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The husband and wife are in good (not great) health and have excellent medical insurance. I would like to determine the recommended amount that should be kept in liquid cash reserves for anything unexpected at this age.

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Cash? I would only keep what they need monthly accessible to them , or they may be tempted to gift it away.
Reserve/Savings: enough for two years of private pay in a facility. If you can private pay for two years, they will be glad to take you and convert to Medicaid after two years. That could easily be $500K, but keep it in safe investments, not in liquid cash.
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Thank you pamstegma. They currently have monthly SS# and pensions with one small annuity distribution annually that gives them more than enough to cover their annual assisted care needs. There is; however, about $50K in cash that is just sitting in checking accounts. The couple are my husband's parents and my husband thinks that they should have all the cash fully liquid in the event something serious happens where their care needs accelerate. They have had a number of health issues in the past 5 years but at this point it has mostly been covered by their insurance. Now that I think about it, I'm not sure if they have long term care insurance or not.
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I agree with his decision. Their level of care could increase at any time.
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andreada, hopefully your husband's parents have someone who is their financial Power of Attorney.... that person can sell stock, cash CD's, etc.

If the money is sitting in bank accounts, whomever is the Power of Attorney will need to add his/her name to the accounts so he/she can write checks for your husband's parents, etc.    I can fully understand having $50k in checking, it kind of like a security blanket.

I agree with Pam above, with today's cost, if one needs to go into senior living and be self pay could easily cost $500k for two people.   I see from your profile that your husband's parents are already in Assisted Living.   Thus there must be some health reasons for them to be in a caregiving residence.   At 78, they are still quite young by today's standards.
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I'd be concerned that at 78 already in AL with health concerns, they are going to outlive their $ and their ability to private pay for NH care. Right now they are ok for AL from their income but have only 50K in savings plus the annuity. That's it, right? If NH where they live are double or more of AL costs, they will run out of funds within a year or so if they both go into a NH. They will end up applying for NH medicaid. The costs of care are just staggering.

I'd more plan that this scenario is the future. The opportunity for doing any creative Medicaid planning is kinda past if they both have health issues & already in AL. The only thing I can think of that could be looked at is IF they have each other as their life insurance beneficiary. It could instead be set up to be a special needs trust & Medicaid compliant. It's something to discuss with an elder law atty.

So what's the situation with the annuity? If they will need a higher level of care perhaps sooner in their early 80's, your hubs may want to think about doing whatever is the maximum withdrawal annually withOUT penalty each year from the annuity. Often elders get sold annuities that wind out in their 90's. And invariably they run through their other $ and need a NH and apply for Medicaid in their 80's. So have to quickly cash out annuity with penalty to spend-down & qualify for Medicaid. The annuity is an asset for medicaid which limits assets to 3K total for couples. To me, you want to keep a cash out annuity penalty from happening if you can. Review their policy carefully to see whats what.
Good luck and keep your sense of humor going.
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I have been wondering about this also. My wife and I have annuities we haven't started drawing from and that are guaranteed to pay a certain amount annually as long as we live. My idea is to start taking a payment each year now and putting that money in CDs or something until we need it, so we have more years' worth to use in the future. If we live long enough, we will have taken out more than we started with, possibly by a lot. I am also considering long term care insurance paid by the annuity if that seems to provide more dollars. We have no idea, of course, how our lives will play out. We are in good health, our home is remodeled to "age in place" if we can avoid AL or nursing homes, but with the cost of those today and the cost of in-home care, we still wonder about the best path to take. If we end up not needing that annuity money, it can then go to our son and family after we pass, so the more we have when that happens, the better. We have two very young grand children that will face who knows what for college costs. If we throw in the value of our home to the total amount of money, it will take a long time to be eligible for medicaid, so for now, using medicaid is not in our thinking. With everyone's situation so different, it is probably impossible to come up with a strategy for people in general to consider. If there is one, I certainly would like to find out about it.
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I don't think you actually mean to keep cash in the home. I think you mean how much for you should save. See your investment counselor and have them put long-term care into your portfolio.
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If I had $50K that I didn't know would be needed tomorrow, I would consider investing it in a conservative bond fund, such as those offered by Fidelity or Pilgrim. They get higher interest than setting in the bank and can be accessed in 4-5 days if there are needs. The downside of them is that, though they are fairly low-risk, they are not risk free. The value of them can change from day to day. The upside of them is the interest is usually fairly good and can be reinvested to buy more shares of the bond fund. Or the interest can be used as extra income each month -- whichever you choose. I have a fairly good bond fund with Fidelity. The value of it has taken a tumble with the new federal administration, but the interest is still decent.
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