This is the second part on what may be needed to provide for long-term care for an individual. As discussed in the prior post, there are three ways to pay for long-term care in the U.S.A.: 1. Self-Pay, 2. Long-term care insurance, 3. Medicaid. We discussed self-pay previously. Today, we will look at long-term care insurance.

Long-Term Care Insurance. If you were to need full-time nursing home care, the costs for southwest Oklahoma tend to run between $3,500 and $5,000 per month. If you have purchased a long-term care insurance contract, the provider of the insurance will typically cover most of this cost. I say “most” because the specific contract will dictate the amount that the insurance provider will pay and I typically do not see contracts that will cover all costs for as long as the individual is in the nursing home.

Long Term Care insurance is a great way to cover expenses should you need nursing home care, but there are two main things to consider when you look to purchase (or if already purchased, when you review your coverage) a long-term care insurance policy.

First, the policies are issued by companies that seek to make a profit on the sale of the policy, so one of the main things they consider when underwriting it is if you are healthy and what your family history is with these type of expenses. The main thing to learn here is that you should apply early for the policy and you should be aware that you may not get accepted for a policy. If you are accepted, then premiums will vary greatly depending upon when you purchased and what coverage you get.
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Second, you need to review what the coverage will be of your policy. When many of these policies first came out, they were great deals (meaning an individual often paid way less in premiums than he ultimately got out in payments). However, the insurance companies have learned to manage their risks much better since then, so most policies now have lifetime benefit limits or maximum montly payments that will be made. These are just part of the business, but if you have a policy that you may depend on, it is best to look thoroughly at the policy to see if one of these limits will affect you.

What should you learn from this? I highly recommend long-term care insurance, but you need to be aware that you have to first qualify for it to be issued to you and even after qualification, it may not cover all expenses of a nursing home, especially if you need the care for an extended period of years.

If you already have a policy, or if you are interested in a policy, then come by and meet with me and we can look at all aspects of your estate plan and we can ensure you get the policy your and your family need.

Today is the second day of oral arguments on the Constitutionality of the Patient Protection and Affordable Care Act (Obamacare). While the first day’s arguments mainly focused on the ability of the Supreme Court to hear the case, or if it should be deferred until a date when someone actually pays the penalty for not complying with the individual mandate, today’s arguments actually go to the heart of the individual mandate case.

Although most people that know me, know where I stand on this issue, there are some good writings out there. My favorite analysis comes from Legal Insurrection at http://legalinsurrection.com/2012/03/obamacare-oral-argument-day-2-the-mandate/ .
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One of the main things to consider is that if the government can force you to enter into a contract with any private company, what will be limit on its powers? How will this decision affect your ability to plan your own estate and assess the taxes that you will have to pay? And, lastly, do you, a citizen of Altus and southwest Oklahoma, want your health care decisions made by someone appointed in Washington, D.C.?

A recent survey of costs for nursing homes in southwest Oklahoma shows that typical costs for full-time care in a nursing home will cost between $3,500 and $5,000 per month. When it comes to these nursing home costs, there are generally considered only three ways to have it paid: 1. Self-pay, which is where you or someone you love pays the full cost; 2. Insurance pay, where a long-term care insurance provider pays for either the full or partial costs; or 3. Medicaid pays for the cost of the care. I will summarize each of these options so you can assess where your coverage would be, should you need long-term care.

Self Pay. This is where most individuals who need nursing home care now usually are. They have to use their own assets to pay for their own costs. This is considered the American way, and generally it is thought that if one can afford it, one should have to pay those expenses. The issue that arises is when you look at the costs ($5,000 per month) and you look at most people’s estates, the whole estate is used very quickly and there is nothing of a legacy to pass on to the children of the individual in the nursing home. The main issue I want to address and the assets I want to protect for the children come when the children depend upon an asset that may have to be sold to cover mom or dad’s nursing home expense.

The case that I think of is where a farm has to be sold. Dad was the owner of the farm, but Son had been farming it for years. When Dad had to go into the nursing home, he was in the Self-Pay category and had to cover the $5,000 per month expenses. Because rental on the farm was only about $7,000 per year, the Son had to give up farming because Dad was forced to sell the land. This not only caused Dad to incur taxes on the sale, but also caused Son to lose part of his livelihood because of the sale.
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Where does this leave you as an individual? As I said, self-pay is the American way, but that may not be the way it will have to be. With proper planning, you can look at one of the other ways to pay for long-term care expenses. We will look at them later and what you can do to get that proper estate and elderlaw planning.

The main thing to think about, though, is if your children rely upon your assets (or business) for their livelihood, have you taken steps to ensure that their ability to use that asset will not be placed in jeopardy if you are no longer able to care fro yourself?

I cannot stress the importance of funding your Living or Revocable Trust enough!  A trust is a great tool for passing a legacy on to your children or beneficiaries when you pass away, however, the Trust only covers property actually funded (transferred) to it.

I am in the process of probating an Estate for a deceased person here in southwest Oklahoma. The individual was drawn in by an Oklahoma City attorney who created a “cut-rate” living trust for him and his wife. The problem with a cut-rate trust is that you get what you pay for and what the couple received is just a skeleton. The Oklahoma City attorney did not follow through with any funding of the Trust or keep in contact with the client to know that their living situation had changed. After the creation, the Oklahoma City attorney put all of the burden on the client to transfer assets, and it never was completed.

So what does all of this add up to? I am having to complete a public probate for the couple and will incur around $3,000 in expenses for the client. All of this is necessary because the “deal” received from the Oklahoma City attorney of a trust for $1,500 wasn’t that good of a deal, after all. In addition, the cut-rate trust does not have any planning to provide for mom now that she is in a nursing home, so there will be additional costs to get it up to date.
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What lesson is there to be learned here? The better value is to stay local and have a qualified estate planning attorney complete your Trust. You should know who you are dealing with and you should know what you are getting as part of your plan. If you have any questions on your plan, please come see me now and get them addressed, so your children do not run into the same hassle as these new clients.

I want to leave you with the quote from the son of the couple mentioned above. He said, “I guess that Oklahoma City attorney just wanted a check [from mom and dad], and when she got it she was through with us. I wish we would have come to you, because now we understand all she was after and we should have done it right and local from the start.”

Looking at proposals to raise revenue to cover the federal government deficits, the one item the President always come back to is that the “rich don’t pay their fair share”, and that if millionaires and billionaires paid more equitable amounts, the deficits would disappear (or be lessened).

A study was just completed by the Joint Commitee on Taxation that the “Buffett Rule” would generate less than $5 Billion per year. The “Buffett Rule” states that individuals making more than $1,000,000 would be subject to an additional 5% tax on income.

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The main thing to learn from this lesson in the lack of restraint by the government is that taxes will have to increase for everybody, so now is the time to visit with a qualified tax and estate planner and to ensure that your assets are properly set up in a trust or other estate planning device to avoid future taxation by Uncle Sam when these deficits become due.