Baby Boomers - Long Term Care Costs are Rising


Kiplinger - Why you need Long Term Care

Skilled Nursing - Medicare Coverage?  # 10153 

Skilled Nursing - Medicare

The Basics

A quick look at Medicare coverage of skilled nursing facility (SNF) care
What’s skilled nursing facility (SNF) care?
Why would I need skilled nursing or therapy care?
How do I find and choose a skilled nursing facility (SNF)?

Medicare SNF Coverage 

When will Medicare cover skilled nursing facility (SNF) care?
How long does Medicare cover my SNF care? 
Examples of Medicare skilled nursing facility (SNF) coverage
What does Medicare cover when I qualify for skilled nursing facility (SNF) care?

What You Pay

What do I pay for skilled nursing facility (SNF) care in 2015?
Ways to get help paying for skilled care and other health care costs 

Your Care in a SNF 

What’s an assessment?
What’s a care plan?

When Your Medicare Coverage Ends

What if I think my skilled nursing facility (SNF) coverage is ending too soon?
Plan ahead

Your Rights & Protections

What are my rights in a skilled nursing facility (SNF)?
How can I report and resolve problems?
What if I think my SNF charges are wrong?

Skilled Nursing Facility Checklist





Home & Long Term Care Insurance

Long Term Care Insurance  pays for help both in your home and nursing home, when you  can no longer care for yourself, that is you are not able to fully do 2 or more of seven Activities of daily living” which include eating, bathing, dressing, ambulating, transferring, toileting, and continence.  The money from your policy are not taxable as income and the premium can be deductible.   What are your Costs of Long Term Care and chances of needing Long Term Care?  

Medicare does NOT pay for Long Term Care (Page 147)..   Medicare may pay for 90 days in a nursing home after 3 days in a hospital.  Click here for Medicare Publication 10153 to learn more above coverage in skilled nursing, when you need medical care and not just maintenance.

Click here for
complementary Long Term Care Proposal


Long Term Care includes a wide range of mostly non-medical services that are designed to help people maintain the maximum level of independence.  Care can be custodial, intermediate or skilled in nature and can be provided in the home, (most claims are for in home care) community or institutional setting. Long term care can be provided in a formal (nursing home) or informal manner (home care, family & friends).

The Three main types of coverage are:

  • nursing facility,
  • home care  – here’s what Medicare covers publication # 10969 32 Pages
  • comprehensive, which includes both nursing and home care coverage.

Questions to ask yourself to figure out what you might need?

Miscellaneous Information 

Children can pay the premium on their parents policy.

Husband & Wife Planning – 2 page brochure

Benefits are generally income tax free, see the Taking Care of Tomorrow brochure for more details.

Premium Tax deduction if medical expenses exceed 10% or 7.5%  if over 65 Mutual of Omaha 

If your employer pays, it’s no income to you and the employer gets a deduction.

Medi-cal (Medicaid)  Welfare, might pay, however if you have $$$ or Property, they might put a lien on your home.

The average cost for a private room in a nursing home in Los Angeles is $175/day.  Average hourly home heath care is $15.Genworth CalculatorDaily Cost Chart 5% Compound

Get LTC Quote

Please email us [email protected] for more details.


More and ask your own question 


Can I be denied because of genetic testing?


The Genetic Information Nondiscrimination Act of 2008 (Pub.L. 110–233, 122 Stat. 881, prohibits the use of genetic information in health insurance and employment. The Act prohibits group health plans and health insurers from denying coverage to a healthy individual or charging that person higher premiums based solely on a genetic predisposition to developing a disease in the future. The legislation also bars employers from using individuals’ genetic information when making hiringfiring, job placement, or promotion decisions.[1] The Act contains amendments to the Employee Retirement Income Security Act of 1974[3] and the Internal Revenue Code of 1986.[4]

CA Law – genomics law * SB 559 – 2011 Padilla


See also worksheet from NAIC


Cut & Paste these questions into an email and send to us at [email protected] 

1. Seven percent of my annual income is approximately $_______________.  (This is the maximum amount of annual income experts advise spending  on a premium.)

2. The cash value of my non-housing assets* is $____________.  (This is the amount you would otherwise have to spend for long-term care.)

3. My non-housing assets would last _____________ years if I needed care today.  (This is the approximate number of years of coverage you might consider buying.)

4. I can afford to pay $____________ a day towards the cost of my own care.  The difference between the amount I can afford and the cost of care today is $_________. (This is the approximate amount of daily benefit you will need.)

5. I can afford to pay a total of $____________ for the first days of care in a nursing home. Therefore, I will need a waiting period no longer than:

30 days $__________ 60 days $__________ 90 days $____________.

(To determine the amount you would pay, multiply the daily nursing home cost times the number of days in the waiting period.) Copied from Taking Care of Tomorrow

Links & Resources

CA Health Care Advocates

Dave Ramsey on when you need Long Term Care  

Rate Increases?   Calif. Health Line 3.16.2016

How will we pay for LTC?   CA Health Line 3.16.2016

Asset & Income Questionnaires?  Do you have too much $$$ so you don't need LTC or so little it's Medi-Cal?

NAIC  National Assoc. of Insurance Commissioners

CA Taking Care of Tomorrow

Will annuities take care of your planning needs?

Long Term Care.Gov

Genworth - What is long Term Care

Total Living Coverage Brochure 20 pages Rev 11.2013

Privileged Choice Flex Rev 6.2015

the long term care

Life Happens.Org  - Long Term Care  

AHIP  Who buys Long Term Care Insurance?

Medicare Website on what Medicare Covers

American Assoc. for Long Term Care Insurance

Long Term

Sample Long Term Care Policy

Genworth - Care & Support for your family

Long Term Care Fact Sheet

Prevent & Report Elder Abuse CA Attorney General

Veteran's Administration on Long Term Care

Long Beach Breakers Hotel may lose license

Cal Pers 85% Rate Hike 2.22.2013

California Health Insurance Counseling and Advocacy Program (HICAP)

LTC Consultant’s

LTC Glossary   ♦  Long Term Care Glossary  ♦    Genworth Glossary

Home Health Care in CA  

long term

California Partnership Website
California Partnership 3 Page Explanation

California Department on Aging


Importance of Completing Application Properly Lawyer’s Website    Steve Shorr’s Website


CA DHCS Resources

California Partnership  Brochure  Rev 2010

CHFC Reports 7.2013

d i law

You Tube Video's on Mutual of Omaha Long Term Care....  

Borden Hamman Broker Training Video's  

How much does Home & Long Term Care Coverage Cost?

Click here for our proposal  and   needs assessment forms - click to enlarge 

Cost of long term care insurance

NIH Long Term Car

Rob Lowe - Maria Shriver Video


Suze Orman - Long Term Care

14 comments on “Long Term Care

    • Here’s a short term highly liquid MYGA Multi Year Guaranteed Annuity for those who prefer to pay out of pocket instead of going with a lifetime income solution to pay for care at point of need. For someone already diagnosed as impaired a pre-planning solution like the FG isn’t an option really, so I thought you may like to see this.

      It has an optional ROP rider, pays full account value at death, and has a 15% annual penalty free withdrawal available yr one. So, as an alternative to a bank account this is much more attractive as they client can get more interest on their funds while maintaining a high level of access and an exit strategy via the ROP feature. We would typically make the impaired the annuitant so at their death, the funds are 100% payable to the bene including interest.
      Preferred Series Annuity (Principal) – This is a super liquid fixed rate deferred annuity for those who opt to continue taking regular withdrawals from a lump sum they have set aside to pay for care)

      I’ve also included links to other solutions for your convenience.

      Point of Need Care Funding Solutions:
      Income Assurance (Genworth) – Underwritten SPIA to maximize income for the impaired
      LifecareXchange (GWG) – Turn Life insurance into cash even if the policy has no cash value
      Reliable Living Plan (Legacy/Americo) – 1st ever guaranteed issue single premium LTCi

    • Let’s take a look at Taking Care of Tomorrow by CA Department of Aging for definitions and explanations. I think once we get that, we can answer the question for ourselves. What is the “most popular” doesn’t necessarily apply to our or your situation. In fact, we are not allowed to say best in Medicare Advantage.

      How Much Does Long-Term Care Insurance Cost?

      The cost of long-term care policies varies according to the type of policy, the coverage provided, and the choices you make when you buy the policy. Some of the factors that can influence the cost of long-term care insurance include:

      • Your age and your health at the time you apply for coverage;
      Inflation protection and what kind you buy;
      • The deductible, waiting period, or elimination period you choose before the policy begins paying benefits;
      • The combination of the benefits you want included in the policy;
      • The daily or monthly benefit amount you want the company to pay when you need care; and
      • The number of years or total dollar amount you want the company to pay in benefits.

      How Much Will A Policy Pay?

      That depends on the benefits you choose. Most policies pay daily amounts (sometimes
      times called “daily benefits” or “daily benefit maximums”) from $80 a day to more than $300 a day for the covered services described in the policy.

      For Example:

      If you choose a daily maximum of $150 per day and your nursing home expenses are $200 per day, you will be responsible for the difference, $50 per day, or $1,500 a month. (This is your co-payment.)

      While you may have the income to pay this co-payment today, you need to be sure that you can pay it in the future too. Nursing home costs have increased 5.4 percent annually since 1980 and will continue to increase each year due to inflationary increases in the cost of providing care (refer to Chart #6).

      This means that the co-payment you choose will also increase. Once you qualify for benefits, many companies will pay your benefits on a monthly or weekly basis, which allows you or your caregiver to organize your care more efficiently.


      Some companies pay you for the cost of your covered expenses only “up to” the daily benefit
      amount that you chose when you bought your policy. In that case you will be responsible for any amounts greater than the daily benefit.

      In Another Example:

      If you choose a daily maximum of $200 and your nursing home expenses are $275, you will be responsible for the difference ($75).

      Conversely, if you choose a daily benefit of $200 and your nursing home expenses are only $150, a company that reimburses for covered expenses will only pay $150, the actual cost of your care.

      NOTE – more modern plans use the concept of a “Pool of Money

      Inflation Protection I think is pretty much self explanatory. Learn more on page 35.

      inflation protection

      See these webpages also:

        • We can reduce the premium/benefits. If we cut the benefits – potential payout to half that will still provide half the monthly LTC Long Term Care benefit and in in some policies 1/2 the death benefit.

          Even a small LTC benefit is still a huge value due to the leverage

          One has 70% chance they will need LTC services in their lifetime… That’s a greater risk than car accident, home damage, or pretty much anything else they already are paying insurance premium for.

          How about instead of self-insuring and paying dollar for dollar for care if needed, use the monthly pay AssetcareIV which has guaranteed premium and unlimited claim period. That way one might pay for example $1,208/mo click here for a specific quote for you – now which will provide them with 10,000/month combined LTC benefits (5k/mo each). That is leverage of 827% on the dollar. And if you never need care and both the husband and wife passed away their beneficiary(ies) get the $166,667 tax free death benefit. OR, if they want to cash out one day for some reason, the policy builds cash value which they could tap for any reason.

          More Clarification of Leverage

          When you pay a premium and it is buying you coverage worth more than you paid, that is leverage on your dollar. For example, paying $500/month in LTC premium for a monthly benefit of $5,000 for LTC is leverage of 10 times your premium

          See also

          If 1208/mo is too high for them to budget, reduce the premium/benefits. Half that will provide half the monthly LTC benefit and death benefit. Even a small LTC benefit is still a huge vaule due to the leverage.

          OR, though Mutual of Omaha LTCi is not guaranteed premium, it may better fit their budget at 942/mo premium for 10k/mo(5k each) LTC protection which is 1061% leverage on their dollar. Or reduce premium/benefits to fit budget.

          Need to relay the severity of the risk, and the power of the leverage, so it’s a no brainer versus self-insuring. Then it’s just, finding the premium to fit their budget and refining the coverage to maximize the benefits they can afford on their budget.

          • severity of the risk, and the power of the leverage, so it’s a no brainer versus self-insuring

            finding the premium to fit their budget and refining the coverage to maximize the benefits they can afford on their budget.

            We will research and update this….

  1. I am saving this web page URL (in my LTC folder) to keep its links to the State of California info regarding LTC.

    Even if affordability is questionable today, if a family member were to die and leave me enough money, I might be able to swing the deal. — As morbid a thought that is!

    Money can suddenly come from more than one source. — A lucky lawsuit, perhaps?

    • Sorry, No. Here’s an explanation from the 2005 Medicare & You Publication

      Long-term care includes non-medical care for people who have a chronic illness or disability. This includes non-skilled personal care assistance, like help with everyday activities, including dressing, bathing, and using the bathroom. At least 70% of people over 65 will need long-term care services and support at some point. Medicare and most health insurance plans, including Medicare Supplement Insurance (Medigap) policies, don’t pay for this type of care, sometimes called “custodial care.” Long-term care can be provided at home, in the community, in an assisted living facility, or in a nursing home. It’s important to start planning for long-term care now to maintain your independence and to make sure you get the care you may need, in the setting
      you want, in the future.

      Here are some of the different ways to pay for long-term care:

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