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I just discovered the long term care insurance my mother took out about 16 years ago had no inflationary clause. Meaning after all these years of paying premiums, her maximum daily allowance is at 1999 rates - $100/day. Respite care is half that. She also has a 90 day exclusionary period for NH before they will enact the insurance. How doea this work with Medicaid or any VA Aid & Assistance? The policy is for around $75,0000, but cannot be cashed in, just used for care. ( It s better than nothing, but I think she would have been better off putting the money in an investment.) Too late for that, but need some advice. In the great state (sarcasm) of Illinois.

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Also some NH will not take LTC policies. My moms 2nd (&better) NH was only Medicaid or private pay. Business office told me that they stopped dealing with LTC insurance as the paperwork and compliance was just too heavy as the companies want staffing details, info on staff training, etc & not worth the time and delays after delays. So be sure to ask clearly when looking at facilities as to what the accept for payment.
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GG - your thinking that mom is going to need Meducaid to pay for NH in the near future right? If so, you might want now to start planning on this. Medicaid will want something in writing as to there being NCV - no cash value on the policy. I'd try to get that request going with the insurance co as it could take time.....

.then find out what moms state has as it maximum monthly income for Nh Medicaid. It will vary by state - like TX it's $ 2,163. If moms monthly is below the amount, you may be able to have the $100 ltc a month viewed as income and she qualifies for Medicaid as she is within income limits even with the big 100. Also if she is getting A&A, it will stop once she goes into NH/ skilled nursing care but she will get a $100 personal needs stipend from VA that does not have to be paid to the NH as income.

8k is about average NH room & board monthly cost. East coast ones more 12-15k. Southern less 5k. NH have a tiny profit margin as staffing & equipment costs and liability are high. Now AL, well those are little cash registers of profit. Really if you live long enough you will end up needing skilled care & caregivers will run out of steam and you will run out of funds. So hello! Medicaid.
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GGSgirl I did misunderstand....WOW, that certainly is not enough to cover the NH costs... AND yes, an investment would have been a big payoff by now. WOW. I am so sorry about that.

Not being that familiar with Medicaid I cannot answer your question. But, it sounds to me that the NH is way higher than I would have to pay here in Oregon. It would be about 3500 a month here for one bedroom and less for a studio. (SEAVIEW INDEPENDENT LIVING) But, if she needs extended care YES, it goes up to $8,000 a month. I was totally shocked when a friend of mine had to pay $8,000 a month for his wife in a NH. JUST BECAUSE he was not eligible for State care. It nearly cleaned him out and it was a blessing she died before long. I hate to say that, but the friend was already himself in a wheel chair and struggling. They both worked SO hard their whole life only to have their retirement money totally cleaned out before they could get outside help It is SO unfair. He died within 1 year. He probably could not handle the bills anymore.

$8,000 a month to me sounds way out of order. It was enough to scare me and I will take care of my Partner and hire someone to come in before I give them $8,000 dollars a month. I could have around the care help for less than that. Our system is so screwed up. The help these places hire are not even trained in a specific field and are trained on the job. How in the heck can they charge so much?
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Oregongirl, I don't expect anyone else to pay while she is fully able. And don't get me wrong, I appreciate every little bit of help. The respite care is not an issue, but if she did that her insurance pays only $50/ day - not even close to the NH daily charge. But that she can handle, and for my hospital stay will probably do home health & apply for a reimbursement from the insurance.

What has me more concerned is, should she have to become a full.time resident of a NH, her insurance pays only $100/day. She will run out of her own money/assets paying the balance out of pocket way before the insurance benefits are used up. How does that then affect Medicaid? Not sure the insurance she bought was a great deal. She's spent close to 45 grand on premiums so far - and, yes, insurance is a gamble, but I still think under the terms of the insurance, a private investment would've been wiser. Any other thoughts?
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Oh my gosh, you are so lucky she took that out. I had one and due to the economy and my job, I had to stop paying on it. I guess I don't understand the question. If she has this money, why would some other entity have to pay anything?
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OK let's say you get her to respite for 89 days. No coverage.
Medicaid would NOT want you to cash it in, but they would expect you to use it up. That will take 25 months. I would have it pay directly to the Nursing Home.
Be glad she has it, because it will open many doors that Medicaid alone will not.
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