Posts by Romeo Raabe

This is my 27^th year of doing Long Term Care planning exclusively.  Many of my clients come by referral from financial planners and attorneys all over Wisconsin.

You can check me out at www.TheLongTermCareGuy.com,  Call me at (920) 884-3030 to schedule a visit or just ask questions.

Stay safe from the Coronavirus, you do not need to go to a seminar to investigate how you might find help.  We can talk on the phone, or you can come by my one-person office.

While it may be prudent to stay at home right now due to the Coronovirus, questions about how to handle long term care for someone who now needs it will arise.  While I cannot help find care, I can offer ideas on how to access benefits to pay for such care.

Are you aware that there is home care coverage available to anyone – no matter health or diagnosis – who can currently live on their own for 30 days?  It will pay a neighbor or a home care agency to provide that care at home when it becomes necessary.

There is also coverage for assisted living or nursing homes that will pay for a year of such care, and the cost is quite reasonable–$17.87/month at age 50.  If you have been turned down for Long Term Care insurance, there is a good chance that this may still be available.

If someone is already in care, and spending savings down to Medicaid impoverishment, there may be a way to protect some of those savings for family that fits Medicaid rules.  No matter what the health or financial situation, there may be a plan for you.

You do not need to go to a seminar to investigate how you might find such help.  We can talk on the phone, or you can come by my one-person office (I have not been outside of Wisconsin since February 1).  It is important to call ahead to schedule a meeting to investigate.

For those of you who realize that your IRA and 401K has shrunk considerably, and you do not feel wealthy enough to pay for $50,000 to $90,000 a year of care out of pocket, you might consider investigating Long Term Care insurance for yourselves.  It can pay for years of care and save your wealth to pass on to heirs, instead of spending it for your nursing home care.

This is my 27^th year of doing Long Term Care planning exclusively.  Many of my clients come by referral from financial planners and attorneys all over Wisconsin.  You can check me out at www.TheLongTermCareGuy.com,  Call me at (920) 884-3030 to schedule a visit or just ask questions.

Over 550 nursing homes in the United States have closed in the past 4 years!

Over 550 nursing homes in the United States have closed in the past 4 years. Almost 60% of them—328—closed in just the past 20 months.  Wisconsin was one of 9 states that accounted for more than half of the closures. Brown County, WI, where Green Bay is located, has lost 4 in the past 4 years. The latest is one located at the corner of Webster Avenue and Mason Street, closing in March. While these closures have an impact on the residents and the community at large, they can hit rural areas even harder, as rural areas have few (if any) alternatives.

Nursing homes make their money two primary ways.  The first source is Medicare.  Most call themselves rehabilitation centers and provide short term recovery care following a hospital stay.  This is paid for by Medicare, as long as patients are making progress in recovering.  The second source of revenue is from people who live there who and are not progressing toward recovering and returning home. At a typical cost of $11,000 a month or more, most residents in this group run out of money to pay for their care themselves and end up on a welfare program called Medicaid.

The duration of rehabilitation care allowed under Medicare is getting shorter and shorter. Medicaid pays nursing homes much less than the cost to keep a resident, causing homes to go broke and close.

Most long-term care (LTC) is provided at home or in assisted living facilities – but each year fewer and fewer assisted living facilities accept Medicaid.  If you need care and can’t afford home or assisted living facility care, it’s the welfare-supported nursing home for you.  And now there are fewer and fewer.  Do you see the problem?  Where do you go when you cannot afford LTC?  When there is “no room at the inn”, you have to resort to other less appropriate alternatives–perhaps your children have a spare bedroom, a hospital bed in the living room, or one of them retires early (even if they can’t afford to do that) and care for you.

What does this mean to people who are planning on Medicaid paying for their LTC?  They are likely to see the proverbial “NO VACANCY” sign on at the few nursing homes that remain open. If they cannot pay for the care they need when their health changes, they will be in despair and at a loss for options.

Have you addressed this need that many of you will face?  Will you be prepared?  Do you know how to choose LTC insurance products that are appropriate for your situation?  Most people need far less insurance than they might imagine. If this is not something you are familiar with, why not consult an expert with over 26 years of LTC planning experience?

Consider using www.TheLongTermCareGuy.com to help investigate this.  Even the wealthy buy LTC insurance so they can leave their wealth to whom they wish and their children do not have decide what to liquidate first.  People with little nest egg need advice too.  A client at age 50, in poor health, with little money, can buy a 1-year policy for LTC of $9000 a month for $214 annually – that is $17.83 a month.  Most anyone can afford that.  I have solutions for nearly every health or financial situation.  Let me help you investigate this.

Romeo’s has 27+ Years Experience giving Advice Dealing with Cost of Long Term Care

I just viewed an email from a stockbroker containing information on Long Term Care (LTC) and LTC insurance.  It mentioned that 70% of people who reach age 65 will need LTC services.  That statistic is accurate and comes from the US Department of Health and Human Services.

The email then went on to say how long the typical stay in a nursing home is, and the typical cost per year.  Those numbers are irrelevant today, and that they were quoted shows how stockbrokers may not be knowledgeable enough to help you plan for LTC. They may be excellent at investing money but most are not familiar with long term care.

Stockbrokers and other investment sales people typically have a very limited array of LTC insurance products they can offer.  They can only hope these limited products are the most appropriate for any particular client.  In addition, most have very limited experience in dealing with LTC costs, facilities, or how services are used.

Very few people today will need to stay in a nursing home unless they are sent there for short term rehabilitation care following a hospitalization.  This post-hospitalization rehabilitation care is paid for by Medicare, your health insurance.  The other people living in a nursing home are primarily there because they ran out of money paying for care and had to fall back on a welfare program called Medicaid.

Most assisted living facilities no longer accept Medicaid as it pay less than the costs of care, but nursing homes who accept Medicare for rehabilitation care (their cash cow) must.

Today most LTC is provided in your home or the assisted living facilities, which can do nearly everything a nursing home did 20 years ago.  Thus, in my planning with clients, we determine the amount needed for them to pay for homecare or assisted living care.  These two kinds of care cover nearly 98% of the risk. People are happy to know that assisted living typically costs thousand less per month than nursing homes, and the amount of insurance needed reflects that.

Get Expert Advice Dealing with Cost of Long Term Care

If you are planning ahead, and investigating LTC insurance, consider doing so with someone with years of experience in doing just this.  I am in my 27^th year of planning exclusively for LTC and how to pay for it.  My business comes primarily by referral from attorneys and financial planners from across the state of Wisconsin who realize they cannot be all things to all people.  I am happy to help their clients find the best, most reasonable, and appropriate solution to finance LTC.  I also can counsel people on how to best qualify for Medicaid if that is needed, and possibly protect some of their assets from the costs of care.

So, feel free to contact Romeo Raabe LUTCF, LTCP at www.TheLongTermCareGuy.com or by calling (920) 884-3030 to schedule a meeting to investigate.

Are you worrying about putting off long term care planning?

Are you one of the people worrying about putting off long term care planning?  Sure, it’s no fun to think about, but it’s actually a fairly simple discussion.

First, some good news: Contrary to what you might think, most people do not need to worry about having to live in a nursing home.  These days, the only people who must live in a nursing home are those who have run out of money paying for their care, and then need to apply for a welfare program called Medicaid.

Medicaid pays facilities less than the cost of care.

Because of this, many of the much nicer assisted living facilities won’t accept Medicaid – but federal law says nursing homes have to.  So, if you can afford the assisted living facilities or home care, you are in good shape.

Most assisted living for hands-on care costs between $4000 and $6500 per month, while caring for those with dementia (40% of all LTC) can easily cost $8500 per month.  Home care typically costs less, so this is the planning number I start with.

Your Social Security and pension income continues for your lifetime.  Your savings, including your 401k or IRA, probably earn interest, so we take into account what it can contribute monthly to your available income without using up principal.  Only the shortfall between this total income and the anticipated costs of care needs come from some other source. There are two alternatives for this—either you need to spend down your assets or consider LTC insurance.

Remember, your lifestyle will change drastically when care is needed, so expenses like golf, extra vehicles, boats, motorcycles, campers, trips to Branson, cruises, etc. will diminish significantly when care is needed.  Thus, more of your income is available for care costs than you might imagine, meaning less insurance is needed.

Then, using your age and health, we can choose the best company for your situation and give you prices.  Now it’s your turn to choose – is this worth it or not?  It’s your choice.

See, it’s not difficult, but having someone with 26 years of experience guiding you through this can be very helpful in choosing appropriate coverage and keeping costs low.

If you are ready to stop worrying and start investigate solutions, call an expert.  I’m Romeo Raabe, and I want to be your Long Term Care Planner– it’s all I do.  There is a reason so many financial planners and attorneys send their clients here for good advice.  Call me at (920) 884-3030 or check me out online first at www.TheLongTermCareGuy.com  You’ll be glad you did.  I can help people in almost any situation, even those already in care.

Providing long-term care to a Burgeoning Elderly Population isn’t the problem. We know how to do that. Paying for it is.

Providing long-term care isn’t the problem. We know how to do that. Paying for it is.

So, I’m going to define the long-term care financing problem. Both government and scholars have focused corrective action on symptoms of the problem instead of its causes.

Long-term care for our Burgeoning Elderly Population includes a broad range of social, medical and custodial services that caregivers provide for three months or longer to help disabled people of any age perform activities of daily living such as eating, bathing, and toileting. Our focus is long-term care for the aged.

Let’s briefly restate that the this is a big issue. You know we have an aging baby boom generation. The numbers of beneficiaries already stressing Medicare and Social Security. They’ll overwhelm Medicaid, the dominant long-term care payer, when they start turning 85 in 2031. The U.S. age 85+ population, the cohort with the highest long-term care need, will triple between 2015 and 2050.

After age 65, people have a 70% probability of needing extended care, and a 5% probability that long-term care users will need ten years or more costing hundreds of thousand–even millions–of dollars. That there’s this gap between the number who need care at all and those who need extended care makes it possible to obtain insurance to protect you.

Care is very expensive wherever it is provided.

On average, nursing homes charge $9,500 to $11,000 per month.  Assisted Living costs $4,000 to $6,500 per month; dementia care can easily reach $8,500 or more.  The U.S. spent $366 billion on facility-based long-term care in 2016. Families and friends provided an additional half-a-trillion dollars’ worth of unpaid care, at huge financial and emotional distress.

Family-provided care is not free. It requires much time off from work, early retirements, declined transfers and promotions, and a surprising amount of out-of-pocket incidentals.  Then there is Medicaid, a welfare program that favors nursing homes (just where you do not want to end up) because most assisted living facilities no longer are willing to accept its woefully inadequate reimbursement rates.

When people think care is free on Medicaid (welfare), they don’t prepare.  Once they find they are not welcomed where they want care delivered, it is too late to qualify for the insurance that can pay for care.  Medicaid takes more and more of your tax dollars, provides inadequate reimbursement for care – limiting your options of where you will be cared for, and makes you think you don’t need insurance.

Is the insurance prohibitively expensive as many mistakenly think?  Not when it is chosen appropriately.  There is no need to purchase enough to cover the entire bill. (An analogyis auto insurance–do you have 100% coverage for your car, or did you choose a deductible?)  Once you determine how much of the cost of care you can comfortably pay for yourself, you only need to buy enough LTC insurance to make up the difference.

A 50-year-old can buy coverage that will provide $9000 a month for one year of care ($108,000 total) for a premium of just $214 per year.  A 65-year-old can purchase $850,000 of coverage for less than $2000 a year.

If you want choices of where you might receive care, if you do not want to spend your entire nest egg on care, if you want to leave something other than your funeral bill to your family, perhaps you should investigate LTC insurance.  But, do it with an expert who knows the costs, how and where care is delivered, and how to choose appropriate coverage.

Romeo Raabe LUTCF, LTCP known as TheLongTermCareGuy.com has been helping people choose appropriate LTC insurance coverage for 26 years.  He can be reached at (920) 884-3030.

By Judith Graham , Kaiser Health News
December 12, 2019

NAVIGATING AGING

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

It was a promise Matt Perrin wasn’t able to keep.   “I’ll never take away your independence,” he’d told his mother, Rosemary, then 71, who lived alone on Cape Cod, Mass., in a much-loved cottage.

That was before Rosemary started calling Perrin and her brother, confused and disoriented, when she was out driving. Her Alzheimer’s disease was progressing.  Worried about the potential for a dangerous accident, Perrin took away his mother’s car keys, then got rid of her car. She was furious.

For family caregivers, this is a common, anxiety-provoking dilemma. They’ll promise Mom or Dad that they can stay at home through the end of their lives and never go to assisted living or a nursing home. Or they’ll commit to taking care of a spouse’s needs and not bringing paid help into the home. Or they’ll vow to pursue every possible medical intervention in a medical crisis.

Eventually, though, the unforeseen will arise ― after a devastating stroke or a heart attack, for instance, or a diagnosis of advanced cancer or dementia ― and these promises will be broken.

“My mother-in-law and I got into a disagreement; I don’t remember what it was about. But I remember her saying to me, ‘You promised you would take care of me,’ and making it clear that she felt I’d let her down. And I said, ‘I know, I was wrong ― I can’t do it all,’” she remembered. “I still feel bad about that.”

“No caregiver I know sets out to deceive another person: It’s just that none of us have a crystal ball or can predict what the future will hold,” she said. “And the best we can do isn’t always as much as we thought was possible.” “We have to figure out a way to forgive ourselves.”

*****

Have you made that promise?  Have your children?  You know what comes next: use liquid money first, then retirement accounts (don’t forget the IRS imposed penalties for certain withdrawals as most LTC is NOT deductible), then sell the family home. Then, .when all the money is spent on care, the loved one eventually needs to go on a welfare program called Medicaid which may only be accepted at welfare nursing homes.

I want a nice assisted living facility with attentive and caring staff, a pool, happy hour, lots of activities and good meals.  I want the end of my life to be as comfortable and fun as it can be.  I can afford this because 18 years ago I bought a LTC insurance policy.

How will you pay for their care when your health changes?  Or will you need to sell assets at fire sale prices because you need the cash, regardless of what the market is like?

Contact Romeo Raabe LUTCF, LTCP (920) 884-3030 www.TheLongTermCareGuy.com