I had seen this also. It is quite the read - I think there are quite a few "take-aways" in it, especially, in my view, how pursuit of LTC reimbursement can potentially become almost a full time job.
In my state, a hospital group that includes about half the hospitals in the area finally just "gave up" in trying to negotiate with UHC (United Health Care) due to the low reimbursement and ridiculous pre-authorizations ("need a bandaid? you'll have to get the MA (Medicare Advantage) plan to authorize that, that could take a while") and dropped MA altogether. Hmmm.... So, perhaps there is some hope for real change when the providers stop providing. Yes it is unfair to the MA plan members who are caught in the middle, but it should be a clear warning to anyone else considering an MA plan.
Thanx for posting. Actual experiences with any of these systems/bureaucracies that many of have to deal with are invaluable. Whenever people post about experiences, especially "what not to do", as you have, I try to make a note and the reference in a ongoing document I keep. As Warren Buffet has said "It's good to learn from your mistakes. It's better to learn from other people's mistakes."
"I’ve seen occasions where elderly parents, sincerely concerned about not burdening their children, wait too long to acknowledge their challenges, and honestly communicate with their children. At some point the inevitable emergency occurs, and the children now have a more significant burden with little time to plan." My parents are in a CCRC and were in independent living, and, as they hit their 90s, it was clear to all except perhaps them that they needed to move to the next level of care (assisted living). I was trying to have this discussion with them. What I said to them was: "right now, there is no immediate urgency, so perhaps you have 5 months to make a decision on where you want to live if "something happens". If you wait too long and "something happens", you may find yourself in a position where a decision needs to made in in 5 hours, and, you might not even get a vote." Well, with my and my siblings urging (and trying really hard NOT to act like “we know what is good for you”), they ended up transitioning to a higher level of care. The timing was auspicious. They did move, and, within several months, after some steep mental decline topped off with a bad fall, they are now both in the perhaps the last level of care – full-on nursing care. So, even if plans don’t work out, the planning process is very important as it allows one to at least familiarize oneself with the all the possibilities and potential steps to be taken.
Yes, this goes back to to what I said: “memory tends to be altered by what has happened since the event took place. “ From everything I have read, and, from my own experience, I am 100% certain that I (and, if I may be so bold, everyone else) will not remember exactly what they did, and, more importantly, exactly the rationale for having made a certain decision in the past. Everything that has happened to me since the decision was made will necessarily color how I view what really happened in the past. This is why I keep spreadsheets with numbers entered at the time or near the time I made decisions. In a remarks column at the right, when I make a decision, I try to record what I was thinking at the time. Recorded numbers and thoughts don’t lie (even if I want them to). Years ago, I started keeping a journal - private, highly-encrypted, of the ongoing struggles in my life. When I go back occasionally and read (from years ago) what was going on and my thoughts about what was happening at the time, I am often surprised to see what I wrote, as it does not exactly match how I remember it. And yet, since I recorded what was happening and my feelings about it right when it was happening, my “record” of it is certainly 100% accurate in how I felt, since that is what I wrote down at the time. So, my point is, I try (within the limits of being human) not to make decisions on how I feel, but rather on what the data says; so, for all you star trek nerds, I try to think and act like Spock (or perhaps Warren Buffet, perhaps the closest human to be Spock-like in investing). But, even knowing this about myself, it is still hard not be swayed by “how I feel”. -- BTW – off topic – but I believe that writing down what one thinks (and keeping it) is a cheap an effective form of Cognitive Behavioral Therapy. When one one writes down what they are thinking, it is much more likely to result in a coherent narrative that stays on topic, and, as I said, forms a record of the past about oneself, that, try as one might, becomes hard to deny if one is truly open to honest self-reflection. Being able to brutally honest with myself did not come easy, and sometimes, can be “hard to swallow”, but, I have found out quite a bit about myself that I doubt I ever would have recognized or have been able to accept any other way.
“If you are concerned about IRMAA, you have done far better than the great majority of retirees.” You are correct, and I count myself among the lucky, and in no way because of any great financial smarts I have (or think I have). And I am grateful that at this time (early 60s, although perhaps mid-60s, but I have not yet been able to admit that to myself) my wife and I enjoy good health. And I realize that that, by definition, that cannot last forever. Still, when I look at health overall insurance costs when I am 75 (and must start taking RMDs which will trigger IRMAA), it is a bit staggering.
I agree also. As I look at back it now, it was far easier to accumulate by just saving more than I spent, even having made a number of investment and other financial mistakes. Now, I am faced with the task of not having it taken away by taxes, IRMAA, cyber-criminals, yada, yada. Much more thought required, and, I think, much easier to screw it up. I do lots of spreadsheets, but I think the prime value in keeping good data is that it forces you to look at what you are doing and, most importantly, what you have done. Relying on memory, even a really good memory, is often problematic: memory tends to be altered by what has happened since the event took place.
I find this site: https://www.advisorperspectives.com/ to be of value. Every day it posts a half-dozen or so opinions by industry professionals. As we all know, no one knows the future yet everyone has an opinion on it. So, on the same day I can read “qualified” opinion pieces that say we are going into a recession/growth period or, (conversely?) into a growth/recession period. So, it keeps me grounded in the only thing that is 100% certain in the market – no one knows. I think it keeps me from doing stupid things. (Well, I still do stupid things, just perhaps not AS stupid).
Years ago I read this article: https://nymag.com/news/features/parent-health-care-2012-5/# as well as this one: https://www.washingtonpost.com/wp-dyn/content/article/2009/01/09/AR2009010902298_2.html?sid=ST2009010903215 and, lots of others since then. I certainly would not judge the decisions on this topic by anyone else, but, around that time I decided, if I have anything to say or do about it when the time comes, that long term care, funded or not, was not for me. Today, my parents are in their 90s, and, my family is living much of what was written in that first article from 2012 (in fact, many of the similarities are eerily striking). My parents have some LTCI and it helps a lot, but, in my opinion, the money part of this whole thing is really not the important part. My best to all of you.
Take a deep breath, and read this article (actually, DON'T read the article, JUST the HEADLINE): Strategic Income Outlook: Magic 8-Ball Says, “Cannot Predict Now” https://www.advisorperspectives.com/commentaries/2025/01/16/strategic-income-outlook-magic-8-ball-cannot-predict
Comments
I had seen this also. It is quite the read - I think there are quite a few "take-aways" in it, especially, in my view, how pursuit of LTC reimbursement can potentially become almost a full time job.
Post: Interesting White Coat Investor on Lessons Learned Dealing with a LTC Company
Link to comment from June 18, 2025
In my state, a hospital group that includes about half the hospitals in the area finally just "gave up" in trying to negotiate with UHC (United Health Care) due to the low reimbursement and ridiculous pre-authorizations ("need a bandaid? you'll have to get the MA (Medicare Advantage) plan to authorize that, that could take a while") and dropped MA altogether. Hmmm.... So, perhaps there is some hope for real change when the providers stop providing. Yes it is unfair to the MA plan members who are caught in the middle, but it should be a clear warning to anyone else considering an MA plan.
Post: Author of Medicare Advantage Speaks Out
Link to comment from June 18, 2025
Thanx for posting. Actual experiences with any of these systems/bureaucracies that many of have to deal with are invaluable. Whenever people post about experiences, especially "what not to do", as you have, I try to make a note and the reference in a ongoing document I keep. As Warren Buffet has said "It's good to learn from your mistakes. It's better to learn from other people's mistakes."
Post: Medicare Signup Goes Awry
Link to comment from June 14, 2025
"I’ve seen occasions where elderly parents, sincerely concerned about not burdening their children, wait too long to acknowledge their challenges, and honestly communicate with their children. At some point the inevitable emergency occurs, and the children now have a more significant burden with little time to plan." My parents are in a CCRC and were in independent living, and, as they hit their 90s, it was clear to all except perhaps them that they needed to move to the next level of care (assisted living). I was trying to have this discussion with them. What I said to them was: "right now, there is no immediate urgency, so perhaps you have 5 months to make a decision on where you want to live if "something happens". If you wait too long and "something happens", you may find yourself in a position where a decision needs to made in in 5 hours, and, you might not even get a vote." Well, with my and my siblings urging (and trying really hard NOT to act like “we know what is good for you”), they ended up transitioning to a higher level of care. The timing was auspicious. They did move, and, within several months, after some steep mental decline topped off with a bad fall, they are now both in the perhaps the last level of care – full-on nursing care. So, even if plans don’t work out, the planning process is very important as it allows one to at least familiarize oneself with the all the possibilities and potential steps to be taken.
Post: Who Will Care for Us? by Dennis Friedman
Link to comment from June 5, 2025
Yes, this goes back to to what I said: “memory tends to be altered by what has happened since the event took place. “ From everything I have read, and, from my own experience, I am 100% certain that I (and, if I may be so bold, everyone else) will not remember exactly what they did, and, more importantly, exactly the rationale for having made a certain decision in the past. Everything that has happened to me since the decision was made will necessarily color how I view what really happened in the past. This is why I keep spreadsheets with numbers entered at the time or near the time I made decisions. In a remarks column at the right, when I make a decision, I try to record what I was thinking at the time. Recorded numbers and thoughts don’t lie (even if I want them to). Years ago, I started keeping a journal - private, highly-encrypted, of the ongoing struggles in my life. When I go back occasionally and read (from years ago) what was going on and my thoughts about what was happening at the time, I am often surprised to see what I wrote, as it does not exactly match how I remember it. And yet, since I recorded what was happening and my feelings about it right when it was happening, my “record” of it is certainly 100% accurate in how I felt, since that is what I wrote down at the time. So, my point is, I try (within the limits of being human) not to make decisions on how I feel, but rather on what the data says; so, for all you star trek nerds, I try to think and act like Spock (or perhaps Warren Buffet, perhaps the closest human to be Spock-like in investing). But, even knowing this about myself, it is still hard not be swayed by “how I feel”. -- BTW – off topic – but I believe that writing down what one thinks (and keeping it) is a cheap an effective form of Cognitive Behavioral Therapy. When one one writes down what they are thinking, it is much more likely to result in a coherent narrative that stays on topic, and, as I said, forms a record of the past about oneself, that, try as one might, becomes hard to deny if one is truly open to honest self-reflection. Being able to brutally honest with myself did not come easy, and sometimes, can be “hard to swallow”, but, I have found out quite a bit about myself that I doubt I ever would have recognized or have been able to accept any other way.
Post: Is it possible to achieve financial well being without a plan or even a spreadsheet?
Link to comment from May 26, 2025
“If you are concerned about IRMAA, you have done far better than the great majority of retirees.” You are correct, and I count myself among the lucky, and in no way because of any great financial smarts I have (or think I have). And I am grateful that at this time (early 60s, although perhaps mid-60s, but I have not yet been able to admit that to myself) my wife and I enjoy good health. And I realize that that, by definition, that cannot last forever. Still, when I look at health overall insurance costs when I am 75 (and must start taking RMDs which will trigger IRMAA), it is a bit staggering.
Post: Is it possible to achieve financial well being without a plan or even a spreadsheet?
Link to comment from May 26, 2025
I agree also. As I look at back it now, it was far easier to accumulate by just saving more than I spent, even having made a number of investment and other financial mistakes. Now, I am faced with the task of not having it taken away by taxes, IRMAA, cyber-criminals, yada, yada. Much more thought required, and, I think, much easier to screw it up. I do lots of spreadsheets, but I think the prime value in keeping good data is that it forces you to look at what you are doing and, most importantly, what you have done. Relying on memory, even a really good memory, is often problematic: memory tends to be altered by what has happened since the event took place.
Post: Is it possible to achieve financial well being without a plan or even a spreadsheet?
Link to comment from May 26, 2025
I find this site: https://www.advisorperspectives.com/ to be of value. Every day it posts a half-dozen or so opinions by industry professionals. As we all know, no one knows the future yet everyone has an opinion on it. So, on the same day I can read “qualified” opinion pieces that say we are going into a recession/growth period or, (conversely?) into a growth/recession period. So, it keeps me grounded in the only thing that is 100% certain in the market – no one knows. I think it keeps me from doing stupid things. (Well, I still do stupid things, just perhaps not AS stupid).
Post: My Favorite Websites
Link to comment from March 13, 2025
Years ago I read this article: https://nymag.com/news/features/parent-health-care-2012-5/# as well as this one: https://www.washingtonpost.com/wp-dyn/content/article/2009/01/09/AR2009010902298_2.html?sid=ST2009010903215 and, lots of others since then. I certainly would not judge the decisions on this topic by anyone else, but, around that time I decided, if I have anything to say or do about it when the time comes, that long term care, funded or not, was not for me. Today, my parents are in their 90s, and, my family is living much of what was written in that first article from 2012 (in fact, many of the similarities are eerily striking). My parents have some LTCI and it helps a lot, but, in my opinion, the money part of this whole thing is really not the important part. My best to all of you.
Post: How Are You Planning to Pay for Potential Long Term Care Expenses?
Link to comment from February 5, 2025
Take a deep breath, and read this article (actually, DON'T read the article, JUST the HEADLINE): Strategic Income Outlook: Magic 8-Ball Says, “Cannot Predict Now” https://www.advisorperspectives.com/commentaries/2025/01/16/strategic-income-outlook-magic-8-ball-cannot-predict
Post: Is There a Change Coming in the Direction of the Markets’ Winds?
Link to comment from January 16, 2025