions there are onto Medicaid
Even for those who can afford and find LTC insurance costs are going way up in relation to what you are getting. Many companies made bad bets (that their customers would basically die shortly after or before claiming benefits) that didn't pan out. So places are either trying to get out of that line of business and or raising prices to compensate.
Over the past decade or two there has been a major shift from nursing homes to "aging in place". That and or various assisted living communities. All things IIRC Medicare does not pay for and Medicaid very little if and when you can find decent providers that will take.
If everyone paid a small amount via payroll taxes for a new part of Medicare designed to provide LTC it would take a huge weight off many American's shoulders now and in future.
May seem like opening a can of worms here but think when (not if because we all know it is coming) changes are made to Social Security it is time for the USA to look at some sort of national long term care scheme. This instead of shifting what limited LTC provisions there are onto Medicaid
Even for those who can afford and find LTC insurance costs are going way up in relation to what you are getting. Many companies made bad bets (that their customers would basically die shortly after or before claiming benefits) that didn't pan out. So places are either trying to get out of that line of business and or raising prices to compensate.
Over the past decade or two there has been a major shift from nursing homes to "aging in place". That and or various assisted living communities. All things IIRC Medicare does not pay for and Medicaid very little if and when you can find decent providers that will take.
If everyone paid a small amount via payroll taxes for a new part of Medicare designed to provide LTC it would take a huge weight off many American's shoulders now and in future.
Interesting concept. I am not sure it would get past the current electorate. It would work though as well as SS has over the years.
The trouble I see though is we still give too much away from our hard earned pay to taxes that others who do not pay in and don't want to. I am all for giving support to folks but I am not for giving away the bank on people who do not contribute and can.
Interesting concept. I am not sure it would get past the current electorate. It would work though as well as SS has over the years.
The trouble I see though is we still give too much away from our hard earned pay to taxes that others who do not pay in and don't want to. I am all for giving support to folks but I am not for giving away the bank on people who do not contribute and can.
Well that is it, isn't it? We know already from FICA tax collection what works and does not in terms of bringing in required revenue to fund any such LTC scheme.
Clearly the first change from regular SS would be that premiums would have to be based upon marital status. That is you cannot charge single persons and married couples the same amount if the latter is to include a non or under employed spouse.
Unless Congress would be willing to front load a vast amount of funding to kick start the scheme there would have to be some sort of lag between contributions and first payments. So this scheme would end up benefitting mostly the youngest Boomers and the generations coming afterwards. Again that is unless Congress would be willing to pony up.
Next *EVERYONE* would have to pay something regardless of income being earned or unearned. While Mr. Zuckerberg and the other "one percent" probably can safely say they can self fund LTC for themselves, spouses and or children/family members; there are plenty of households considered "wealthy" that could be ruined by LTC costs.
This would be a plan for those who have worked/contributed. The indigent and or those on SS disability could continue to receive whatever LTC benefits are provided by Medicaid.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
