Category Archives: Long Term Care

Long term care insurance. Long term care partnership insurance. Medicaid. Medicaid penalty period. medicaid look back rules.

Long term care insurance: If you’re a woman, be prepared to pay more!

Over ten million people have purchased long term care insurance, primarily to cover healthcare expenses that may occur in old age or during catastrophic illness.

Up until now, this insurance usually treated men and women equally.  Policy price depended on health status and age, not gender.

But this year, long term care insurance companies have indicated that they are going to start charging women more for their policies.  One of the first companies to introduce this new type of pricing is Genworth Financial Inc., purported to be the largest seller of insurance in the United States.  Their goal is to reflect statistical realities.  Women live longer than men and prepare more effectively for their futures by buying long term care policies.

According to Genworth, two thirds of its long term care payouts go to women, even though, in 2011, women only bought about 57% of its policies.  Women live longer than men and have higher rates of disability and chronic health problems.

So this spring, if their proposed plan is approved by regulatory agencies, Genworth will introduce gender specific policy pricing.  For women, that will boost the cost of a new policy by 20 to 40%, depending on age and benefit package selected.

A Genworth spokesperson said that the new pricing will only affect women applying on their own.  Lower rates will still be offered to married couples who purchase joint coverage and the changes won’t affect current policy holders.

For more information about long term care, go to


Nursing Home: If your parent needs one, will you have to pay the bill?

This is a true and shocking story.  John Pittas was ordered by a Pennsylvania court to pay his mother’s $92,943.41 nursing home bill under a filial support law.  The filial support law states that certain family members are liable for the care, maintenance and financial support of some other indigent members of that family.  It’s a law that’s been around since colonial times in one form or another.  Several states have abolished it but 29 have not.

John’s mother entered the Liberty Nursing Rehabilitation Center in Allentown, PA and spent about six months there after breaking two legs in an auto accident in September 2007. 

In March 2008, his mother, who was born in the United States, relocated to Greece where two other children live.

As the only family member still living in this country, Pittas was sued for payment of the huge bill.  The owners of the nursing home sued him for the money and a 2011 court trial was decided in the nursing home’s favor.

If his mother’s Medicaid application had been approved prior to the accident, this never would have happened.  Medicaid would have paid.  Last year, Pittas appealed but the Superior Court of Pennsylvania once again ruled in favor of the nursing home.

If you have an aging parent who may one day need nursing home care, what can you do to avoid having the same problem as John Pittas?

1) Talk with your parent about his or her financial resources.  If your parent is reluctant to have this discussion, relate John Pittas’ story.  It’s better to have a plan prior to an accident or other health crisis.

2) If your parent has limited resources, find out whether that parent is eligible for Medicaid.   If so, get your parent to apply immediately so that it will be available when needed.

3) If your parent is not eligible, sit down with all the members of your immediate family and talk about which family members can provide care or financial aid in case it is needed.

Don’t delay.  Put a plan in place today so that you won’t suddenly receive an unexpected bill for $93,000 or more.

For more information about planning for long term care and Medicaid, go to

End-of-life care: We must find ways to improve it

In the 1900’s, death often took place in someone’s home with loved ones nearby. Now, as more people are living longer and lifestyles have changed, death often occurs in a hospital overseen by trained staff. The resulting increase in the cost of dying has raised serious issues related to the current American health care system.

The National Institute of Medicine, the health branch of the National Academy of Sciences, recently announced that “given the rapidly changing environment for health care delivery, punctuated by the landmark passage of the Affordable Care Act in 2010, and the twin imperatives of improving the quality of health care while controlling costs, the time is ripe for a new examination of how individual values and preferences can be aligned while assuring compassionate care focused on the needs of individuals approaching death in an affordable and sustainable manner.” “…the matter of death and dying has become a political as well as an ethical, moral and societal one.”

The Institute said that it is pulling together a panel of experts to tackle this critical subject. “Given the importance of death and dying to our citizens and our nation, the IOM plans to examine the current state of end-of-life care with respect to delivery of medical care and social support; patient-family-provider communication of values and preferences; advance care planning; health care cost, financing and reimbursement; and education of health professionals, patients and their loved ones.

The study will also explore approaches to advance the issues surrounding the end of life from a wide variety of perspectives including clinical care and delivery, resources and workforce, economics, spirituality and compassion.”

On January 29th and 30th, the National Academy of Sciences also hosted the first National Summit on Advanced Illness as part of their effort to find ways for people to get good end-of-life care.

As our society ages, end-of-life care – how to afford and sustain it – becomes a critical subject. To read more, go to

Planning for Incapacity or Death: “A Cranky Old Man”

A friend sent me this poem by a “Cranky Old Man”. It has a message that all of us should think about as we care for elderly or incapacitated family members.

When an old man died in the geriatric ward of a nursing home in an Australian country town, it was believed that he had nothing left of any value.

Later, when the nurses were going through his meagre possessions, They found this poem. Its quality and content so impressed the staff that copies were made and distributed to every nurse in the hospital.

One nurse took her copy to Melbourne. The old man’s sole bequest to posterity has since appeared in the Christmas editions of magazines around the country and appearing in mags for Mental Health. A slide presentation has also been made based on his simple, but eloquent, poem.

And this old man, with nothing left to give to the world, is now the author of this ‘anonymous’ poem winging across the Internet.

Cranky Old Man

What do you see nurses? . . .. . .What do you see?
What are you thinking .. . when you’re looking at me?
A cranky old man, . . . . . .not very wise,
Uncertain of habit .. . . . . . . .. with faraway eyes?
Who dribbles his food .. . … . . and makes no reply.
When you say in a loud voice . .’I do wish you’d try!’
Who seems not to notice . . .the things that you do.
And forever is losing . . . . . .. . . A sock or shoe?
Who, resisting or not . . . … lets you do as you will,
With bathing and feeding . . . .The long day to fill?
Is that what you’re thinking?. .Is that what you see?
Then open your eyes, nurse .you’re not looking at me.
I’ll tell you who I am . . . . .. As I sit here so still,
As I do at your bidding, .. . . . as I eat at your will.
I’m a small child of Ten . .with a father and mother,
Brothers and sisters .. . . .. . who love one another
A young boy of Sixteen . . . .. with wings on his feet
Dreaming that soon now . . .. . . a lover he’ll meet.
A groom soon at Twenty . . . heart gives a leap.
Remembering, the vows .. .. .that I promised to keep.
At Twenty-Five, now . . . . .I have young of my own.
Who need me to guide . . . And a secure happy home.
A man of Thirty . .. . . . . My young now grown fast,
Bound to each other . . .. With ties that should last.
At Forty, my young sons .. .have grown and are gone,
But my woman is beside me . . to see I don’t mourn.
At Fifty, once more, .. …Babies play ’round my knee,
Again, we know children . . . . My loved one and me.
Dark days are upon me . . . . My wife is now dead.
I look at the future … . . . . I shudder with dread.
For my young are all rearing .. . . young of their own.
And I think of the years . . . And the love that I’ve known.
I’m now an old man . . . . . . .. and nature is cruel.
It’s jest to make old age . . . . . . . look like a fool.
The body, it crumbles .. .. . grace and vigour, depart.
There is now a stone . . . where I once had a heart.
But inside this old carcass . A young man still dwells,
And now and again . . . . . my battered heart swells
I remember the joys . . . . .. . I remember the pain.
And I’m loving and living . . . . . . . life over again.
I think of the years, all too few . . .. gone too fast.
And accept the stark fact . . . that nothing can last.
So open your eyes, people .. . . . .. . . open and see.
Not a cranky old man .
Look closer . . . . see .. .. . .. …. . ME!!

It’s Donate Life Month

This is Donate Life Month. It’s a good time to think about how you can help others. Just pledge to donate your organs, tissues and corneas to others when you die; by doing so, you may save up to eight lives and enhance the lives of many others.

Did you know that as of March 2012, there were 113,115 patients waiting for an organ donation or tissue or cornea transplant? More than 1,800 of them were children. (Source:

In 2011 there were:
14,144 organ donors
28,535 organ transplants
More than 46,000 cornea transplants

Each day, an average of 79 people receive organ transplants.  However, an average of 18 people die each day waiting for transplants that can’t take place because of the shortage of donated organs.

To learn more about how and why you should help or to sign up, go to today.

Isn’t great to think that you can save others, even after you’re gone?

To find out more about end of life planning, check out