BS: Retirement in the USA?

18 Apr 02 - 10:00 AM (#692798)
Subject: Retirement in the USA?
From: Morticia

What happens in the States when someone has not made provision for their old age but nonetheless needs residential care?

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18 Apr 02 - 10:10 AM (#692808)
Subject: RE: BS: Retirement in the USA?
From: MMario

depends on the circumstances. Usually someone else goes into hock up the wazoo for them.

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18 Apr 02 - 10:33 AM (#692824)
Subject: RE: BS: Retirement in the USA?
From: GUEST,Midchuck downstairs

Medicaid will take care of it but they have to use up their own assets first. Goodbye, family homestead!

In the US, if you either (a) have bright kids that get into a good (i. e. expensive) college, or (b) live to be old, and are either physically or mentally unable to care for yourself in your later years, you had better be either very poor or very affluent. The system is set up to shaft the middle class. And being very poor has numerous other disadvantages.

Peter

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18 Apr 02 - 10:37 AM (#692828)
Subject: RE: BS: Retirement in the USA?
From: MMario

There are inexpensive colleges?

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18 Apr 02 - 10:42 AM (#692831)
Subject: RE: BS: Retirement in the USA?
From: GUEST,Midchuck downstairs

Sorry, Mario, I should have said "very expensive."

Peter.

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18 Apr 02 - 10:53 AM (#692841)
Subject: RE: BS: Retirement in the USA?
From: MMario

sorry for the thread drift - 30 years post-grad and I'm still paying!

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18 Apr 02 - 11:19 AM (#692865)
Subject: RE: BS: Retirement in the USA?
From: catspaw49

As Midchuck said, that's about the situation. If there is any expectation of going the Medicare/Medicaid route, you need to have gotten rid of all of your assets several years earlier.....Give your money and home to the kids then and let them take care of you. Because as soon as you go into the residential centers if that's what you need, all of your assets and money will go to pay the bills there first before any government money kicks in......so would you prefer to pay the Daisybrook Nursing Home all of your money or give it to your kids?

We ran into a situation with Karen's grandmother where she was being "cared for" by her son and his wife. During that time, the "care" mainly involved whatever minimum was possible while the wife controlled her money.   Nell asked on several occasions if Karen or others had gotten their CD money but was assured that all was being taken care of........yeah, right. When it came time that she needed full time care, they had indeed gotten rid of her money, but she came here instead and we had to put her into a nursing home. The social Security people questioned many of the previous expenditures but chose not to prosecute the son and daughterr-in-law. Instead they held up her Medicaid money and we were paying for the nursing home. It's a long story and it doesn't have a happy ending for anyone....least of all Grandma and Karen. Grandma had wanted to live with us to begin with but that was ruled out by the son and "the wife." When grandma finally did get to come here she was far too ill to live with us and within a month we had to put her her into the nursing home. Karen has never and will never get over this one because she was so close to to Grandma.

Old age pretty well sucks in the U.S..........Especially for the middle class...........and even moreso with dysfunctional families!

Spaw

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18 Apr 02 - 11:56 AM (#692907)
Subject: RE: BS: Retirement in the USA?
From: Morticia

what if you don't have health insurance either?

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18 Apr 02 - 11:57 AM (#692908)
Subject: RE: BS: Retirement in the USA?
From: Jim Dixon

My mother is in a nursing home right now, so it's something we think about...

Nursing homes in America are mostly privately owned and operated, sometimes by nonprofit charitable organizations, and sometimes by for-profit companies.

In America, everyone over age 65 is covered by Medicare (a government program), which covers basic medical care but NOT the cost of medications (which can be expensive) or nursing home care. In addition, there are private "supplemental" insurance policies available which can cover these things. But of course the premiums are expensive.

My mother has an insurance policy that covers the medication, and I think some other things, but not the nursing home care. The insurance policy is sort of a carry-over benefit that she is eligible for as the widow of a railroad employee. She still has to pay premiums, but I think she gets a good deal. I'm kind of vague on the details.

Her house was sold last year, along with a lifetime accumulation of furniture and miscellaneous household equipment. I kept only a few things that have sentimental (but very little monetary) value. The proceeds, plus her savings, plus her pension and an annuity are all being used up to pay for her care, and I figure they will be gone in about 3 years, if she lives that long.

The good news is, when her money runs out, I will not have to pay anything out of my own pocket. Some government money will come in, and the nursing home, which is a nonprofit organization with an endowment, will make up the difference. My mother will stay in exactly the same place and receive the same level of care. Not even the nurses on her floor know which patients are paying for their own care, and which are receiving General Assistance – only the business office knows. I think that's great, and it's one of the reasons we chose this nursing home, even though it's more expensive than some. Some nursing homes, including the one that would have been our second choice, segregate their patients according to the source of their finances, maybe just to simplify their accounting. That would have meant a move, and when you're old and disabled, even a move to another floor in the same building can be as traumatic as a move a hundred miles away.

And my mother is thriving there. She has a more active social life, and is happier, I think, than when she was living alone. It reminds me of a college dorm (but usually quieter), more than a hospital!

I don't think I will mind being in a nursing home myself, when the time comes, as long as I have an Internet connection!

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18 Apr 02 - 11:58 AM (#692910)
Subject: RE: BS: Retirement in the USA?
From: Barbara Shaw

People who have worked enough during their lifetime get social security payments when they retire. Many live on just this. Medicaid does not require that you give up the family home. In fact, you can continue to live in it if you are able and still get medicaid to cover health benefits. You do have to reduce your other assets to a certain minimum level. I believe they look back over a period of years to see when the assets were reduced, but the penalty period is only 30 days. Not clear how this works.

There are also many other safety nets that older people are able to use, local and state, which help with various things like fuel assistance during the cold weather, tax breaks on property taxes, etc.

I personally don't have a problem with the idea that if we ask the state to take over all the person's financial needs, they must use up their assets and cannot leave them to their children. I've recently had need to look into this whole area for an older relative, and my experience has been fairly positive.

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18 Apr 02 - 12:17 PM (#692925)
Subject: RE: BS: Retirement in the USA?
From: catspaw49

Barbara......Get very familiar because when it happens the "laws" get some odd interpretations. If you do go to a nursing home, all of your assets must be used before the goverment kicks in and that includes real estate. And while Jim up there will not be required to pay, if the assets were used in a questionable fashion as it happened in the case of Karen's grandmother, then they can require payment for services past that 30 days.......and at the rate of about 10 grand a month for nursing homes, it can be a lot.

Even though Karen and I were not the ones to have used her grandmother's assets, the folks at Social Security (a real pain in the ass bunch) held up the Medicaid. You can only divest yourself of a certain amount per year and her son and his wife had made some "rather poor" decisions. But since we had custody (but none of the money, which was gone) we had to take the financial responsibility until the Medicaid kicked in........All in all, about 25,000 that we are still paying for.

Spaw

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18 Apr 02 - 12:31 PM (#692935)
Subject: RE: BS: Retirement in the USA?
From: Barbara Shaw

Wow, spaw, that's unbelievable. What would have happened if you had not taken on the responsibility? Or did you legally have to because you had "custody"?

I have another relative (with alzheimer's)in a nursing home and covered by medicaid (title19). All her assets are gone (and they were considerable at one point), but we're relieved that she is well taken care of, something that we could not do.

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18 Apr 02 - 12:45 PM (#692950)
Subject: RE: BS: Retirement in the USA?
From: catspaw49

We had legal custody because we wanted it. The story is long but basically she was NOT being properly cared for and there was no reason to think she would be. We wanted her cared for no matter what and we both "assumed" the problems that the SS people found in her assets would be held against the son and his wife. They (SS) said they had done wrong, but it wasn't their problem, it was ours.

If we had stuck to our guns years before and Grandma had come here, her last years would have been much better. Karen still feels guilty over the whole thing and I guess I do too. Again, we never dreamed that the son and his wife would do as they did.

Spaw

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18 Apr 02 - 12:48 PM (#692952)
Subject: RE: BS: Retirement in the USA?
From: Ebbie

In Oregon I have a friend who is able to live in her home, along with deferred taxes, until she dies. At that point, the state will take the home in payment for her husband's nursing home care. He died in the nursing home years ago.

In that sense, one could lose the 'family home'. I suppose if there were family who wanted to keep the home they could pay the state for his care in lieu of seizure.

Ebbie

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18 Apr 02 - 06:05 PM (#693168)
Subject: RE: BS: Retirement in the USA?
From: Art Thieme

What is known out there about a SPECIAL NEEDS TRUST even if one is on Medicaid?

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18 Apr 02 - 06:47 PM (#693201)
Subject: RE: BS: Retirement in the USA?
From: Sorcha

Watch out for Medicaid! When a parent's resources are gone and Medicaid kicks in, LATER they can come after the children AND grandchildren's assets to recover costs.

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18 Apr 02 - 08:50 PM (#693285)
Subject: RE: BS: Retirement in the USA?
From: Celtic Soul

There are State run homes...but, having known someone who worked in one in Baltimore, I wouldn't send a corpse there to stay.

I dunno if it is commonplace amongst these facilities, but it *reeked* of urine, and the patients regularly were left unattended. Even those who needed constant care, or who were too senile to be left alone.

I would also look to the way VA homes are run...not pretty.

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18 Apr 02 - 08:55 PM (#693288)
Subject: RE: BS: Retirement in the USA?
From: Ebbie

Are you sure of that, Sorcha? That is not my understanding at all. Let's look it up.

Ebbie

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18 Apr 02 - 09:50 PM (#693326)
Subject: RE: BS: Retirement in the USA?
From: artbrooks

CelticSoul: if you are really really lucky you can get into a VA nursing home. The ones I'm familiar with, and I worked for the VA for 27 years, have 24x7 physician and nursing staff, on site physical and occupational therapy, 16x7 recreation programs, separate altzimers and hospice units, and modern two-person rooms with TV and phones. The older facilities are scheduled for remodeling to this standard.

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18 Apr 02 - 10:14 PM (#693349)
Subject: RE: BS: Retirement in the USA?
From: kendall

Morty, I'm curious about why you ask, are you coming here to get old?

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18 Apr 02 - 10:28 PM (#693358)
Subject: RE: BS: Retirement in the USA?
From: Bobert

Ol' Bobert hates to throw another wet blanket on top of the wet blankets that have allready been thrown on this subject, but as bad as things are now, they will be even worse in 10 years, especially if the current administration can keep Americans occupied with food TV, shopping malls and threats of terrorism long enough to get another term. The best time to be retired ever is now. Lots of hard working Baby Boomers supporting a relative small number of retirees compared to 10 years from now. Then both Social Security and Medicaid/Medicare will be stretched...

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18 Apr 02 - 11:40 PM (#693386)
Subject: RE: BS: Retirement in the USA?
From: WyoWoman

I'm going to wander off into the hills with a jug of wine and a loaf of bread. A handful of cashews. When the food's gone, let the buzzards pick my bones. I'll become a sushi bar for desert rats. Compost.

I just hope I'm able to wander ... ww

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18 Apr 02 - 11:55 PM (#693398)
Subject: RE: BS: Retirement in the USA?
From: Troll

I have been told that if the assets are put into a revocable trust, they cannot be taken.

troll

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19 Apr 02 - 12:49 AM (#693416)
Subject: RE: BS: Retirement in the USA?
From: GUEST

they die behind a dumpster or on an abandoned davenport

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19 Apr 02 - 07:28 AM (#693577)
Subject: RE: BS: Retirement in the USA?
From: kendall

Is anyone sorry they didnt let Bush mess with his social security? I'm glad none of mine went into Enron! Did anyone see the report on 60 minutes about Enron in India? The original Bush let that happen. The nut seldom falls far from the tree.

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19 Apr 02 - 03:14 PM (#693895)
Subject: RE: BS: Retirement in the USA?
From: GUEST,Rowana at work

Here's how nursing care works in New Jersey. My papa suffered from Alzheimer's. I cared for him for several years until he became too difficult to manage, and then went looking for a nursing home. (A Veteran's Home was not an option. In our area the beds are reserved for veterans who have no resources.) If the patient has no assets he/she is put on the home's Medicaid waiting list. The patient may wait from one to five years for one of the limited number of Medicaid beds to become available. An Alzheimer's patient can wait longer as there are generally fewer available beds. If the patient has assets, either the patient or the responsible party can wave cash at the nursing home and if it's enough (Papa had $30,000) the patient will probably get the next available bed. As Papa's savings were depleted, I sold his house and belongings, and cashed in his life insurance policy. I used the proceeds to continue to pay for the nursing home. When that money ran out he was transferred to county public assistance ("welfare"). His pension and social security continued to be paid directly to the nursing home welfare paid the balance. I do not have to reimburse the county public assistance office. However, it was a requirement of public assistance that all his assets be used first. When he entered the home the annual bill was $50,000. By the time he died five years later, the annual bill was $75,000. Some may say how awful it was that, after working so hard all his life to save for retirement, all his money had to go to pay for nursing care. I say that he saved so that he could live comfortably in his retirement, which he did. He had very good round the clock care for five years. It was far better than I could have provided. The money was well spent. That said, the cost of care is far too high. I'm thinking I'll end my days like WyoWoman.

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19 Apr 02 - 04:46 PM (#693960)
Subject: RE: BS: Retirement in the USA?
From: kendall

My mother saved all her 86 years, and when she got too old to care for, she went into a nursing home. All her assets were used up first, then she went onto medicaid. We could have "cooked the books" but I refused to have any part of that. Why should the taxpayers pay for my mother's care when she had money and property?

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19 Apr 02 - 05:17 PM (#693979)
Subject: RE: BS: Retirement in the USA?
From: Ebbie

I read that too, Sorcha. But the operative word is "attempt". The states that sign on to that particular bit are required to try to recover the monies expended from those deemed to have Third Party Liability. Basically, what that means is that the heirs must show whether or not they meet the legal standards set for recovery. TITLE XIX 4.22(d)(1)

Of the states I found on the first 10 pages of the 30-page website on Liens and Recovery, 14 states don't attach liens onto the property of the nursing home inmate on Medicaid post death; 21 do. In addition, most of the states reserve the right to attach liens on real and personal property when a court judgment finds 'incorrect benefits' to have been paid out. (Utah does not, however, seize "personal effects where there are surviving heirs".

Since Medicaid is a partnership between individual states and the Federal Government, the states enjoy some autonomy and vary a good deal.

If anyone is interested further, acquire the U.S. Health & Human Services Handbook Title XIX 42 CF4.433.36 ©1902 (a)(18). Any local HSS office should have a copy. When I worked at Health and Social Services, we often referred to it.

Ebbie

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19 Apr 02 - 05:20 PM (#693982)
Subject: RE: BS: Retirement in the USA?
From: Sorcha

Any road, I don't want to be middle class and needy in the US.....it's a real bitch. My daughter says she is NOT going to do what I did (nurse mum through the end). She says she is going to slap me in a nursing home. I don't think I'll mind being there, but paying for it may bankrupt us all. Sad, messy situation here.

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19 Apr 02 - 05:41 PM (#693992)
Subject: RE: BS: Retirement in the USA?
From: Ebbie

I agree, Sorcha. And since we're all living longer these days, many, many people outlive their savings. (Although I agree that one's end time is what we've saved up for. It will do us a lot more good than giving it as found money to the next generation)

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19 Apr 02 - 05:45 PM (#693993)
Subject: RE: BS: Retirement in the USA?
From: artbrooks

I'm about to bust for $200+ per month for long term care insurance. Medicare/Medicaid doesn't pay much, if anything, for alternative care programs, such as in-home care or adult day care.

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19 Apr 02 - 05:55 PM (#693998)
Subject: RE: BS: Retirement in the USA?
From: Mrs.Duck

How strange language is. In England being middle class means you are well off, upper class means your family go back years but doesn't guarentee wealth, working class probably means you just about get through and below that god help you! I too am curious as to why Morty suddenly wants to know about retirement in the US but it may be because she has family there and I know an elderly Aunt has been poorly. Surely if the law there is that medicaid can recover costs from the heirs to the estate then they are assuming that an estate has been inherited so are only claiming from over and above what the heirs already had so to speak. This presumably would include life insurance payouts and the like.

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19 Apr 02 - 06:07 PM (#694003)
Subject: RE: BS: Retirement in the USA?
From: Morticia

Sorry, I should have said,Kendall.It was a question that came up at the office from one of my colleagues on the elderly team....I said I didn't know, but I bet I could find out *BG*.

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19 Apr 02 - 06:12 PM (#694005)
Subject: RE: BS: Retirement in the USA?
From: Mrs.Duck

See, we don't get rid of her that easily;-)

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19 Apr 02 - 06:52 PM (#694018)
Subject: RE: BS: Retirement in the USA?
From: Sorcha

In the US, poor is no money. Low class means you may have money but no class. Middle class is middle income--usually $30,000-$70,000 per year. Upper class means money. Upper crust means class but maybe no money. The Kennedy family is in a class of its own.........upper income, upper crust, but sort of lacking in true class......(imo, of course)

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19 Apr 02 - 07:01 PM (#694023)
Subject: RE: BS: Retirement in the USA?
From: artbrooks

And defining "class" is a lot like defining "folk music".

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19 Apr 02 - 07:46 PM (#694047)
Subject: RE: BS: Retirement in the USA?
From: Celtic Soul

That's interesting Artbrooks, point taken. There have been a couple of local news expose's on some around here, but this must be like anything else...some are good, some are bad, and lots in between.

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19 Apr 02 - 08:05 PM (#694054)
Subject: RE: BS: Retirement in the USA?
From: Ebbie

Where does the working class fit, Sorcha? To my mind, the middle class is also the working class- unless you're talking about working with one's hands. And that means 'blue collar', versus white collar and even pink collar.

And 'low class' is not the same as the working class- it's more 'low lifers', right? Like drug dealers, thieves, maybe even the silent gatherers under the street lights in the middle of the night. On the other hand, that would include the homeless - and the homeless are not necessarily low lifers. Ah, 'tis so confusing.

The 'working poor', however, are those who work slavishly- and can barely make it financially. Probably can't afford health insurance, try to get by without vehicle insurance, try to NEVER go to the doctor or the dentist... These are the people, by and large, who didn't finish high school in an age when a college degree means about the same thing that a high school diploma meant a generation ago.

Upper middleclass to me denotes the bankers, the corporate warm bodies, the governmental ambassadors, the social climbers, the ones who try so hard to appear swave and debonner...

I haven't known too many (maybe none) of what I would call the Upper Crust- that to me means the few who live very well indeed off the interest of working money.

My guess is that each of us would mentally divides these classes differently.

It's been a long time since this subject has even occurred to me. Thanks, Sorcha. This country is kind of weird.

Ebbie

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19 Apr 02 - 08:11 PM (#694058)
Subject: RE: BS: Retirement in the USA?
From: katlaughing

Boy, Sorcha, by that definition, I'd sure have a hard tome classifying the Shrub et al as "upper class!" *BG* I was always told one is bred with class, it can't be bought...so there were a lot of rich folks who might be wealthy, but they sure didn't have class! Upper class to us always meant well-educated, well-mannered, gracious, and, if lucky, also having money.

In the olden days, my great-grandma lived out here years in her house. She had an agreement with the little town she lived in; they made sure she had the care she needed until she passed on, she deeded the hosue and land over to them, to take effect upon her death.

Whatever happened to parents saving up, having a home place for their kids to grow up in and inherit? I know parents don't "owe" their kids such, but I personally think if a parent wants to help a kid out by passing on their home, etc. there should be a way to do that without having it taken away as an asset. We've all, presumably, paid into Medicare/Medicaid all of our working lives, so why would we then have to give up everything we've ever worked for, in order to rely on the government insurance we've paid for? Seems to me as though people are being penalised for working hard all of their lives. Guess we still live in a kingdom after all, huh?

kat

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19 Apr 02 - 08:20 PM (#694062)
Subject: RE: BS: Retirement in the USA?
From: artbrooks

I recall reading somewhere that your home wasn't a "disposable asset" according to the Medicare definition.

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19 Apr 02 - 08:40 PM (#694072)
Subject: RE: BS: Retirement in the USA?
From: Ebbie

That's right, artbrooks. And some of the states, in their Medicaid law, stipulate that they won't seize the "family home". What that ends up meaning in actual practice, whether it's automatic or whether you have to protect it, I don't know.

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19 Apr 02 - 09:19 PM (#694086)
Subject: RE: BS: Retirement in the USA?
From: catspaw49

It means you need to have that base well covered.

Spaw

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