Problems, Policies, and Proposals for Long-Term Care

The long-term care (LTC) crisis is on the rise for aging Americans. Industry driven, massively underpriced policies are playing fiscal catch up with hefty premium rate increases. This price increase is forcing some aging Americans to abandon their policy while others struggle to reduce their amount of LTC coverage to keep their rates affordable or reduce their future lifestyle by dipping into their retirement savings. Abandoning LTC policies turns out to be the last resort for many policyholders as they understand how valuable they are and that a policy lapse would cause them to lose all of their monies paid to the insurer.

Throughout the insurance industry, the metrics applied to the long-term care business model underestimated how long policyholders would live and the number of claims they would submit. Policyholders are living years longer than the actuaries had projected. Compounding the crisis of this flawed business model is years of very low-interest rates. On an inflation-adjusted basis, return on investment has fallen vastly short of needs for all long term investors, including pension funds, life insurers, and the average American saving for retirement. The financial fallout is that fewer people are seeking long-term care insurance policies and those that are, typically pay more and receive less coverage.

Further compounding long-term care problems is the escalation of Alzheimer’s diagnoses and other dementia diseases, which invariably increases an individual’s need for long-term care. Medicare does not make provisions for coverage in long-term care facilities. Even if you position yourself financially to qualify for Medicaid, which does provide for LTC, there is often a long waiting list and reportedly not a high standard of care when you become a resident.

Senator Patrick Toomey (R-PA) is preparing legislation that includes a clause to allow people to pay for long term care insurance via a tax-free withdrawal from their 401(k) retirement plan. The withdrawal, up to 2000 dollars a year, would not be subject to income tax, and the limit would be indexed for inflation over the years.

The Internal Revenue Service is also trying to offset tax liabilities for Americans that cover long term care insurance premiums in 2020. There is a range of tax-deferred dollar amounts depending on your age, and this information is posted on the American Association for Long-Term Care Insurance website.

Nakedcapitalism.com

Relying on the federal government to fix the long term care crisis is a cautionary tale. McKnight’s Senior Living reports that the LTC sector typically gets very little play in Washington, DC. Hospitals, doctors, insurance companies, and drug companies with big lobby monies are far more likely to receive legislative attention, often to the demise of long-term care operators and the vulnerable American population they support. Beyond the untenable high costs of LTC premiums, excessive administrative costs burden the US health care system. Washington DC, notorious for its complex, plodding policy progress, will not likely address the situation beyond creating tax-deferred access to retirement accounts and other tax incentives. Instead, the government is okay to allow the paying public to absorb the high costs of long-term care as the industry sector tries to salvage itself.

One of the worst outcomes of these scenarios is that long-term care has become such an expensive problem that Americans are shying away from proactive planning to address the very likely need they will require long-term care insurance in their future. The US Department of Health and Human Services has a website that addresses long-term care basics and provides resources, tools, and links to guide your LTC planning.

Other solutions can provide the essentials for long-term care packaged in different insurance programs. Short-term care insurance, or convalescent insurance, provides a long-term care type of coverage for 180 to 360 days. Because there is no long- term commitment to the insurance companies, premiums usually are less than traditional LTC. Critical-care or critical-illness insurance are two similar types of insurance coverage offering lump-sum cash payments to those who are diagnosed with a stroke, heart attack, and other serious illnesses. The benefits range can be six months up to two years, depending on the company and policy chosen. The drawback to these insurance policies is they do not cover pre-existing conditions. Deferred annuities for after retirement and annuities with long-term care riders can also be alternative solutions to traditional LTC insurance.

The time to get proactive and creative about long-term care insurance is now. Current statistics may give a false sense of security regarding the likelihood you will need long-term care. Projections are indicating between 65 to 75 percent of Americans will require some level of long-term care after retirement. The unspoken truth that many within the LTC industry and government do not address publically is that if the problem is not resolved, it will still ultimately go away because the person who receives sub-standard or no care will die. The idea that aging Americans would be allowed to languish without proper care when they are at their most vulnerable is unthinkable from a human standpoint. Pro-active planning to find a long term care solution is essential to your future health and financial well-being.

We can help you put a plan in place that includes accessing and paying for appropriate long term care. We can review potential programs to help offset some of the costs while creating a legal plan to protect your assets from the high costs of care. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your long-term plan needs.

Protected: What a Personal Property Memorandum Can Do in Addition to Your Will or Trust

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The Benefits of Having an Elder Law Attorney on Your Side

Elder law encompasses a wide range of legal matters affecting an older or disabled person. An elder law attorney or certified elder law attorney (CELA) specializes as a legal advocate for aging adults and their loved ones.  Issues related to guardianship, retirement, health care including advance directives, long term care planning, Social Security, Medicare and Medicaid, and other relevant matters to aging all fall under the umbrella of elder law.

Elder Law Benefits Senior Citizens

An older family member who legally prepares for their aging process helps their family members by addressing day to day issues that affect their actual care through proper legal documentation should the senior become incapacitated. Seniors often falsely assume that a close family member, including a spouse, will automatically be able to make decisions on their behalf if something goes wrong with their finances or health. Postponing legal document preparation through an elder attorney generally winds up being more problematic and expensive to a senior’s estate and wellness.

Many seniors find making legal preparations uncomfortable at first, as the task forces them to confront and assess their mortality. Further into the process, many aging adults experience relief, having removed the fear of the unknown of aging to the best of their ability. Legal preparation can keep a senior from health or financial ruin if they become incapable of making informed decisions regarding these matters. In the absence of legal documents, their family is left with the expensive and time-consuming process of petitioning the courts for legal authority to act on their loved one’s behalf – referred to as establishing a guardianship. By planning early and making sure the correct legal documents are prepared stress on the senior and the senior’s loved ones is greatly reduced.

Elder Law Benefits Family Members

Personal choices regarding end of life care and the disposition of assets and property outlined in legal documentation guarantees that your wishes will be respected by law. This documentation is especially important for seniors when a family member might seek control over the process, whether moral or self-serving, to follow their whims when handling your wellbeing when you are most vulnerable. Besides adhering to your expressed wishes, having your choices documented relieves family members from guessing what you want.

When preparing for your aging process, seek out a well-regarded attorney who specializes in elder law. While many general practice attorneys may have some experience with elder law topics, regulations are ever-changing and complex. It is best to find an attorney who specializes in elder law so that you get the best and most up-to-date advice.

Proactively address your aging process with a qualified elder attorney to make sure your wishes are carried out now, and in the future, regardless of what happens with your health. Both you and your loved ones will garner invaluable peace of mind knowing that your wishes are known and legally documented.  Please contact our office by calling us at (318) 255-1760 and schedule an appointment. We would be happy to help you with your planning and we look forward to hearing from you.

Understanding Veterans, Home Health Care, and Technology

In the quest to provide cost-effective, quality in-home care for veterans, the Department of Veterans Affairs (VA) has been surprising trailblazers. Although the agency has long been mired in controversies surrounding its programs, particularly arbitrary caregiver dismissals, the home health services sector of the VA has long been touted as an overall success story. As Thomas Edes, director of comprehensive geriatrics and palliative care programs for the VA puts it “We’re working in this environment of challenging budget constraints, and at the same time, we’re a very mission-driven organization. Put those together and what happens? That really pushes us to innovate.”

The VA Innovations

This innovation has seen home-based primary care for veterans quadruple since 2000, and all VA medical centers throughout the US now have a palliative care program as well. The VA Medical Foster Home program care has expanded from a pilot to a national program, recognized in at least 45 states and providing veterans housing as well as in-home care. These success stories are great news for veterans and a must for the Veterans Administration in part because the median age of a veteran is now 64 and the US aging veteran population is growing even faster than the senior civilian population.

It is not just the “new-comer” seniors straining the VA health care system. Nationwide the 85 plus population is on track to increase 70% from 2000 to 2020 according to the US Department of Health and Human Services. The overall unsustainability of the US health care system has forced the hand of the VA, and there is no more cost-effective way than through subsidized, at home family and community-centered health care and technology to meet veterans’ care needs.

The Official Blog of the U.S. Department of Veterans Affairs reports that Telehealth is revolutionizing veteran care and providing high-quality treatment for them. The VA Video on Demand is delivering convenient, accessible health care particularly to those 24 plus percent of veterans who live in rural and remote access locations. Telehealth is also important for those veterans who are disabled. Although a veteran might live in a city they might be unable to get themselves to a medical center for an appointment

Technology Trends for Veterans

Assisted living technologies for veterans include assistive mobility equipment – an ever-expanding category including wheelchairs, all-terrain vehicles, exoskeletons, and in-home ceiling track mobility systems. Each of these continue to be refined and specialized to meet the individual veteran’s needs. The Veterans Administration awards grants to develop technology to assist veterans and service members in modifying their homes. Adapted computer access and electronic aids to daily living and environment control units (personal assistants) provide customized interactive abilities for veterans.

Electronic cognitive devices help veterans who struggle with activities of daily living (ADL). These devices include personal digital assistants (PDAs), smartphones, pocket personal computers (pocket PCs) and other handheld devices, global positioning systems (GPS), reminder watches, pagers with reminder features, and digital voice recorders. The use of these devices helps a veteran stay on schedule with medications as well as stay connected with family, friends, and their medical monitoring community. Those veterans with Post Traumatic Stress Disorder (PTSD) are further helped with their ADLs when robots with artificial intelligence (AI) are introduced into their environment. These AI “tech bots” are capable of reading human facial expressions and can identify when a veteran is feeling particularly stressed, isolated, angry, or depressed. The robot can upload the information to the veteran’s caregivers thus alerting them to the need for human intervention. Wearable sensors can also alert a caregiver or medical professional when vital signs are outside of a normal, healthy range.

Disabled Veteran Opportunities

The VA will provide a payment to disabled veterans toward the purchase of a car or other transportation and additionally will pay for adaptive equipment, repair, reinstallation or replacement of necessary equipment due to disability. If a veteran has lost the use of at least one foot, hand, or has a permanent impairment to their vision or severe burn injuries or immobile joints that their limit mobility, the VA will help to fund the adaptation of the vehicle to make it fully operational to the veteran.

While the latest technology brings benefits to all seniors opting to age in place, the veteran community is especially helped. Many veterans would like the luxury of aging without combat or noncombat injury so inherent to military service. Some of the aging in place obstacles they must overcome are extreme, commensurate with the injuries (psychological and physical) they have endured. Navigating the benefits that are available to a senior veteran is complicated if you are not well versed in the process. Getting enrolled in the correct program and receiving benefits can also be a lengthy process, so it is best to seek help before wasting valuable time.

If you have questions or would like to discuss your particular situation, please don’t hesitate to contact our office by calling us at (318) 255-1760 and schedule an appointment.

 

Social Security Myths Debunked

Americans file early for benefits even though researchers claim it would be better to wait to claim their social security benefits. According to NerdWallet, more than half of Americans apply for social security before reaching their full retirement age, and more than 30 percent of those apply for benefits at 62 years of age. It DOES matter when you opt-in to take your social security benefit. Between the age of 62 and full retirement, your benefits increase by about 7 percent each year and additionally 8 percent each year between your full retirement age and 70. These percentages reflect an actuary adjustment to ensure those Americans who opt for a larger check for shorter periods do not receive less than those receiving smaller checks for more extended periods.

Current State of Retirement

Currently, full retirement age is 66 for those born before 1960 and 67 for those born after that. Social security benefits will max out at age 70 and by waiting that long your checks could be 24 to 32 percent more than what you would receive at full retirement age and a whopping 76 percent larger than what you would receive at 62. However, statistics show that only about 1 in 25 applicants will wait to collect benefits at the age of 70 when monthly benefits hit their peak. Economic hardship for some seniors clearly defines part of the trend in early benefit assumption, but what of those who have retirement planning in place?

Currently, low-interest rates and survivor benefit rules coupled with longer life expectancies generally mean most retirees would benefit by delaying their benefits as long as possible. Those destined to become super-seniors, living well into their 90s and 100s, can quickly run out of savings and may end up depending entirely on their social security benefits check. Having delayed taking social security provides maximum benefits for these super-seniors. Additionally, this older age group typically has qualities in common like a strong work ethic, positive outlook, close bonds with family, and a tendency to be religious. These traits factor into a purposeful life so that even on limited social security benefits when combined with the help of their family and community systems, they can still make ends meet.

At the other end of the spectrum are those Americans who feel, or know, they will have shorter life term expectancy. The Stanford Center on Longevity, however, reports that most people underestimate how long they will live. Today a 65-year-old man can expect to reach 84 years of age while a woman of the same age will probably reach 86.5 years. Studies by the Society of Actuaries are reporting life expectancies for those currently in their mid-50s (one in two women and one in three men) will live into their 90s. The cautionary tale is even if you project that you may not live long, you might indeed. It is best to anticipate being around and making financial decisions about social security benefits that reflect a longer life.

The Pitfalls of Claiming Benefits Early

Claiming benefits early to invest the money does not mean you will come out ahead and may put you significantly behind. There is no guaranteed investment product with a return as high as delaying your application for social security benefits. Claiming benefits early can also shortchange your spouse. A married couple will lose one of their checks when the first spouse dies. The loss of a check can create a severe drop in income even if the survivor receives the larger of the two checks. This benefit loss should incentivize the higher earner of the couple, with the larger check, to delay taking their benefit so that the survivor spouse benefit is more substantial.

You do not need to claim your social security benefit as soon as you stop working. Most financial planners will suggest tapping into other sources of income like a retirement fund or additional savings that allows your social security benefit to grow. Just delaying your benefits from age 62 to 66 can translate in a sustainable annual increase of 33 percent, so even a four-year delay can provide substantial returns.

The Future of Social Security

What about 2035 and the projected insolvency to fund social security benefits? If Congress does not act, the social security system will only be able to pay out 77 to 80 percent of the benefits promised. While this is not good, social security is not going bankrupt. The funding mechanisms must, however, get straightened out by politicians who want your vote to keep them in office. The silver tsunami of voters ensures that Congressional leaders and policymakers cannot overlook the senior demographic, which is critical to their re-election.

Each person’s or couple’s situation is different; their savings, assets, debt, work history, and retirement planning all vary widely. Additionally, according to Barrons.com, every state has a distinct annual spending threshold recommended for a comfortable retirement. To learn your best options and create your plan for a successful financial retirement, including when to take your social security benefit, talk to elder counsel. The social security benefit structure and rules are changing, change with it to maximize your benefits.  If you have questions, please don’t hesitate to reach out. We are here to help. Please contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss your planning needs.