LTC Bullet: New LTC Numbers You Need to Know

Wednesday, November 5, 2008

Clayton, New Mexico (LTC Tour Mile 24,074; State # 37)

LTC Comment: New Medicaid "spousal impoverishment" numbers and key Medicare premiums updated for 2009. Where to find them all and how they've increased since 1991, after the ***news.***

*** Congratulations, Good Luck, and Best Wishes to President-Elect Barack Obama ***

*** LTC LALLAPALOOSA. Will you be in, near or within reach--by air, rail or road-- of Woodland Hills, CA on November 18? If so, do your prospects, clients and bank account a favor. Attend Barry Fisher's "Silver Bullets for Long-Term Care Insurance Sales Success" program. You'll hear Steve Moses (with the Silver Bullet of LTC in tow) and Marilee Driscoll explain why LTC insurance is soon to take off and how you can do well doing good riding the LTCI rocket. Other industry experts round out the agenda. Be there from 7:30 AM to 2:00 PM for breakfast, lunch, 2 hours of insurance CE credit, and dynamite insights, analysis and sales techniques. Go to for details and registration. ***

*** SUBSCRIBE TO LTC BULLETS. Please encourage your colleagues to fill out the simple online subscription form at . Subscriptions are free to everyone for the first month. After that, we'll ask you to help support the cause: rational long-term care public policy. ***

*** ART JETTER AND ASSURITY INSURANCE sponsored a superbly organized and well-attended LTC Tour event in Lincoln, Nebraska on Monday, November 3. We'll provide more details soon, but right now wind gusts of 50 miles per hour are buffeting the Silver Bullet. I need to wrap this up, ready the rig, and hit the road. On to Santa Fe, New Mexico today. More from there tomorrow. ***


LTC Comment: According to scholars Jeff Brown and Amy Finkelstein, the availability of Medicaid financed long-term care crowds out two-thirds to 90 percent of the potential market for long-term care insurance.

Therefore, if you're one of the AMGs (altruistic, masochistic geniuses trying to sell protection the government has been giving away since 1965), it behooves you to know how Medicaid eligibility for long-term care is determined.

That's too complicated a subject for us to cover fully here today, but the Centers for Medicare and Medicaid Services (CMS) recently updated some key numbers related to "spousal impoverishment" that you should know about. Here's why.

In the Medicare Catastrophic Coverage Act of 1988, Congress and President Reagan eliminated a major shortcoming of Medicaid-financed long-term Care. Before MCCA '88, community spouses of institutionalized recipients were often devastated financially. They were mostly wives, left at home by husbands who required nursing home care. The old Medicaid rules required spend down of assets to $2,000 and spend down of income to the SSI monthly allotment, back then around $350 per month. So, Grandpa got Medicaid-financed nursing home care, but Grandma was left at home broke and eating cat food.

MCCA '88 eliminated "spousal impoverishment" by protecting half the couple's joint assets, not to exceed $60,000 and up to $1,500 per month in income. The law also provided for an annual increase in these protections against impoverishment commensurate with inflation. As of 2009, CMS reports that community spouses of institutionalized Medicaid recipients will be allowed to retain . . .

Half the joint assets not to exceed $109,560

Up to $2,739 in monthly income.

Now, obviously, these updated income and asset protections don't guarantee the maintenance of a middle class life style. But that's why they are called SPOUSAL IMPOVERISHMENT protection. Senior advocates who lament how low the protected amounts are and demand big increases should insist instead on the following:

"If you want to protect more income and assets AND stay out of a nursing home on public welfare, then plan early to save invest or insure for long-term care."

Don't hold your breath waiting for such a sensible recommendation from the advocates for more government financing of LTC.

Center members can find all the "Medicaid Spousal Impoverishment Standards by Year" going back to 1991 at . You will need your user name and password. Need a reminder? Contact Damon at 206-283-7036 or .

CMS has also published 2009 Medicare Deductibles and Co-Insurance. For all those key numbers with annual updates going back to 1993, Center members can go to . You will need your user name and password. Need a reminder? Contact Damon at 206-283-7036 or .