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Author: Rayvt Big gold star, 5000 posts Top Favorite Fools Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 76406  
Subject: Re: Big Problems wth LongTermCare Insurance Date: 7/11/2013 4:37 PM
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No, the 90 day exclusion is because Medicare pays for your first 90 days regardless.
Not even close.

"Under certain limited conditions, Medicare will pay some nursing home costs for Medicare beneficiaries who require skilled nursing or rehabilitation services. To be covered, you must receive the services from a Medicare certified skilled nursing home after a qualifying (3-day) hospital stay."

"However, the conditions for obtaining Medicare coverage of a nursing home stay are quite stringent.
...
•The care provided in the nursing home must be for the same condition that caused the hospitalization.
•The patient must receive a "skilled" level of care in the nursing facility that cannot be provided at home or on an outpatient basis. In order to be considered "skilled," nursing care must be ordered by a physician and delivered by, or under the supervision of, a professional such as a physical therapist, registered nurse or licensed practical nurse. Moreover, such care must be delivered on a daily basis. (Few nursing home residents receive this level of care.)
* As soon as the nursing facility determines that a patient is no longer receiving a skilled level of care, the Medicare coverage ends. And, beginning on day 21 of the nursing home stay, there is a significant copayment equal to one-eighth of the initial hospital deductible ($148 a day in 2013)."

Medicare specifically does NOT cover nursing home care for just being in poor health.

I've been through this with 2 family members. Everyone in that field is well aware of the Medicare rules, and knows just how far they can stretch them -- and it's not very far.

depending on the specifics of that policy, you would also be protecting anywhere from $547,000 to infinity from medicaid spenddown.
Again, wrong. In this cae, the MAXIMUM that would be protected is $547K, because that's the most the policy will pay. Everything above that is on your dime.

if you are really retiring with $1-2 mil, how significant is SS to your retirement needs?
Insignificant. But that wasn't my point. I was noting that the premium would consume most of your SS benefit.

If you have $1M-$2M, then you don't have much need for an expensive insurance policy that'll only give you ~$500K of benefit. IMHO.
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