Toni: I am retiring in June when I turn 70 and my wife, Bonnie, will be 68. Our Medicare issue is that recently we applied for a long-term care plan and were both denied due to our simple health issues.

I had my prostate removed due to cancer about 5 years ago with no current issues and Bonnie has A-Fib which is under control. The agent who helped us search for the insurance plan said that people older than 60 find it difficult to be accepted by a long-term care insurance plan.
Our concern is that my brothers and I are paying about $9,000 a month to an Alzheimer’s facility for our father’s care. Because our contribution to my father’s rate of $9,000 per month will drain our retirement, can you please explain other long-term care options that Bonnie and I can explore? We do not have a plan in place should we need extra financial help since we were not approved for a long-term care policy. Thanks, Toni. — Peter from Tulsa, Okla.

Hi Peter: I’m glad you took the time to email me about your situation, because I have good news for you and Bonnie. In the past few years, new plans with extended health care benefits have been developed, assisting Baby Boomers with unexpected health or accident issues.

The Medicare & You handbook, under “Paying for long-term care,” discusses how important it is to plan now to maintain your independence and receive the proper care in the setting you desire. Medicare only pays for medically necessary skilled nursing facility care or for home health care if you meet certain conditions. Skilled nursing has 100 days of benefit with days 1-20 having a $0 copay per day and days 21-100 with a specified copay per day. If you cannot qualify or do not meet Medicare’s qualification for skilled nursing, you will pay 100% of the cost out of your pocket. Medicare doesn’t cover non-medical long-term care. This is why purchasing a policy to help with a long-term need becomes essential.

Let’s discuss options that can help to assist with various ways to protect your finances from excessive long-term care costs, especially for those who have health issues that can keep them from being accepted by a long-term care plan.

1. Short-term care insurance plans: These policies have a simple health questionnaire with yes/no questions, making it easy to qualify. They will assist paying for a nursing home, assisted living and a personal care home, which qualify as “facility care,” with additional benefits for care in your home. Providing various options ranging from $50-$400 per day with benefit periods ranging from 1 or 2 years, depending on the plan, they prevent one from draining their savings or 401k for an illness recovery.

2. Life and Annuity policies: Many life/annuity insurance policies have a provision for long-term care; one can receive a certain amount of long-term care with your life/annuity policy’s face amount. Health questions may keep one from qualifying.

3. Aid and Attendance benefits: The VA can help veterans with long-term care issues. More than $20 billion dollars is available for long-term care from pension money, just waiting for veterans to apply for their Aid and Attendance benefits. You need to have a long-term care issue to qualify.

4. Traditional long-term care: If you are younger than 60 and in good health when you purchase a long-term care policy, it may be easier to qualify with lower premiums.

Americans are concerned about a chronic illness not covered by Medicare being their biggest retirement expense. Plan for it properly, because with Medicare it’s what you don’t know that will hurt you!

Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. For a Medicare checkup, call the Toni Says call center at (832) 519-8664 or email info@tonisays.com regarding your Medicare plans and options. Toni Says Medicare Survival Guide Advanced edition is available at www.tonisays.com.