long-term care

By: Robert Moore, Tuesday, September 27th, 2022

Legal Groundwork

For people who are concerned about potential long-term care (LTC) costs, LTC insurance may be an option.  Several insurance companies sell these policies that pay out to cover some or all LTC costs.  There are many different types of policies and coverages available.  For example, some coverages may start soon after LTC is needed while some coverages will not begin to pay for a longer period, sometimes as long as one year.  Also, some policies are combined with a death benefit so that the policy holder can be sure that at least some benefit will come from the policy.   The following are some, but not all, of the terms and conditions to consider when exploring a LTC insurance policy:

Duration of Benefits.  Most policies cover at least one year and may cover up to five.  Policies that cover more than five years are no longer available.  Obviously, a longer-term policy is preferable but that must be balanced against the higher premiums.

Benefit Triggers.  The LTC policy will only start to pay out when certain triggers, or conditions, are met.  Before paying out, most policies require the policy holder to need assistance with at least two of the following activities: bathing, dressing, toileting, eating, transferring and continence.  Be sure to understand what conditions are required for payout to be triggered.

Waiting Period.  Policies will include a waiting period.  The waiting period may be a few days or as long as one year.  The longer the waiting period the lower the policy premiums will be.  

Daily Benefit Amount.  A LTC policy will include a daily benefit amount.  Some policies may pay 100% of the daily LTC costs.  Other policies may only cover 50% of the LTC costs.  The policy can be used to cover only that portion of LTC costs that income does not.

Inflation Protection.  Like any cost, LTC costs will increase over time.  Some policies will have inflation adjustment built in and automatically increase over time.  Other policies will offer the holder the ability to increase the coverage to keep up with inflation but this will also increase the premium.  It is important to know what type of inflation adjustment provision is in a policy.

Depending on the type of policy and robustness of coverage, LTC policies can be expensive.  Not everyone will be able to fit LTC policy premiums into their budget.  Also, not everyone is insurable.  People with significant pre-existing health care issues may not be able to obtain a LTC policy.

If a policy can be obtained to cover all LTC costs or at least cover the deficiency that income does not cover, all assets will be protected.  Therefore, the owner can keep all their assets and continue to enjoy and use them for the remainder of their lives.  LTC insurance policies, in many ways, provide the most flexible LTC plan.

It is worthwhile to at least explore incorporating a LTC insurance policy into a LTC management plan.  Many insurance agents and financial advisors can provide free estimates for policies without too much difficulty.  They can also help with a risk assessment to determine what policy may be needed for a given circumstance.  Before assuming that assets must be gifted or transferred to protect them, the possibility of LTC insurance should be explored.

Posted In: Estate and Transition Planning
Tags: long-term care
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Webinar announcement with picture of elderly couple walking on a farm.
By: Peggy Kirk Hall, Friday, July 08th, 2022

Do you worry about the possibility of long-term care needs and how those needs might affect your farming operation or family farmland?  We'll examine that issue in an upcoming webinar for the National Agricultural Law Center.  Join OSU Attorney and Research Specialist Robert Moore for the webinar, "Long-Term Care Impacts on Farming Operations."

Long-term care costs can be a significant threat to family farming operations. Nursing homes can cost around $100,000 per year, an expense that some farms cannot absorb while remaining viable. That's why many farmers believe long-term care will force the sale of farm assets, including farmland.  But statistics and data indicate that, on average, this may not the case and that the average farmer can likely absorb the costs of long-term care.  However, few farms can withstand the outlier scenario:  where many years are spent in a long-term care facility.

In this webinar, Robert Moore will explore the costs and likelihood of needing long-term care.  Using this data, he will analyze normal scenarios and the dreaded outlier scenarios of long stays in nursing homes.   By understanding the actual risks of long-term care costs, we can better understand and assess strategies that can mitigate long-term care risks. Robert will review several strategies attorneys can use to lessen the exposure of farm assets to long-term care costs.

The National Agricultural Law Center (NALC) will host the webinar at noon on July 20.  OSU's Agricultural & Resource Law Program is a research partner of NALC, and Robert's work is the result of funding provided by the USDA National Agricultural Library through our partnership with NALC.

There is no fee for the event, but registration is required.  Register at https://nationalaglawcenter.org/webinars/longtermcare/.

 

NALC and USDA logos

Farmer holding clipboard with tractor in background and Legal Groundwork Series title
By: Robert Moore, Thursday, April 28th, 2022

We discussed long-term care (LTC) costs in our April 20 blog post and analyzed recent data to project that a 65-year-old Ohioan, on average, can expect about $100,000 in LTC costs, and double that for a married couple.  In this post, we continue to examine LTC costs by addressing an important question for farmers:  can the average farmer absorb this cost without jeopardizing the farm and farm assets? 

First, we need to remember that any income received by the farmer could be spent on paying the LTC costs.  Farm income, land rent, social security income, and income from investments can all pay for LTC costs.  After income is used to pay for LTC care costs, non-farm assets, like savings, can be used to pay for the costs. It’s the portion of the LTC costs that income and savings cannot cover that causes farm assets to be at risk.  For example, if the farmer has $40,000 in savings, using that savings to pay LTC leaves only $60,000 of farm assets at risk.

Let’s next turn to the risk to farm assets.  While a farmer would never want to sell any farm asset to pay for LTC, their land is probably the last asset they would want sold.  Most farmers would sell grain, crops, livestock, and machinery before they would sell land.  So, if income and savings cannot pay for LTC care costs, how at risk is the land?  Data can also help us answer this question.  According to the Economic Research Service – USDA (ERS), the total amount of non-real estate, farm assets owned by farmers in the US for 2020 were as follows:

                        Financial Assets                                 $92,013,020,000

                        Inventory (crops, livestock, inputs)      $62,866,872,000

                        Machinery                                          $278,809,055,000

                        Total Non-Real Estate Farm Assets   $533,688,897,000

The ERS further estimates that there were 2.02 million farmers in the US in 2020.  So, on average, farmers owned $264,202 of non-real estate, farm assets.  If income and savings are unable to pay for LTC costs, the average farmer would have an additional $264,202 of assets to sell before needing to sell real estate. 

So, what does all this data tell us?  On average, if farmers are forced to sell farm assets to pay for LTC, they will not need to sell their land.  They may need to sell crops, livestock and/or machinery to help pay for the LTC costs but the land is probably safe.  That is the good news.

The bad news is the above analysis is all based on averages.  When dealing with large numbers, averages are very useful.  We can say with some confidence that on average, a 65-year-old farmer in Ohio will spend around $100,000 on LTC.  However, the numbers cannot tell us with any certainty what a specific farmer will spend on LTC. Farmer Smith in Delaware County, Ohio might never pay any LTC costs, might pay the average of $100,000 or they might be an outlier.  An outlier is someone whose specific circumstances end up being significantly different than the average.

Being an outlier is what farmers are really concerned about regarding LTC.  We all know someone, or have heard of someone, who was in a nursing home for 10 years.  That’s close to $1 million in LTC costs.  Few farmers have the income, savings and non-real estate assets to pay for $1 million of LTC. 

So, what LTC planning for farmers really ends up being is protecting against the outlier scenario that puts the land at risk.  Most 65-year-old farmers would probably sleep well at night if they knew they would only have $100,000 of LTC costs for the rest of their lives.  That amount of LTC costs is probably not going to cause a farm liquidation.  What keeps farmers up at night is the chance they will be the outlier and spend 10 years in an expensive nursing home.

The outlier scenario is important for farmers to understand as they develop their LTC strategy.  For any risk management plan, the true nature of the risk must be understood and not just presumed.  The fact is most farms can probably withstand the average LTC costs.  It is also factual that most farms cannot withstand an outlier scenario of being in a nursing home for many years.  This understanding is critical in developing a LTC plan.  That is, the LTC plan should probably seek to mitigate the risk of being an outlier, not on being average.

Fortunately, there are strategies to help mitigate the risk of losing the farm to the outlier scenario, although each of the strategies have significant drawbacks.  In future posts, we will discuss those strategies.

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