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camut
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PostSat May 22, 2021 12:46 pm 
LTCI is no guarantee that you won't end up in a nursing home.  Maybe you can begin to get some of your questions answered here:  https://agingoptions.com

If there is a senior center near you, they may also be able to provide you with info and resources for getting your questions answered.

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Randito
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PostSat May 22, 2021 9:34 pm 
camut wrote:
LTCI is no guarantee that you won't end up in a nursing home.

People reside in nursing homes based on their physical needs,  not so much who is paying the bill.

Nursing homes serve folks that require skilled nursing -- for example some friends of my family had family member with severe brain injury and was in a persistent vegitative state resided in a nursing home.

My mom was in the same nursing home a number of times following hospitializtion for an infection, after she now longer requires the high level of care provided by a hospital, but not yet ready to return to her assisted living facility.

The parent's of one of my brother-in-laws managed their aging years very well -- they moved with 3 other couples that they were already friends with into a Continuing Care Community,  which features independent living, assisted living and skilled nursing.     Independent Living is essentially living in an apartment when you do your own shopping, cooking, etc -- perhaps having the option of some meals being provided.    Assisted living, is similar, but with all meals provided and other services, like medication managment (ensuring that folks take their medication as prescribed), help with dressing and bathing, prompting and other forms of engagment and finally skilled nursing (aka "nursing home" services)   These sorts of communities typically require a "buy in" as well as a detailed financial inspection before joining -- but once you have joined they take care of you through the end.     It worked out very well for my brother-in-law's folks -- espcially the moving with friends aspect.

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Get Out and Go
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PostSun Aug 15, 2021 12:08 pm 
From the WA Cares website: 
Quote:
To qualify for benefits from the WA Cares Fund, you must have worked and contributed to the fund for:
At least ten years at any point in your life without a break of five or more years within those ten years, or
Three of the last six years at the time you apply for the benefit, and
At least 500 hours per year during those years.

This means employees who plan to retire in the next 10 years have to pay premiums, but will not qualify for the benefits.  rolleyes.gif   I will be retiring in another year or two and the withholding is not insignificant, all the more if one is closer to 10 years left until retirement.  I need to investigate if a long term care annuity might be the way to opt out, keep your money and be responsible for your own care.   Another kicker is that you cannot retire out of state and access benefits.
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Bowregard
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PostSun Aug 15, 2021 2:13 pm 
I haven't read the whole thread so this may have been mentioned before but if you do try to take advantage of the state plan guess who decides if you qualify? Your doctor can qualify you on a private plan but for the state plan the determination is made by a state employee. That's probably all I should say before my blood pressure goes up!

To answer the OPs question - yes, I am purchasing private and planning to opt out of the state plan. At least it is cheaper since I will retire before I can qualify for any benefits.

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Randito
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PostSun Aug 15, 2021 4:28 pm 
Additional note:  There has been some discussion of whether LTCI covers care at home vs care within a facility.

That is certainly worth checking into on a policy.

IME: A number of my family members have and parents of friends try to avoid moving out of their home as long as they can.    This is mostly due to fear of the unknown and fear of loss of control.

What I've observed is that this doesn't serve them well.

Staying in the house they have known for years is familiar.   However as a person becomes more limited in their ability to travel it become very isolating and depression is a frequent effect.    I've also observed that many long term close friends visit less frequently as a person's abilities diminish.

My mom had Parkinson's and her many friends stopped visiting with her as she became more limited in her ability to move.   This is disappointing,  but not unexpected as watching a friend become trapped in their own body is uncomfortable.

Another family member remained in their home as they never wanted to be subject to anyone else's rules.   But they became so isolated that visiting them was exhausting as they would try cram an entire week's worth of conversation into a three hour visit.

My mom really resisted moving to an assisted living place.   But two weeks after the move she said "If I knew I could have ice cream every night, I wouldn't have put up such a big fuss"

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Kim Brown
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PostMon Aug 16, 2021 9:16 am 
The HR at my firm has been on this subject like a bulldog; we've attended 2 mandatory workshops, and we're required to have a one-on-one meeting with the facilitator to help each of us decide whether to opt out of the state program, or purchase private.

Because of the 10 year vesting issue to get the program funded, I'll never see any benefit if I participate in the state program; so I'm planning on opting out and purchasing private, which my firm is facilitating the opt out process and they have selected a private provider for us if we want to use them. Plus the private policy we're being offered to purchase gives at least double the benefit; $36,000 (state program) won't go far for LTD.

I hope other employers are making it clear, and easy for their staff as mine is. It's not an easy issue.

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uww
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uww
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PostMon Aug 16, 2021 10:41 am 
Kim Brown wrote:
I hope other employers are making it clear, and easy for their staff as mine is. It's not an easy issue.

It's an easy issue for me- I want out. I'm actually shocked it has gotten this close without a legal battle pausing things.

I work for UW, and we have not heard much really-they have always offered LTC and get periodic spam from their 'partner' but pretty silent (or at least ineffective) from HR on the new requirement and options.

My partner's work was on top of it and had a company come in and make a presentation (and of course pass out applications).

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Bowregard
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PostMon Aug 16, 2021 12:19 pm 
My employer is following the same path as Kim's for the most part and I am in the same situation. But I have spoken with others who have not heard much at all about what is coming.

I have a relative in the insurance business and with so many people clamoring for a private solution it sounds like the backup is building so if you want to go the private route do it now or you may not get it though underwriting in time to opt out.

I am unsure about what to advise my adult kids. I suspect this may not survive long after the next election. If you were young would you invest in something that you know will give you an eventual return but might cost more or just find the cheapest way to opt out?

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Randito
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PostMon Aug 16, 2021 1:19 pm 
The new LTC insurance program paid for by a 0.58 % earnings tax is a response to the rising costs of providing long term care to seniors and disabled persons through Medicaid.

The anti-progressive aspect of it is that high income individuals can opt out of the tax if they document that they have private LTC insurance.

But there is no follow up requirement,  so a high income person can drop their private LTC policy once they have successfully opted out of the state program and potentially still become a Medicaid long term care recipient.

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uww
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uww
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PostMon Aug 16, 2021 2:29 pm 
You don't have to be a high income person to opt out, anyone can.

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Kim Brown
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PostMon Aug 16, 2021 2:35 pm 
uww wrote:
You don't have to be a high income person to opt out, anyone can.

True; I think the term “high income” is a little over-used in many cases; in this one, to opt out, you have to prove you have private insurance; typically a low income person can’t afford private insurance. After the person with private insurance opts out, they can cancel their private policy and pay no private premium, while also not participate in funding the public program.

Seems there must be a catch; as in the private company notifies the state..? Randito indicates there isn’t a mechanism in place for it. So – those who have can get away with not paying, while those who have not will have to pay.

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alpendave
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PostMon Aug 16, 2021 3:59 pm 
neek wrote:
fourteen410 wrote:
^ This. More people need to pay attention. I don't want to pay for LTC insurance but it will no longer be an option. If you don't want to be on the state's plan, you have to show proof of private LTC coverage. Ended up doing the latter bc the cost was the same but private had better coverage. Ugh.

this is what all high earners will end up doing.  there's a cap on the benefit, but not on the payroll deduction  dizzy.gif  bank for private insurers.  my plan: maximize healthspan, then jump off a cliff.  insurance is indeed just another form of gambling, where on average the house wins.

Jump off cliff, climb without a rope (just make sure you’re high enough), kayaking without a life jacket, anything to avoid LTC. I only want to breath when I’m really living and not a moment more. In my line of work, I’ve seen enough people live past their time in misery (money aside) that I sure as hell don’t ever want to. I only hope I don’t end someone else’s life prematurely in the process.

With that said, there is something to be said about going out like my grandpa. Peacefully in his sleep. Not screaming in terror like the other people in the car he was driving at the time.

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Randito
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PostMon Aug 16, 2021 5:21 pm 
alpendave wrote:
Jump off cliff, climb without a rope (just make sure you’re high enough), kayaking without a life jacket, anything to avoid LTC. I only want to breath when I’m really living and not a moment more. In my line of work, I’ve seen enough people live past their time in misery (money aside) that I sure as hell don’t ever want to. I only hope I don’t end someone else’s life prematurely in the process.

With that said, there is something to be said about going out like my grandpa. Peacefully in his sleep. Not screaming in terror like the other people in the car he was driving at the time.

These things are easy ro say when the discussion is theoretical.   However they become more difficult when they become real.

E.g. I have a relative with MS.  Their disease has been slowly progressing over the last 25 years.   This relation is a MD and self-prescribed a fatal dose of opiates for themselves many years ago, figuring when it got really bad  they would self-administer a peaceful and dignified death.

However now that it is really bad (nearly quadrapaliegec, partial use of one hand, blind in one eye, bowel and bladder incontinence, they are no longer considering using their dose, but are clinging to every bit of life they can.   "I've spent my career working to preserve life, I just can't bring myself to destroy it"

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Sallie4jo
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PostTue Aug 17, 2021 7:21 am 
Wouldn't that be nice.   I work as a Residential Social worker for DSHS...and I can only say that this conversation is incredibly important.   I work with amazing providers and some not so great.  One of the greatest challenges one will find is that those who are willing to provide care are often not people who have English as their first language.   Which also means their understanding of our vast culture is not great as they have not lived it.  AND the owners of the facilities get to choose what residents will be accepted.   Re MediCaid, they will "look back" five years on how money was used..so as someone said,  assets need to be transferred prior to those years.  MediCaid is the fund of "last resort"  so whatever monies you have coming in 1st go to pay for your care.  So if you receive $4000.00 month in retirement and your care cost charged is 5000.00, Medicaid will pay the 1000.00 that your money can't cover.  And the amounts charged 4 private pay care..is very expensive..and more expensive for more care.  Keep in mind the provider must pay the workers 24/7, insurance, food, rent, utilities,  and on it goes.  It is a business..and we have got to realize how difficult this work truly is .  Something taken 4 granted by many for far too long.  The thing I am walking away with is that most of us will be depending upon the goodness of strangers to take care of us, to wipe our butts and help us take a shower or even brush our teeth.  It is humbling

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Randito
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PostTue Aug 17, 2021 8:07 am 
From my experience with various aging and ill relations and friends relations.

I can confirm that many caregivers are immigrants,  from a wide variety of places.

I have also observed that a person's experience in a care facility varies considerably depending on the attitude of the person being cared for.

Some people are friendly and appreciative of the care they recieve and treat their caregivers with respect.   IME: These people needs are tended to with greater attention.

OTH: Some people aren't and have a chip on their shoulder about their circumstances.  One bad case I saw was a friend's mother who had grown up in the South and used the N word to refer to her Nigerian immigrant caregivers.    Another bad case was a relative moving into an assisted care facility after a stroke and called the head nurse the C-word during the intake interview and was often verbally abusive to his caregivers.

One cliché that I've learned through these experiences is "Alcohol and aging reveal, rather than alter a person's personality"

So regardless of how the bill is being paid, when one is able treat one's caregivers with respect,  one receives more attentive care.   Sadly when dementia develops,  sometimes people lash out in frustration.

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