S*******s
发帖数: 10098 | 1 意外事故发生， 或者病了， 老了， 就需要被人护理。
一个客户放弃了美国籍搬去澳大利亚定居， 留下他的太太一个人在美国，她老年痴呆
， 老头留下房子给她， 他自己住国外，还找了2个专业经理帮他投资退休金，他也不
是巨富。通常还没他这么富裕的家庭， 一旦夫妇中有一个人的的脑子和身体技能开始
退化，无法维持日常功能，只能把一辈子积累的资产卖掉， 去支付他/她的护理需要，
而另外一个老伴就没钱生活了。should a long term care need arise你不再能够
fully independent，怎样保护你的资产和独立生活能力？为了防止资产被花光 a long
term care insurance is one option.This type of coverage may help you
maximize your independence.
别以为现在你还年轻，不需要考虑长期护理，护理不光是因为年老的需要， 还是伤残
后的需要，几乎30%的45多岁美国人买了长期护理保险，long-term care insurance
policy.
当你快要50岁时，也许保鲜公司就不乐意卖护理保险给你了。 你50岁时，拜访医生的
机率就开始上升，it almost never gets better (even if you diet and exercise).
需要服用的药物慢慢增多起来，chances are that you leave your doctor's office
with some new prescription in hand. 服药也让你活的长些，但是这些医疗记录和健
康状况使你的年老护理保险变得很贵，或不够资格买它 make it harder or even
impossible for
you to health qualify for long-term care insurance.
2010年被保险公司拒绝的/接受的case(American Association
for Long-Term Care Insurance 2010 Sourcebook)：
从50岁到59岁被拒的14%
从60岁到69岁被拒绝的23%
they did not qualify for the insurance they applied for
从40岁到49岁被接受的62%，
从50岁到59岁被接受的46%， 这个年龄段一半多人被拒绝了。
从60岁到69岁接受的占38%
Costs increase on your birthday. The annual rate increases are generally 2-4
percent in your 50s but start to be 6% to 8% per-year in your 60s.
平均费用 （http://www.kappadelta.org/assets/1280/Long-Term_Care_facts.pdf）
• The average daily cost for a private room in a nursing home is $213,
or 一年7万8千美金
• The average daily cost for a semi-private room in a nursing home is
$189, or一年6万9千美金
• The average monthly cost of living in an assisted living facility is
$2,969, or $35,628 annually.
• The average monthly cost of living in a not-for-profit Continuing
Care Retirement Community is $2,672, or $32,064 annually.
• The average monthly rate for assisted living facilities that charge
additional feesfor Alzheimer’s and dementia 老年痴呆care is $4,270, or
$51,240 annually.
• To move into a community, individuals must also pay an entry fee
ranging from $60,000 to $120,000.首付6万到12万才能入住。
• The average hourly rate for a certified home health aide is $32.37.
• The average hourly rate for a uncertified home health aide is $19.00.
• The national average daily rate for adult day centers
• The national average hourly rate for homemakers/companions is $18
谁支付老年护理？
• Nearly 40 percent of long-term care spending is paid for by private
funds.
• Medicare, which covers rehabilitation services after an individual
is discharged from a hospital, pays for 19 percent of all long-term care
spending.
• Medicaid, which covers health care costs for low-income individuals,
pays for 49 percent of all long-term care spending.
哪些人被长期护理？
• There are more than 1.4 million nursing home residents in the United
States.
• An individual's average age when he or she moves into a nursing home
is 79.
• Women are almost three times as likely to live in nursing homes than
men.
• More than 900,000 individuals live in assisted living residences.
• More than 150,000 individuals receive care and services at an adult
day center.
• There are more than 1.1 million seniors in some type of senior
housing
community in the United States.
• There are approximately 745,000 older adults who live in continuing
care
retirement communities in the United States.
• The average age of an individual moving into a continuing care
retirement
community is 78.
• Nearly 1.4 million individuals receive home health services.
• The average lifetime nursing home use per individual is one year,
and the averagehome care use is a little over 200 visits.
麻省费用
Massachusetts Assisted Living Cost 2011( low high average):
Boston $1,925 $6,400 $4,694
Worcester Area $3,955 $5,456 $4,629
Rest of State $2,850 $6,357 $4,618
Home health Aid Cost/ hour
Massachusetts (MA) 18 $38 $24
Boston Area $22 $38 $25
Worcester Area $19 $30 $23
Rest of State $18 $32 $24
Homemaker Cost
Massachusetts (MA) $18 $30 $22
Boston Area $19 $24 $22
Worcester Area $19 $30 $23
Rest of State $18 $30 $22
Average cost of Nursing Home Semi-privat Room Care
Massachusetts (MA) $250 $400 $327
Boston Area $275 $385 $334
Worcester $250 $385 $321
Rest of State $272 $400 $327
Average cost of Nursing Home Privat Room Care
Massachusetts (MA) $250 $450 $350
Boston Area $300 $435 $356
Worcester $250 $425 $333
Rest of State $295 $450 $357 | S*******s
发帖数: 10098 | 2 What is covered by long term care insurance?
A long term care insurance policy may help you pay for the care needed when
you are unable to do everyday activities such as eating, getting dressed,
bathing, maintaining continence and getting in and out of bed without
assistance.
The goal for long term care services is to provide assistance
and improve the quality of life for those with chronic, long-term conditions
or severe cognitive impairment, such as Alzheimer’s disease.
A comprehensive long term care insurance policy may provide coverage for
long
term care needs in the home, community-based settings, an assisted living
facility or nursing home. | b***b
发帖数: 13249 | 3 Nice post!
long
over
【在 S*******s 的大作中提到】
: What is covered by long term care insurance?
: A long term care insurance policy may help you pay for the care needed when
: you are unable to do everyday activities such as eating, getting dressed,
: bathing, maintaining continence and getting in and out of bed without
: assistance.
: The goal for long term care services is to provide assistance
: and improve the quality of life for those with chronic, long-term conditions
: or severe cognitive impairment, such as Alzheimer’s disease.
: A comprehensive long term care insurance policy may provide coverage for
: long
| S*******s
发帖数: 10098 | 4 我慢慢修改，本来有点误解这个长期护理。你的行业相关，不妨多说说你所知道的?
【在 b***b 的大作中提到】
: Nice post!
:
: long
: over
| C**K
发帖数: 3672 | 5 一對七十幾但很健康的老夫婦告訴我, 他們自己照顧九十多歲老母親到自然離世, 但他
們完全不敢指望子女. 為了以後不給子女負擔, 他們自己買long term care. 他們告訴
有家有子的女兒時, 女兒說: 謝謝~~ | S*******s
发帖数: 10098 | 6 The following scenarios use real rates (2010).
American Association of Long-term care insurance 网页举了一个真实的例子
你在55岁时， 每年只花了$1,084 买就可买到标准的3年期限的护理benefit，大约每天
支付$150块， because you qualify for the preferred health discount (spousal
discount too).50岁之后，大多数人的健康开始走下坡路, 因此买长期护理越来越贵，
you'll pay more if you wait.
随着物价飞涨，长期护理的费用也跟着涨高，So, by age 65, the $172,600 benefit
you bought at age 55 -- will have grown in benefit value to $276,000.过去你
55岁时买的长期护理$172k,现在10年后相当于$276k的价值。
如果现在买$276k长期护理，每年则需要花$3,275才能买到， 因为65岁时的健康已
经不属于“preferred health discount”了。 Someone age 65 (today) would pay $
3,275 for $276,000 in coverage because it's very unlikely they will still
qualify for that good health discount.
And that reflects today's rates. Chances are rates will rise. So, the 55
year old who waits for the 10 years will pay even more.
等待是有代价的。此外，在你犹豫观望期间，一旦出现意外， 引起你伤残而需要护理
的时候， 你就得自掏腰包了。大多数人在70岁， 80岁的时候需要护理， 有些人在50
岁， 60岁的时候就需要它了。 It almost never pays to wait. And, there is
one more important point. While you are waiting, you are uninsured. If
something happens causing you to need long-term care (such as an accident or
an illness), you'll have to pay yourself. . And, while most people need
long-term care in their 70s and 80s, some do need care in their 50s and 60s. | S*******s
发帖数: 10098 | 7 美国法律不允许安乐死， 好像中国也不允许。见证过家人忍受癌症晚期的
痛苦治疗（其实是折磨），本人非常赞同晚期病人要求的安乐死。
有人想回国养老，因为那里护工便宜，可是在国内太拥挤，去一趟医院路上用掉3，4个
小时，老人病痛身体弱，说不定半路就见了马克思。 还不敢吃那边的东西，什么都敢
造假。 我参加一个德国公司外派的华人女子讲座，她从国内逃回来了， 说毒米， 毒
香肠，病毒肉。。。 空气也是很糟糕， 看不清蓝天白云了， 老来肺部有病的还是不
要回去，不敢生活下去。
国内现在请保姆都怕被她们拐卖儿童，老人的话，怕被偷抢虐待。
其实， 美国和欧洲国对老人更好，医疗设施就近， 生活环境清新。 最好在健康还不
错的时候2边走走， 病了就在美国等死。
有一点还没彻底弄清楚， 这长期护理通常要买几年呢？手术的话，康复期可以是半年
， 但是aging related 海默氏， 帕金森症就不知道会有多少年了。 同事说了一个真
实故事， 说一老太太已经有人护理快3年了，当初买的就是3年期的护理保险， 3年期
满后，要是继续呆在特护房，就没有保险cover特护了， 那么还需要自己掏多少年？
等我
去查查有没有统计数据。 | S*******s
发帖数: 10098 | 8 Medicaid Eligibility Fact Sheet
http://www.lifecarefunding.com/whitepapers/treatmentoflifeinsur
Over 10 million Americans now require long term care annually. Medicaid is
the primary payor of long term care services in the United States. The
national average cost of a nursing home is $72,000 per year, for assisted
living it is $38,000, and for home healthcare services it is $21 per hour.
Most people will drain all personal savings and assets paying for long term
care in their first year of usage.
In 2009, Medicaid spent $240 billion on long term care services accounting
for 43% of total expenditures. By comparison, $45.6 billion or19% of long
term care services was paid "out of pocket" by the consumer. States spent on
average 16% of their annual budgets on Medicaid making it the second
biggest budget item behind only education.
Medicaid and state budgets have been impacted particularly hard by shrinking
tax dollars and growing Medicaid enrollment brought on by the economic
crisis and an aging population. There is a combined budget shortfall of $121
billion across 46 states for fiscal year 2011. States are legally required
to operate with balanced budgets every year, and draconian cuts as well as
federal assistance have become necessary. The federal government passed a
temporary increase in federal matching payments (FMAP) for Medicaid of $87
billion in 2009. Over 2010 and 2011, the FMAP was extended at reduced levels
by half and then by half again, and will be eliminated in 2012. As the FMAP
assistance winds down and ultimately concludes, state spending will need to
increase by at least 25% to keep pace—and at a time when the dollars are
not available.
Medicaid Eligibility Fact Sheet
What is Medicaid: Medicaid is health insurance that helps many people who
can't afford medical care pay for some or all of their medical bills.
Medicaid is available only to people with limited income. You must meet
certain requirements in order to be eligible for Medicaid.
Who qualifies for Medicaid: Many groups of people are covered by Medicaid.
Even within these groups, though, certain requirements must be met. These
may include your age, whether you are pregnant, disabled, blind, or aged;
your income and resources (like bank accounts, real property, life insurance
, or other items that can be sold for cash); and whether you are a U.S.
citizen or a lawfully admitted immigrant. The rules for counting your income
and resources vary from state to state and from group to group. There are
special rules for those who live in nursing homes and for disabled children
living at home.
Who qualifies for Long Term Care to be covered by Medicaid: In addition to
financial eligibility, States determine if an individual meets the
functional criteria by assessing the limitations in an individual's ability
to carry out activities of daily living (ADL) and instrumental activities of
daily living (IADL). The Medicaid statute requires states to use specific
income and resource standards in determining eligibility; these standards
differ based on whether an individual is married or single. If a state
determines that an individual has transferred assets for less than "fair
market value" (FMV), the individual may be ineligible for Medicaid coverage
for long term care for a period of time.
Individuals who incur high medical costs may "spend down" into Medicaid
eligibility because these expenses are deducted from their income. Spending
down may bring their income below the state determined income eligibility
limit.
What type of assets count against Medicaid eligibility: Income and Assets
are both calculated to determine Medicaid eligibility. Income from work,
investments, and entitlements such as Social Security all need to be
reported by the applicant. Assets such as cash, stocks, bonds, trusts,
annuities, real estate, vehicles and life insurance all must be reported and
are calculated for eligibility. States determine their own specific
eligibility standards within federally mandated parameters.
How is life insurance counted as an unqualified asset: Ownership of any in-
force life insurance policies must be reported by the applicant when
determining eligibility for Medicaid and failure to report is fraudulent.
Specific limitations vary by state, but any policy with cash value in the
range of $1,500 to $2,500 must be liquidated and the proceeds spent down on
care before eligibility is approved. Exemptions are allowed for final
expense policies if the entire policy is assigned to a funeral home. Term
policies that do not have cash value are also exempt, but the death benefit
and estate is subject to legal action and liens by the Medicaid department
to recover all money spent on care for the deceased.
Life insurance is an unqualified asset and counts against the Medicaid
applicant's eligibility to qualify. Any amount of money derived from
ownership of a life insurance policy must be either spent down on care (cash
value or monetary value available while alive) or the death benefit is
subject to legal action against the estate as part of Medicaid's required
asset recovery procedures. | S*******s
发帖数: 10098 | 9 上次有位网友问：如果我一早买好了extended care benefits, 等我老了回台湾的话
还能享受 benefits吗？我请教了这个方面的一位资深人士， 他是行业内教课让人考
Underwriter资格的元老，今天他给我的回信以及我的问题：
我的问题Hypothetical case: A prospect with a Green card and a permanent
residence in US with SS # would like to purchase an LTC policy. She would
like to retire in her home country of Taiwan. If she needed care in a
nursing facility, would the carrier pay the insured the daily benefit. Also
does the carrier pay the amount of cost up to the daily benefit or do they
pay the actual cost. Ex: cost is 100.00 a day but I have a 200.00 a day
benefit. What does a carrier pay?
Thank You
今天他给我的回信:The answer to your question in regards to the out of
country benefits.
If a person who buys LTC in the US and then leaves this country to retire in
and needs LTC then 保险公司 will pay a reduced benefit amount.
First of all there is a elmination period that is Doubled.
Example: 90 day wait is now 180 day wait.
The lifetime Benefit is reduced to 5yrs and the benefit amount is reduced to
50 % . Example:$200.00 per day fro Lifetime is reduced to $100.00 per day
for a 5 yr benefit.
If the insured purchases a limited time benefit then the benefit is reduced
to 25% of the benefit. Example: 5yr benefit times 25% equals a new benefit
period of 1.25 yrs
Also if the insured has a $200.00 a day benefit and the cost for care is 150
.00 per day then the company only pays the 150.00. 保险公司 will reimburse
actual cost not to exceed the daily benefit amount.
Hope this help | C**K
发帖数: 3672 | 10 Thanks a lot. It seems troublesome....
I didn't have expectation anyway.
Also
they
【在 S*******s 的大作中提到】
: 上次有位网友问：如果我一早买好了extended care benefits, 等我老了回台湾的话
: 还能享受 benefits吗？我请教了这个方面的一位资深人士， 他是行业内教课让人考
: Underwriter资格的元老，今天他给我的回信以及我的问题：
: 我的问题Hypothetical case: A prospect with a Green card and a permanent
: residence in US with SS # would like to purchase an LTC policy. She would
: like to retire in her home country of Taiwan. If she needed care in a
: nursing facility, would the carrier pay the insured the daily benefit. Also
: does the carrier pay the amount of cost up to the daily benefit or do they
: pay the actual cost. Ex: cost is 100.00 a day but I have a 200.00 a day
: benefit. What does a carrier pay?
| S*******s
发帖数: 10098 | 11 在国外受到起居照顾的费用低， 因此美国保险公司支付的benefit随着lower cost而调
低。
我们客户当中有美国人去谏普寨那个国家养老， 为的就是费用低， 当然那是因为他早
年并没有买长期护理保险。台湾的医疗系统是美国人承认要也向他学习的.
【在 C**K 的大作中提到】
: Thanks a lot. It seems troublesome....
: I didn't have expectation anyway.
:
: Also
: they
| C**K
发帖数: 3672 | 12 早年沒買應該是一般民眾普遍的現象吧. 光是應付日常開銷房貸就夠緊張的了, 像這樣
的保險, 心有餘力不足的很多.
【在 S*******s 的大作中提到】
: 在国外受到起居照顾的费用低， 因此美国保险公司支付的benefit随着lower cost而调
: 低。
: 我们客户当中有美国人去谏普寨那个国家养老， 为的就是费用低， 当然那是因为他早
: 年并没有买长期护理保险。台湾的医疗系统是美国人承认要也向他学习的.
| j******d
发帖数: 48 | 13 一般情况，如果从45岁开始pay premium, 要pay多久？一直pay到死为止吗？ | i******4
发帖数: 20643 | |
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