Archive for October, 2014

Age 40? 50? 60? or Later? When is the Best Time to Buy Long Term Care Insurance?

October 21, 2014

The best time to buy long term care insurance is just before you are diagnosed with something that makes you uninsurable.  A smart-alec response to be sure, but it contains an important message: you must qualify medically before you can buy long term care insurance.  So when is the best time to buy?

Your thirties are a good time to buy long term care insurance provided (please don’t quote me out of context) your life insurance, disability insurance, and health insurance needs have been taken care of.  The same is true for your forties.  For both your thirties and forties, you are likely employed and in the best health you are ever going to be.  The rates, which are all based upon your age at the time of application, are lower than they will ever be in the future.  There are exceptions, but many people struggle financially at least until their fifties, so allocating income for another insurance policy may not yet be feasible.

For most people, ages 50-59 is the best time to buy.  Rates are higher than they would have been in your forties, but lower than they will be in your sixties.  What if you missed your fifties and are now in your sixties?  It would have been better if you had applied for this important protection earlier, but you didn’t.  So do it now (if you can qualify medically) before coverage becomes even more expensive.  Now in your seventies? I may still be able to obtain good coverage, if you are healthier than most and are willing to pay the significantly higher premium.

By the way, my oldest client, at time of application, was 81 years of age. Most long term care insurance companies have now set 79 as their maximum age for applying.

Assuming that you have decided to apply for long term care insurance, but your plan is to do so “later”:  What are the advantages of applying now?

  1. You are (presumably) insurable today.  You may not be at any given time in the future.  All of us are but one doctor appointment, or one accident, away from becoming forever uninsurable.  It only takes one diagnosis.

  2. Even if you remain insurable, you may not then still qualify for your current, good rate class.  The healthier you are, the lower your insurance cost.  Most of us become less healthy as time goes by.

  3. Waiting to buy will cost you more in total (over the long run) than if you applied now.  Here is why:  a) The cost of long term care insurance is directly related to your age when you apply.  The older you are, the more it costs.  Wait a year and the cost per dollar of monthly benefit will be higher than it is today.  b) Inflation does not stop because you delay taking action.  A year or more from now, the cost of actual care will be higher than it is today.  So just to keep up with your increasing risk, you will need to buy more dollars of monthly benefit…and at a higher “unit cost” simply because you are older.  c) When you compare the “savings” that results from paying during fewer years, with the higher cost per year because you waited, you will see that the illusionary savings has become a higher total cost.  Ask me and I will show you a real-world example.

  4. Stuff happens.  While you wait to apply, you are not covered.  If the wrong stuff does happen, you will not receive the policy benefits that would have landed in your bank account if you had been covered.

  5. You will sleep better knowing that you and your family are protected.

So when is the best time to buy (or at least apply for) long term care insurance?  Sooner is better than later…you can quote me on this.



Disclaimer: The need for long term care services can happen at any age.  Raymond Smith, The Long Term Care Specialist, cannot predict when anyone will need long term care services or when anyone will become medically uninsurable.  Each reader must decide for himself/herself  when to apply for long term care insurance and must accept responsibility for that decision.  This eNewsletter and all links to other sources should not be construed as tax or legal advice because they are neither. Raymond Smith, The Long Term Care Specialist, does not give legal or tax advice. Consult your attorney or tax advisor for these matters.


© Raymond Smith, The Long Term Care Specialist, 2014


Overwhelmed by a Medical Diagnosis?

October 13, 2014

For yourself or a loved one? Confident that all treatment options have been explained to you?…and you understand them well enough to make a good decision? Don’t comprehend all the medical mumbo-jumbo and afraid to ask for a clearer explanation? Then you should consider talking with Ray Gottesfeld, MD founder and managing partner of the Center for Patient Advocacy.

Recently I had the good fortune of being introduced to Dr. Gottesfeld (thank you Jamie Sarche). What an amazing innovator! As a board-certified OB-GYN, “Dr. G”, as he likes to call himself, was in clinical practice in Denver for 15 years. His growing dissatisfaction with the system of health care delivery led Dr. G to found Healthcare Consulting Specialists in 2008. Healthcare Consulting Specialists later evolved into the Center for Patient Advocacy.

Let me explain how the Center for Patient Advocacy can provide a “must have” benefit. I will start by telling you what Dr. G and the Center do NOT do:
1. This is not a concierge medical practice where you can see a doctor at any time (almost anytime) for treatment.
2. The Center does not provide hands-on, direct patient care, write prescriptions, or order tests.
3. The Center does not accept payment from insurance companies, Medicare, or Medicaid.

Here is what the Center for Patient Advocacy CAN do for you:
1. Coordinate the totality of your treatment. This includes coordinating the efforts of your primary care physician, physical therapists, personal trainers, social workers, chiropractors, psychotherapists, acupuncturists, and anyone else participating in your care.
2. Work closely and cooperatively with your entire existing healthcare team.
3. Translate your care providers’ medical jargon into understandable…to you…language.
4. Attend appointments with you if needed. Ask the necessary questions of your care providers, perhaps some questions that you had not even thought of to ask.
5. Research available treatments (including those that are newly-developed). Then help you make sense of the pros and cons of each alternative.
6. Help prevent unnecessary and costly litigation. When a patient walks into a doctor’s office accompanied by a lawyer, positions harden. The doctor senses that he or she is at risk of being sued. Communication, and consequently problem solving, immediately stop. On the other hand, when a doctor enters another doctor’s office and asks the same questions, mutual professional respect prevails. Try this exercise. Call any medical office that puts you into a phone tree. Listen for something along the lines of: “Press 1 if you are another doctor calling. Press 2-10 for everyone else”. MDs have more credibility among other MDs and are treated with more respect than non-MDs.

The Center for Patient Advocacy is not for everyone. You must first have a need for a health care “quarterback” (no, you cannot have Peyton Manning). Then you must be willing and able to pay the Center’s fees. For those who do meet these requirements, I believe Dr. C can provide a valuable service: Most likely a better healthcare outcome and the peace of mind that comes with knowing that a highly-qualified advocate is in your corner.

Dr. Ray Gottesfeld and the Center for Patient Advocacy can be reached at (303) 253-4711 or by email at The Center website is

Full disclosure: I receive no compensation from Dr. Gottesfeld or the Center for Patient Advocacy.  Instead, I have delved into the Center and have become convinced that the right people can benefit from what it offers.

Raymond Smith, The Long Term Care Specialist, is not a doctor, a CPA, or an attorney.  Therefore he does not give medical, tax, or legal advice.  Please see an appropriate professional for advice concerning these matters.

© Raymond Smith, The Long Term Care Specialist, 2014