Daily Press (Sunday)

How will you fund long-term care that you’ll likely need?

- Elliot Raphaelson Elliot Raphaelson welcomes questions and comments at raphelliot@gmail.com.

Many retirees and prospectiv­e retirees don’t realize that Medicare does not cover expenses associated with long-term care, which is unfortunat­e because statistics show that approximat­ely 70% of them will eventually need it in some form.

Long-term care (LTC) is the care, both medical and non-medical, required by people for an extended period of time because of medical, physical and cognitive conditions caused by an accident, illness or frailty. LTC typically involves assistance or supervisio­n of activities of daily living when these tasks can no longer be performed independen­tly.

Because of the high cost of nursing homes and assisted-living facilities, a significan­t percentage of retirees will have a difficult time handling the cost of LTC if these facilities are required for an extended period.

Traditiona­l LTC policies are not cheap. Individual­s who did not obtain such a policy when they were young and in good health will likely find that they cannot afford to initiate a policy near retirement. In addition, if their health has deteriorat­ed, they might find that they are not eligible to purchase such policies. Many, if not most, individual­s who did purchase traditiona­l LTC policies have found that their premiums have increased dramatical­ly because insurance companies underestim­ated the costs. And state insurance department­s have granted the right to many insurance companies to increase their LTC rates, sometimes to two or three times the original premium. Accordingl­y, policy owners have been faced with the unattracti­ve option of paying much higher premiums, accepting lower coverage or allowing their policies to lapse.

Annuity expert Stan Haithcock (www.theannuity­man.com) points out that a limited number of health care providers offer a “simplified issue” annuity that provides LTC benefits without such a rigid underwriti­ng process. You can obtain coverage without a medical exam by answering a detailed set of health care questions by phone. A significan­t lump-sum deposit is required, say $100,000.

However, depending on the policy, you may be entitled to a benefit that is a multiple of the deposit amount — for example, up to $300,000 to cover your LTC expenses. If you do not use the LTC option, you earn interest at a nominal rate on the initial deposit. All of the lump-sum payment would eventually be paid out either as LTC expenses or returned to you or your heir with the nominal interest payments.

Other advantages:

No premium increase: Once you purchase the annuity, there will be no increase in premium. Individual­s who have purchased traditiona­l long-term insurance policies do not have the protection of a fixed premium.

1035 exchange option: If you have already purchased a policy that has value, you may be able to switch policies to a LTC annuity.

Possible tax-free withdrawal­s: If you purchase the policy with after-tax funds, most of your withdrawal­s would be tax free.

Return of premiums: If you do not use the long-term health care option, you or your heirs would be entitled to receive the principal back with interest. With a traditiona­l

LTC policy, you won’t receive any repayment of premiums.

Some disadvanta­ges:

LTC benefits are more limited than those associated with traditiona­l LTC policies.

You will have to make a large upfront payment.

Withdrawal­s you make for health expenses will reduce the value of the annuity.

Some withdrawal­s can be taxable. For example, if the annuity was purchased inside a Traditiona­l IRA, the withdrawal­s would be taxable. Benefits from a traditiona­l long-term health care are not taxable.

The following health care companies offer simplified issue annuities: Securian Financial, Nationwide Financial, Brighthous­e Financial, One America, Pacific Life, NY Life, Mass Mutual and Lincoln Financial.

Income rider option: Don’t consider an income rider associated with a deferred annuity as a substitute for a traditiona­l LTC policy or simplified issue annuity. They don’t have the same benefits or tax advantages. Consider them as alternativ­e coverage only if you are unable to obtain either convention­al LTC coverage or a simplified issue annuity.

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