David Greene, CFP® hosts Dr. Christine Hunter, to discuss real life long term care planning experiences.
Dave:
Hello and welcome to this CJM podcast focused on long term care planning and all the issues that go around it. My name is David Green. I’m CEO and owner here at CJM Wealth Advisers, and with me today is a very special guest and client, Dr. Christine Hunter. Chris, welcome,
Dr. Hunter:
Terrific to see you in person.
Dave:
Really good to see you live and in person and happy to have you here, especially. I’m going to embarrass you a little bit with a bio. The reason we have Chris here speaking to this topic will become very apparent as I share her accomplished career and history. She has a long history, both distinguished military service, as well as service in the federal health programs. On active duty, Chris actually rose to the rank of Rear Admiral, and some of her leadership roles included the deputy director of the entire TRICARE management system, as well as commanding officer at Navy Medical Center over in San Diego, a couple other distinguished roles as well. Then, upon completing your military career, Chris, you joined the US Office of Personnel Management, what we know as OPM, and no small task as the chief medical officer overseeing the entire federal employee’s health benefits program. You know care.
Dr. Hunter:
Yes, and insurance.
Dave:
And, insurance. So, we feel like the credibility is there to speak to this topic. Speaking of which, there’s also the universal application. This is going to touch us all. It’s touched you. It’s touched me. We want to have our listeners understand that. One of the statistics, as we look at some statistics here, we’ll put a slide up. Someone turning age 65 today has an almost 70% chance, 70%, of needing some type of long term care service during their life expectancy. It’s going to touch us or a parent or a sibling. That’s really why we have you here today, is not to throw too much data driven information, but more case study and anecdotal. You’re going to share, to start off with here, your experience with your mom and her long term care story and how she’s gone through some different planning challenges, et cetera. So, please share.
Dr. Hunter:
Sure. Well, again, nice to be with you. I’ll start by saying that mom’s 90, and as things go in life, when she was in her late 60s, we decided on a long term care policy. Her main concern at that point was to frame the cost of nursing home care, should she ever need that. The women in her family live a long time, and she did well in her own home with some assistance from a neighbor up until the pandemic, when she went to live with my brother. She desperately wanted to get back into her own home. As we transitioned her back into her own home, and I went to live with her for a few months, it became clear to me that she needed a lot more help.
She needed help with daily activities, and she was not necessarily safe in doing things on her own, both mobility and vision-wise. So, we set about hiring care in and also activating her long term care insurance policy. After some ups and downs with both of those processes, finding the right care, and getting through the process of qualifying for her long term care insurance, we had her in a lovely situation with a home caregiver, until unfortunately, she had a stroke. Now, she’s residing in a nursing home, but doing well there and with continued financial assistance with the long term care policy.
Dave:
I really appreciate the personal share there, again have seen my own parents go through it. We’ve had many conversations with clients like yourself. One of the decisions and/or sometimes decided for you is where you’re going to receive care, where your mom received care, and how she’s going to receive it. In fact, she had some in home on her own, and then she did live with an adult child, and is now in a facility. So, these are the options that are out there. She’s done all three, and I think it’s important for people to know. You have had conversations with her and your siblings as to who could do what, how, when. So, when situations came along, it wasn’t a fire sale to decide how we were going to care for mom.
Dr. Hunter:
Right. Mom was adamant that she wanted to stay at her own home as long as possible. I think we see that in many of our seniors. She did not want to move to any kind of retirement community or assisted living. So, we honored that wish all the way up to the point where we couldn’t.
Dave:
Well, and we’re going to talk about that here in a second, I think, is honoring the wish and the dignity, right? Because, it’s hard in a couple different phases of this. We’ll shift over to long term care insurance as part of a way to fund the care that she needed. We’d all love to think that it’s just a flip of a switch, and the insurance policy is active. And, you know very well that that’s not the case. There’s practical challenges with mom in this situation. There’s logistical challenges with the insurance carrier. Can you share a little more?
Dr. Hunter:
Right, so of course there’s convincing mom.
Dave:
Big one.
Dr. Hunter:
That she needs more help than neighbors and friends and family are able to give her and that she could feel comfortable and safe with help coming into her home, which was another concern. I think what ultimately convinced her was we told her that if we were able to activate the long term care insurance and hire some professional help in, that she would stop paying the premium, which was-
Dave:
Incentive she needed.
Dr. Hunter:
An important incentive, right? And, so we set about to do that. Of course, during the pandemic, finding in home care had its challenges. We were able to do that. Then, qualifying for the long term care insurance in her situation was a little bit more difficult. She didn’t have a diagnosis like Alzheimer’s or some of the others that can streamline your entry into the policy. So, we had to prove the assistance she needed with the activities of daily living, so bathing, dressing, eating, transferring, toileting, those kinds of things, and ultimately had a case management nurse into the house to watch her do some activities.
Dave:
And, that is difficult both to get the person receiving the care commit to doing that, because there’s a dignity aspect there, and then, getting through the various different hurdles of qualifying for care. I think you had mentioned even the elimination period was something that was, whether it was confusing or difficult, it wasn’t exactly what you had anticipated.
Dr. Hunter:
Exactly. So, mom’s policy had a 90 day, what I’ll call a deductible. You had to pay for 90 days of care on your own before the policy would pay for care. I thought that those were 90 sequential days from the point at which she qualified to the point at which they start to pay, but in fact it was 90 days in which we could individually, each day, prove that the required level of services had been provided. In order to do that, we had to not only submit receipts from the home care, but we had to get documentation from all of the physical therapy and other services that she was receiving to be sure that they qualified and were not simultaneously being paid for by Medicare.
Dave:
Right, and I think a couple takeaways here are, one, the complexity involved in the claims process, which is not to discourage people from getting long term care insurance, but is the realization that even somebody with your background and understanding had challenges. With that said, anecdotally, I think we can also share as advisors that we have had, even personally, maybe experiences on the other end of the spectrum, where you did run into the care … the relationship manager at the insurance that understood, had the knowledge and the heart that got you through. But, just be prepared. One of the universal communications here is having a plan and being prepared for what’s going to happen. Speaking of being prepared and having gone through and continuing to make choices and help support your mom, you also need to make choices and help support yourself. So, do you mind sharing a little bit as to what you’ve learned and how you’re approaching your own situations?
Dr. Hunter:
Right, not at all, happy to share, because now, mom, as we said, is in nursing home, and the long term care is helping to defray the cost of that. But, we are surprised at how much costs. I think all the listeners will be surprised too, once the monthly bills tally up. So, for my own situation, I chose not to use a long term care insurance policy, but a life insurance policy with a chronic illness provision. Some people call those an accelerated death benefit or long term care rider. But, basically those funds could supplement my pension income to pay for my care, if and when it’s needed. The nice thing about that is if I don’t use it, then the whole policy goes to my heirs.
Dave:
Sure, sure, and so that’s one aspect of your plan, is the cost of care, understanding how much it can cost, and then where the money’s going to come from. One of the other aspects is where might you receive care. So, your daughter’s on the west coast. Do I? Don’t I? Will she be there? These are questions that you’re having to figure out.
Dr. Hunter:
Right, right, and so I’ve decided that when I need care, I should be living in a situation that’s close to my daughter, that when our children have children, it’s not reasonable to think that they can fly across the country or even travel several states to come and help us out in the moment, the unpredictable moment when we need them at the bedside. So, I’ll go where my daughter is, and I hope I have some advanced notice of where that’ll be. I’m also looking at continuing care retirement communities, because one of the things we learned with mom was that when you do need a nursing home, sometimes beds are full at the highest quality facilities. If you have a life care contract, then your admission to a quality facility is usually guaranteed.
Dave:
Really important point that you and I have talked about, and I’ve had some serious conversations with clients recently. Then, I faced it myself when my mom, as you know, was in a wheelchair. Dad was kind of the caregiver. This was September of 2017. I go down there to have a conversation with them. We sign the application for the continuing care retirement community. That night, my dad has a stroke, and all of a sudden, that option is off the table. So, really, because it’s very easy to say, “We’re going to kick the can. I’m going to deal with that in seven years.” But, you need to do the research and have a plan.
Dr. Hunter:
Exactly.
Dave:
So, kudos to you. Maybe we’ll sum it up there, because the purpose of this conversation for our listeners is to hear from somebody who’s been through it to hopefully inspire you to have the conversations, to create the plan, to do the research. Because, there’s a lot to it. There’s a lot to it. So, truly, truly appreciate you sharing your personal experience.
Dr. Hunter:
My pleasure.
Dave:
Hope you as listeners have benefited from that. I appreciate you taking the time with us and look forward to having you attend another CJM podcast here soon. Thank you so much.
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