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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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He is in a memory care facility, and it is terribly expensive. The benefits will probably last another 20 months. Is it possible to purchase more insurance?
I think this is a question for the agent who services the policy.
If necessary, would your husband qualify for Medicaid in 20 months? Does the facility he is in now accept Medicaid, perhaps from residents that have been private-pay for a certain length of time?
Thanks for the quick response! I did contact the insurance company, and they said when the benefits expire, that's it. I was thinking maybe another company? Just was wondering if anyone else had this problem. The facility does not accept Medicaid, so he would have to be moved at that time. I was trying to avoid Medicaid, as I don't think he would qualify. Perhaps I am just borrowing trouble. Would like to be prepared though.
Good for you for looking ahead and trying to be prepared.
Somehow I doubt you'll be able to buy insurance when your husband is already in memory care. Or if you could the cost would be prohibitive.
I assume you have asked the care center specifcally about your husband's situation. Some places that "do not accept Medicaid" have exceptions for residents who have been self-pay for a while.
If you and your husband have too many assets/income to qualify for Medicaid, could you use those assets to pay for his care after the insurance runs out?
from my understanding you will not be able to buy insurance because he already has this condition. I assume you are speaking of long term care insurance.
I would talk to an elder care attorney that specializes in Medicaid. You can start looking for facilities now that take Medicaid. The attorney can help you protect your assets for yourself, but yet help your husband...if it comes to that...be eligible for Medicaid. My mother is in a nursing facility with a memory care unit. It is a locked down unit. I know every nurse in this unit and they are so good with her. They call me and keep me informed. The other day they called because she lonely and just wanted to talk with a family member. I had been to see the day before, but she had forgotten. So I talked to her on the phone. I think if you get to the point to where you have to do something, working with a elder care attorney is best. I also think finding places with memory care that take medicaid in advance, just in case would help also. I researched this option a year ahead, and would ask people who had family there.
You need someone who specializes in geriatric management and works with long term care Ins. Medicaid is not going to be an option as the spend down is 5 years although you might be well served speaking to someone who specializes in trusts which some geriatric care managers/elder attorneys do - or wealth management officer at your bank may point you in the right direction.
It depends upon your resources. If you have too many assets or your income is too high to qualify for Medicaid, you pay for care out-of-pocket once the insurance runs out. If there's a possibility that you would impoverish yourself by paying for your husband's care, you really must go see an elder law attorney to make sure your financial future is protected.
Hello, artnitter -- first, I'm so sorry to hear about your husband's situation. I can relate to how worried you are about the long-term care benefits running out. My Dad also has a (relatively small, in the scheme of "memory care") long-term care policy, because when they bought it, my parents understood that most people only use between 6 months and 2 years of long-term care at the end of their lives, and they didn't want to overpay for insurance they weren't likely to use. (Indeed, my Mom, who died of breast cancer, never used the policy at all.)
Unfortunately, dementia/memory care can go on for many years, and is significantly more expensive than just regular assisted living care. So yes, it is likely that your husband's benefits will run out long before his need for care does.
Also unfortunately, it is very unlikely you would be able to replace or supplement this policy when it runs out. Your husband has a known, pre-existing (and expensive) condition. Insurance companies do not want to sign up such patients for coverage, and they go to great lengths to insure that they do not inadvertently do so. For example, a little over a year ago, my husband's company started offering a "group" benefit of coverage in a long-term care policy to employees and "family members." Family members apparently included in-laws ... so I immediately filled out an application on behalf of my Dad, thinking, hey, here's a great opportunity to buy a bit more coverage for him. He didn't have a dementia diagnosis at the time, but I was seeing some short-term memory issues that concerned me, and I thought it would be worth buying a second long-term care policy, even if it was expensive, if I could.
I could not. The insurance company sent a nurse to Dad's house to do an interview and evaluation. This included a cognitive test with a "delayed word recall" (designed to reveal memory issues), and he did very poorly on it. The company immediately declined to cover him based on this test performance and on the fact that he has bad knees.
So, no, I'm very sorry, but I don't believe you'll be able to buy another long-term care policy. The readers who have urged you to see a Medicaid attorney are absolutely spot on. This is a complicated area, and it is important to do things exactly the "right" one to maximize protection of your "half" of the assets ... and it is important that you understand exactly how to proceed BEFORE you apply to Medicaid. What a spouse needs to (and can) do in this situation is different from what children need to do to try to protect family assets.
Please, please, don't assume you won't qualify for Medicaid! Seriously, talk to a Medicaid attorney. I went and saw these guys in person (http://www.medicaidhelp.com/) because their office is in my Dad's town. Joe Mitchell was extremely knowledgeable and helpful to me. I think they market some kind of "asset protection plan" video on eBay, and I haven't used it myself (because I went to see them personally), but you can read reviews of it there. I don't know if it's "legal" for me to mention them here; I'm not trying to break any rules. Other than having consulted with them once, I don't know them at all, and don't make any kind of commission or anything on recommending them ... I was just very grateful for the information they provided.
Also, jeannegibbs is right ... some care facilities WILL accept Medicaid for a patient who has been self-paying for a while first. It is good to ask NOW, while he is still self-paying, and you have some "leverage" (i.e., the implied threat of moving him somewhere that will take the "self-pay" now but let him stay as a Medicaid patient down the road).
If they will not, I would recommend looking around now in your area for facilities that will take Medicaid patients (or who take a mix of self-pay and Medicaid, and WILL let a self-pay patient stay on after transitioning to Medicaid). Your husband will be a more attractive patient to any facility while there is still self-pay money available.
It is important that you take steps to preserve/protect some of your shared assets for your own needs (including life needs now and possible care needs later). A good Medicaid attorney can help you understand how to do this to whatever extent is possible in your situation. It is absolutely worth spending a little bit of money now to possibly save thousands and thousands later. I can't urge you to do this strongly enough.
Finally, for anyone who is reading this and thinking about buying a long-term care policy down the road a bit ... be aware that if you are "older" (over 65), an insurance company WILL very likely do an in-person evaluation that will take into account any mobility issues you have and any cognitive issues you have. (Both mobility care and memory/dementia care are expensive types of assisted living care, and insurance companies don't want to have to pay for these if they can identify and weed out likely "needers" of this kind of care during the application process.) For this reason, even though LTC insurance can be expensive, it is best not to put off applying for it too long ... you might "pass" the evaluation today, but not a year from now. I'm not suggesting LTC insurance is for everyone ... some people pay a lot for it and don't use it at all ... but it's absolutely a "must have in retrospect, but now it's too late to get it" sort of policy for dementia/memory care patients. (I'm trying to get my relatively healthy in-laws to consider applying for some now ...)
FIND A "CERTIFIED-ELDER-LAW-ATTORNEY" ASAP... MAKE SURE SHE/HE IS "CERTIFIED", MOST NON-CERTIFIED WILL LIE ABOUT IT UNLESS YOU ASK THEM "AS A MATTER OF FACT ARE YOU CERTIFIED? "
Thank you all for your thoughtful responses. I did consult an elder care attorney when I first placed my husband in care. And, Paula K, I also called Joe Mitchell at that time. I think it might be wise for me to follow up with the attorney to review my situation in the spring. I will have about one year of insurance benefits at that time. Thanks again all!
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If necessary, would your husband qualify for Medicaid in 20 months? Does the facility he is in now accept Medicaid, perhaps from residents that have been private-pay for a certain length of time?
Somehow I doubt you'll be able to buy insurance when your husband is already in memory care. Or if you could the cost would be prohibitive.
I assume you have asked the care center specifcally about your husband's situation. Some places that "do not accept Medicaid" have exceptions for residents who have been self-pay for a while.
If you and your husband have too many assets/income to qualify for Medicaid, could you use those assets to pay for his care after the insurance runs out?
looking for facilities now that take Medicaid. The attorney can help you protect your
assets for yourself, but yet help your husband...if it comes to that...be eligible for Medicaid. My mother is in a nursing facility with a memory care unit. It is a locked down unit. I know every nurse in this unit and they are so good with her. They call
me and keep me informed. The other day they called because she lonely and just
wanted to talk with a family member. I had been to see the day before, but she had forgotten. So I talked to her on the phone. I think if you get to the point to where you have to do something, working with a elder care attorney is best. I also
think finding places with memory care that take medicaid in advance, just in case would help also. I researched this option a year ahead, and would ask people who
had family there.
Medicaid is not going to be an option as the spend down is 5 years although you might be well served speaking to someone who specializes in trusts which some geriatric care managers/elder attorneys do - or wealth management officer at your bank may point you in the right direction.
Unfortunately, dementia/memory care can go on for many years, and is significantly more expensive than just regular assisted living care. So yes, it is likely that your husband's benefits will run out long before his need for care does.
Also unfortunately, it is very unlikely you would be able to replace or supplement this policy when it runs out. Your husband has a known, pre-existing (and expensive) condition. Insurance companies do not want to sign up such patients for coverage, and they go to great lengths to insure that they do not inadvertently do so. For example, a little over a year ago, my husband's company started offering a "group" benefit of coverage in a long-term care policy to employees and "family members." Family members apparently included in-laws ... so I immediately filled out an application on behalf of my Dad, thinking, hey, here's a great opportunity to buy a bit more coverage for him. He didn't have a dementia diagnosis at the time, but I was seeing some short-term memory issues that concerned me, and I thought it would be worth buying a second long-term care policy, even if it was expensive, if I could.
I could not. The insurance company sent a nurse to Dad's house to do an interview and evaluation. This included a cognitive test with a "delayed word recall" (designed to reveal memory issues), and he did very poorly on it. The company immediately declined to cover him based on this test performance and on the fact that he has bad knees.
So, no, I'm very sorry, but I don't believe you'll be able to buy another long-term care policy. The readers who have urged you to see a Medicaid attorney are absolutely spot on. This is a complicated area, and it is important to do things exactly the "right" one to maximize protection of your "half" of the assets ... and it is important that you understand exactly how to proceed BEFORE you apply to Medicaid. What a spouse needs to (and can) do in this situation is different from what children need to do to try to protect family assets.
Please, please, don't assume you won't qualify for Medicaid! Seriously, talk to a Medicaid attorney. I went and saw these guys in person (http://www.medicaidhelp.com/) because their office is in my Dad's town. Joe Mitchell was extremely knowledgeable and helpful to me. I think they market some kind of "asset protection plan" video on eBay, and I haven't used it myself (because I went to see them personally), but you can read reviews of it there. I don't know if it's "legal" for me to mention them here; I'm not trying to break any rules. Other than having consulted with them once, I don't know them at all, and don't make any kind of commission or anything on recommending them ... I was just very grateful for the information they provided.
Also, jeannegibbs is right ... some care facilities WILL accept Medicaid for a patient who has been self-paying for a while first. It is good to ask NOW, while he is still self-paying, and you have some "leverage" (i.e., the implied threat of moving him somewhere that will take the "self-pay" now but let him stay as a Medicaid patient down the road).
If they will not, I would recommend looking around now in your area for facilities that will take Medicaid patients (or who take a mix of self-pay and Medicaid, and WILL let a self-pay patient stay on after transitioning to Medicaid). Your husband will be a more attractive patient to any facility while there is still self-pay money available.
It is important that you take steps to preserve/protect some of your shared assets for your own needs (including life needs now and possible care needs later). A good Medicaid attorney can help you understand how to do this to whatever extent is possible in your situation. It is absolutely worth spending a little bit of money now to possibly save thousands and thousands later. I can't urge you to do this strongly enough.
Finally, for anyone who is reading this and thinking about buying a long-term care policy down the road a bit ... be aware that if you are "older" (over 65), an insurance company WILL very likely do an in-person evaluation that will take into account any mobility issues you have and any cognitive issues you have. (Both mobility care and memory/dementia care are expensive types of assisted living care, and insurance companies don't want to have to pay for these if they can identify and weed out likely "needers" of this kind of care during the application process.) For this reason, even though LTC insurance can be expensive, it is best not to put off applying for it too long ... you might "pass" the evaluation today, but not a year from now. I'm not suggesting LTC insurance is for everyone ... some people pay a lot for it and don't use it at all ... but it's absolutely a "must have in retrospect, but now it's too late to get it" sort of policy for dementia/memory care patients. (I'm trying to get my relatively healthy in-laws to consider applying for some now ...)
MAKE SURE SHE/HE IS "CERTIFIED", MOST NON-CERTIFIED WILL LIE ABOUT IT UNLESS YOU ASK THEM "AS A MATTER OF FACT ARE YOU CERTIFIED? "
FINANCIAL PLANNER, 27 YR EXPERIENCE.
NEW JERSEY
Thanks again all!