Comment by georgeburdell
3 years ago
This is why although I’ve almost got enough money to retire (~20x yearly expenses) but I’ll keep on working for another decade or two. All of these whiz-bang new treatments are going to be expensive. The most expensive medical procedure right now is a heart transplant at about $1M. Then there’s the $10k/mo for a nursing home
The other thing you can do is setup a trust for yourself so that you're broke on paper long before the trust runs out of money. I don't know if it's ethical but it's legal.
What's unethical is a system that completely drains a person's wealth for getting sick.
Certainly this happens for procedures that should be cheap, and nursing homes are also a huge issue. But in the current discussion it's not clear to me that something like a heart transplant should be cheap. Development of a novel treatment can be very expensive and sometimes involves scarce resources.
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spend a decade of your life to possibly save a few years later? If you are “investing” your time for someone else, perhaps you could just give them your time directly instead?
Is that the real price of a nursing home in the US? Who can afford that?
Yes - that's not unreasonable for a full time care facility for something like dementia or Alzheimer's in the US (it's below what we paid for my grandmothers).
If you're lucky - they have long term care insurance, and that covers most of the expenses for approx 2 to 10 years (depending on how old the insurance is - it's getting harder to find long plans, and they're all getting significantly more expensive as it turns out more folks needed them).
Otherwise... you spend everything, and then your kids pay.
We split my grandmothers down the middle - my mom's had insurance, we covered my dad's.
I'd rather just die. Throw a party. Tell my kids they're getting a ton of cash. Say good bye on happy terms.
Vs. a miserable decay for everyone involved at huge expense. It's not worth it. Forget the money. The emotional toll is large and for whose benefit?
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Medicaid will pay for nursing homes (if medically justified) once you run out of money; but the per diem isn't that much. Apparently a lot of nursing homes will commit to accepting medicaid reimbursement for continuing care if you can commit to paying N years first. I've heard usually 2, sometimes 3. If you can swing that, your kids won't have to pay, or they'll pay for incidentals, but not the whole thing. There are homes that just straight up take medicaid, but they review poorly; it's not enough to pay decent staff at reasonable levels, so there you go.
What I've heard about long term care insurance is you can't really buy a plan with useful coverage anymore. The old plans were good as long as the insurer remained solvent, but many didn't.
"Otherwise... you spend everything, and then your kids pay."
That's incorrect. With Medicaid, the recipient is require to spend down their assets to a small amount, then Medicaid will pick up the remainder. The recipient's children aren't on the hook for anything. Of course, they won't receive any inheritance since the estate of the recipient has been drained prior to Medicaid.
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My father had long term care insurance. He got Alzheimers, and went into a nursing home, and passed after 3 years. The insurance covered most of nursing home fees.
I did some math on the premiums he'd paid for the insurance, and the payout. It was a break even.
In other words, putting the premiums into an HSA would have financially worked out a lot better.
You either have enough to pay or you pay until all your assets are exhausted to $0 and then Medicaid takes over.
I'm guessing Medicaid isn't going to pay for the kind of nursing home that costs $10k/month?
Medicaid will force you to sell your house once that happens.
It's the type of nursing home. If you are in an "assisted living" home, it is less. As a data point, maybe $5800/mo in CA, which includes food and various social programs.
Yes it sounds crazy but when i was kid i worked as waiter at a nursing home and heard it cost 8k a month. That was nearly 20 years ago.
Pay lots of money to spend more of your life dying
If you need a heart transplant, are you planning to self-pay that?
I have health insurance but I don’t trust some company to not dither when time counts