Long Term Care Premium Increases — Things to Consider if You Receive a Notice

Contributed by: Sandra Adams, CFP®

No one likes to receive a letter stating that their premiums are going up — especially with a Long Term Care insurance policy that already seems relatively expensive. Unfortunately, when you own something other than a “paid up” Long Term Care Insurance Policy, the question is not if but when you might receive such a notice. To review, remember that the law allows insurers to apply to regulators for an increase in premiums.

Increases are allowed only if they apply to all policyholders and the company’s data shows current premiums will not cover current and future claims based on costs, projected interest rates, projected increases in claims or length of claims. (Companies cannot increase premiums for specific individuals based on increases in age, gender, health conditions, or filing of a claim.)

Taking the time to make an educated decision about your options when a premium increase occurs is crucial when it comes to Long Term Care insurance, especially as you get older. The more time passes, the greater the likelihood that you might need this type of insurance.

If you are faced with a premium increase, you typically have a limited number of options: 

1. Pay the increased premium and keep your current coverage.

2. Continue to pay your current premium or a reduced premium and accept some combination of reduced benefits (likely in this category, your Long Term Care insurance company will offer you a short list of options from which to choose). *NOTE: We have recently discovered that the list of options provided WITH the premium increase are not the only options. If you wish to consider additional options, you (and/or you advisor) can contact the Long Term Care company to request additional options. For example, a client in their mid-80s may consider an option to discontinue the compound inflation rider going forward and considerably decrease the premium. The added benefit for someone in their mid-80s is negligible at that point.

3. Take the Contingent Non-Forfeiture Option. If the percentage of premium increase is at a certain level, you may be able to stop paying premiums, and you would be entitled to a long-term care benefit based on the amount of premium dollars you have already paid.

It makes sense to carefully weigh your options when it comes to the Long Term Care insurance decision. Understand that you have full control. The Long Term Care insurance company will provide additional options if you request them — but you have to ask. And work with your financial advisor to review your options and see what makes sense. The only option that likely DOES NOT make sense is NOT writing the check to the Long Term Care insurance company at all!

Sandra Adams, CFP®, CeFT™, is a Partner and CERTIFIED FINANCIAL PLANNER™ professional at Center for Financial Planning, Inc.® She specializes in Elder Care Financial Planning and serves as a trusted source for national publications, including The Wall Street Journal, Research Magazine, and Journal of Financial Planning.

Health Care Costs: The Retirement Planning Wildcard

Contributed by: Kali Hassinger, CFP®

When planning ahead for retirement income needs, we typically think about how much it will cost us to live day-to-day (food, clothing, shelter), and to do those things we want to do, like travel and helping grandkids pay for college. The costs we don’t often think about, those that could potentially wreak havoc on retirement income planning, are health care costs.

According to a recent article from the Employee Benefits Research Institute, the average 65-year-old couple will need $400,000 to have a 90% chance of covering health care expenses over their remaining lifetimes (excluding long-term care).

Longevity is a critical factor driving health care costs. According to the Social Security Administration’s 2020 study, a couple, both 66 years of age, has a 1-in-2 chance that one will live to age 90 and a 1-in-4 chance that one will live to age 95. And considering that Medicare premiums are means-tested, the more income you generate in retirement, the higher your Medicare premiums.

So, what can you do to plan for this potential large cost?

1. If your goal is to retire early, plan on self-insuring costs from retirement to age 65. Some employers may offer retiree healthcare, or you can purchase insurance on the Health Insurance Exchange through the Affordable Care Act (still out-of-pocket dollars in retirement).

2. Consider taking advantage of Roth 401(k)s, Roth IRAs (if you qualify), or converting IRA dollars to ROTH IRAs in years that make sense from an income tax perspective. You can use these tax-free dollars for potential retirement health care expenses that won’t increase your income for determining Medicare premiums.

3. Work with your financial planner to determine whether a non-qualified deferred annuity or similar vehicle might make sense for a portion of your investment portfolio. Again, these dollars can be tax-advantaged when determining Medicare premiums.

4. Most importantly, work with your financial planner to simulate retirement income needs for health care expenses and include this in your retirement plan. Although you will never know your exact need, flexible planning to accommodate these expenses may help provide confidence for your future.

Contact your financial planner to discuss how you can plan to pay for your retirement health care needs.

Kali Hassinger, CFP®, CDFA®, is a CERTIFIED FINANCIAL PLANNER™ professional at Center for Financial Planning, Inc.® She has more than a decade of financial planning and insurance industry experience.

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UPDATED from original post on March 11, 2014 by Sandy Adams.

Any opinions are those of Kali Hassinger and not necessarily those of Raymond James. This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Investing involves risk and you may incur a profit or a loss regardless of strategy selected. Prior to making an investment decision, please consult with your financial advisor about your individual situation. Roth IRA owners must be 59½ or older and have held the IRA for five years before tax-free withdrawals are permitted.

The One Mistake You DON’T Want to Make with Your Long Term Care Insurance

Contributed by: Sandra Adams, CFP®

If you’re reading this, you are likely among the few people who have planned ahead and purchased Long Term Care insurance. By doing this, you intend to protect yourself and your family, and hedge your assets against the possible threat of a long-term care event (need for care in your home, assisted living or nursing home).

Given that only about 15% of Americans own Long Term Care insurance (Fidelity 2016) and 70% of Americans over the age of 65 will need some form of long-term care services for cognitive or physical impairment (HealthView Insights 2014), you will likely need the insurance you’ve purchased. The question is, will you use your Long Term Care insurance when the time comes?

I have had several client experiences that looked like this:

• The client was at or near a point of qualifying for benefits under their Long Term Care insurance for either physical or cognitive reasons;

• The client and/or the family made the decision to not begin the claim process. Why? They wanted to wait a while longer, continue to try to care for the client on their own, save the Long Term Care insurance benefits for later, when they really needed them.

• The results in nearly all of these cases? The clients either never filed a claim or filed far too late, ended up in a long-term care facility, and ultimately passed away without ever receiving the policy benefits for which they had made years – even decades – of payments.

In my experience as a financial advisor, I have never had a client run out of a Long Term Care benefit pool. I am not here to tell you that it does not happen – it certainly can. But I am here to tell you that I do not believe it happens often. I have searched far and wide for statistics that would show how often it happens and cannot find a number!

Although your Long Term Care insurance company would prefer that you wait to put in your claim, I recommend that you do so as soon as you are eligible. You can always stop the benefits if you no longer need them, then restart later. And if you max out your benefits, you have the satisfaction of knowing that you received 100% of your benefits and protected your assets to the greatest possible degree. Don’t lose out (or let your parents lose out) on the Long Term Care insurance benefits they have purchased!

If you have questions or need additional guidance on this or related issues, please do not hesitate to reach out. We are always happy to help! Sandy.Adams@centerfinplan.com

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc.® Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

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Any opinions are those of Sandra D. Adams, CFP® and not necessarily those of RJFS or Raymond James. The information contained in this report does not purport to be a complete description of the securities, markets, or developments referred to in this material. Guarantees are based on the claims paying ability of the issuing company. Long Term Care Insurance or Asset Based Long Term Care Insurance Products may not be suitable for all investors. Surrender charges may apply for early withdrawals and, if made prior to age 59 1⁄2, may be subject to a 10% federal tax penalty in addition to any gains being taxed as ordinary income. Please consult with a licensed financial professional when considering your insurance options. These policies have exclusions and/or limitations. The cost and availability of Long Term Care insurance depend on factors such as age, health, and the type and amount of insurance purchased. As with most financial decisions, there are expenses associated with the purchase of Long Term Care insurance. Guarantees are based on the claims paying ability of the insurance company.

High-deductible medical insurance plan? Try an HSA!

Contributed by: Josh Bitel

With the first year of the new Tax Cuts and Job Act behind us, tax-efficient saving seems to be top of mind for many Americans. In a world of uncertainty, why not utilize a savings vehicle you can control to help with medical costs?

USING AN HSA

A Health Savings Account, or HSA, is available to anyone enrolled in a high-deductible health care plan. Many confuse an HSA with a Flex Spending Account or FSA – don’t make that mistake! A Health Savings Account is typically much more flexible and allows you to roll any unused funds over year to year, while a Flex Spending Account is a “use it or lose it” plan. 

WHAT AN HSA CAN COVER

Many employers who offer high-deductible plans will often contribute a certain amount to the employee’s HSA each year as an added benefit, somewhat like a 401k match. Dollars contributed to the account are pre-tax, and tax-deferred earnings accumulate. Funds withdrawn, if used for qualified medical expenses (including earnings), are tax-free.

The list of qualified medical expenses can be found at irs.gov; however, just to give you an idea, they include expenses to cover your deductible (not premiums), co-payments, prescription drugs, and various dental and vision care expenses.

As always, consult with your financial advisor, tax advisor, and health savings account institution to verify what expenses qualify. If you make a“non-qualified” withdrawal, you will pay taxes and a 20% penalty on the withdrawal amount. 

HERE ARE THE DETAILS FOR 2019:

Individuals

• Must have a plan with a minimum deductible of $1,350

• $3,500 contribution limit ($1,000 catch-up contribution for those 55 or older)

• Maximum out-of-pocket expenses cannot exceed $6,750

Family

• Must have a plan with a minimum deductible of $2,700

• $7,000 contribution limit ($1,000 catch-up contribution for those 55 or older)

• Maximum out-of-pocket expenses cannot exceed $13,500

WITHDRAWING FROM AN HSA

Once you reach age 65 and enroll in Medicare, you can no longer contribute to an HSA. However, funds can be withdrawn for any purpose, medical or not, and you will no longer be subject to the 20% penalty. The withdrawal will be included in taxable income, as with an IRA or 401k distribution. This can present a great planning opportunity for clients who may want to defer additional money, but have already maximized their 401k plans or IRAs for the year.

Although you have to wait longer to avoid the penalty than with a traditional retirement plan (age 59 ½), this investment vehicle could reduce taxable income in the year contributions were made, while earnings have the opportunity to grow tax-deferred and tax-free.  

As you can see, a Health Savings Account can be a great addition to an overall financial plan and should be considered if you are covered under a high-deductible health plan. No one likes medical expenses, but this vehicle can potentially soften their impact.

Josh Bitel is a Client Service Associate at Center for Financial Planning, Inc.®

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Links are being provided for information purposes only. Raymond James is not affiliated with and does not endorse, authorize or sponsor any of the listed websites or their respective sponsors. Raymond James is not responsible for the content of any website or the collection or use of information regarding any website's users and/or members.

Practical ways to qualify for an Obamacare subsidy

For any “early” retirees between the ages of 55-64, one of the biggest burdens on cash flow will probably be medical expenses. More specifically health insurance premiums. Although enrolling for Obamacare won’t make you healthier per se, if you structure your income correctly, there are ways to qualify for significant subsidies to help ease the burden of your monthly health insurance premiums.

The Threshold to Qualify

In order to qualify for a subsidy, your modified adjusted gross income (MAGI) must be between 100-400% of the federal poverty level. For 2014 those levels were $15,739-$62,920 for a family of 2, and $23,850- $95,400 for a family of 4. The lower you are in these thresholds, the higher the subsidy amount will be. Also, the older you are, the higher the subsidy will be. For example a 62-year-old couple with a MAGI of $50,000 will be eligible for a larger subsidy then a 55-year-old couple with the same MAGI.

You might be thinking your income is too high and this article doesn’t pertain to you. Not so fast.  There are ways to structure your retirement income so that you will fall well within these thresholds. Here’s an example:

Let’s take a 62-year-old married couple (family of 2) with these assets:

                                                $1,500,000 of IRA money,

                                                $250,000 in checking & savings

                                                $250,000 in a taxable brokerage account

Their annual income need is $100,000 gross (before-tax). Their taxable portfolio kicks off $12,500 of interest and dividends and the husband has a $30,000 pension. Both must be reported as income on your taxes. So far, we have $42,500 of taxable income, and the threshold before you are completely ineligible for a subsidy for a family of 2 is $62,920.  That means we have $20,420 left of taxable income left to recognize before they are completely phased out.

How to Plan for a Subsidy

As mentioned previously, the couple’s annual income need is $100,000 and they have $42,500 of taxable income (so far) to go towards satisfying that need. This means they still need $57,500 to fulfill their need for the year.  This is where the planning comes into place.  By taking $57,500 from their savings account, their need for the year would be met, and they wouldn’t need to report any more taxable income as a result of this withdrawal from checking & savings (because taxes were already paid on these dollars). Also, by having a MAGI of $42,500 they would qualify for a significant Obamacare subsidy … probably $6,000-$10,000 based on the Henry J. Kaiser Family Foundation’s Obamacare calculator I used here.

Things that will affect your taxable income (and possibly disqualify you):

• Social Security:  if you decide to collect early at age 62, up to 85% of your benefit could be taxable and could push you out of the thresholds for a subsidy.

• Taxable dividends & interest:  Dividends and interest are good, but you should try to estimate what they will be for the year to make sure they won’t push you out of the parameters for a subsidy.

• Capital Gains:  You bought shares of Apple when it was at $5 and decided to sell it all in 2014. Great you made a lot of money!  But you can probably forget about an Obamacare subsidy because that gain is going to push your MAGI up too high.

• Part Time Work: Obviously earned income is going to be reported on your tax return, and have an impact on your eligibility.  Also, if your employer offers “affordable” health care to you, you don’t qualify for a subsidy.

Please keep in mind that this planning must be done very carefully, and you should almost certainly work with a professional to make sure it is done properly.  The thresholds are a “cliff” so if you go one dollar over, you will need to pay back the subsidy in its entirety. Don’t let this deter you or your family from considering a similar strategy!  We have helped many clients navigate through similar situations and would love to be a resource if you have questions or would like us to look at your personal scenario. 

Matthew Trujillo, CFP®, is a Certified Financial Planner™ at Center for Financial Planning, Inc. Matt currently assists Center planners and clients, and is a contributor to Money Centered.

The information has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material is accurate or complete. Material is provided for informational purposes only and does not constitute a recommendation. Any opinions are those of Center for Financial Planning, Inc. and not necessarily those of RJFS or Raymond James. You should discuss any tax or legal matters with the appropriate professional. This is a hypothetical example for illustration purposes only. Actual results will vary. Links are being provided for information purposes only. Raymond James is not affiliated with and does not endorse, authorize or sponsor any of the listed websites or their respective sponsors. Raymond James is not responsible for the content of any website or the collection or use of information regarding any website’s users and/or members. C14-041066

Health Care Costs: The Retirement Planning Wildcard

Planning ahead for retirement income needs, we typically think about how much it will cost us to live day-to-day (food, clothing, shelter) and to do those things we want to do, like travel and helping grandkids pay for college.  The costs we don’t often think about, those that could potentially wreak havoc on retirement income planning, are health care costs.  According to an October 2012 article from the Employee Benefits Research Institute, an average 65 year-old couple will need $283,000 to have a 90% chance of having enough money to cover health care expenses over their remaining lifetimes (excluding long-term care).

Longevity is a critical factor driving health care costs.  According to the Social Security Administration’s 2020 study, for a couple, both 66 years of age, there is a 1 in 2 chance that one will live to age 90 and a 1 in 4 chance that one will live to age 95.  Add to these longevity statistics the fact that Medicare is now means-tested, so the more income you generate in retirement, the higher your Medicare premiums.

So, what can you do to proactively plan for this potential large retirement cost?

1. If you plan to retire early, plan on the costs of self-insuring from retirement to age 65.  Some employer’s may offer retiree healthcare, or you can purchase insurance on the Health Insurance Exchange through the Affordable Care Act (these are still dollars out of your pocket in retirement).

2. Consider taking advantage of Roth 401(k)s, Roth IRAs (if you qualify), or converting IRA dollars to ROTH IRAs in years that it makes sense from an income tax perspective.  This will give you tax-free dollars to use for potential retirement health care expenses that won’t increase your income for determining Medicare premiums in retirement.

3. Work with your financial planner to determine if a vehicle like a non-qualified deferred annuity might make sense for a portion of your investment portfolio, again dollars that can be tax advantaged when determining Medicare premiums.

4. Most importantly, work with your financial planner to simulate the need for future retirement income for health care expenses.  Although you will never know what your exact need will be, providing flexibility in your planning to accommodate for these expenses may help provide you confidence for future retirement.

Contact your financial planner to discuss how you can plan to pay for your retirement health care needs.

Sandra Adams, CFP®is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In 2012 and 2013, Sandy was named to the Five Star Wealth Managers list in Detroit Hour magazine. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.

Five Star Award is based on advisor being credentialed as an investment advisory representative (IAR), a FINRA registered representative, a CPA or a licensed attorney, including education and professional designations, actively employed in the industry for five years, favorable regulatory and complaint history review, fulfillment of firm review based on internal firm standards, accepting new clients, one- and five-year client retention rates, non-institutional discretionary and/or non-discretionary client assets administered, number of client households served.

The information has been obtained from sources considered to be reliable, but we do not guarantee that it is accurate or complete, it is not a statement of all available data necessary for making an investment decision, and it does not constitute a recommendation. Any opinions are this of Center for Financial Planning, Inc. and not necessarily those of Raymond James. Every investor’s situation is unique and you should consult with your financial advisor about your individual situation prior to making an investment decision. Please discuss any tax or legal matters with the appropriate professional. C14-005524