# [2008] Does Long Term Care insurance make sense?



## noson7982 (Sep 12, 2008)

My wife (55) and myself (58) went for our review with our financial Guy. Went over our investments to make sure were in the right track because we would like to retire in 4 years. He then brought up long term health insurance. It then felt like a Timeshare pitch. How the cost of nursing homes could wipe out most your assets. Well he then got a quote for us of $5,500 a year for coverage and this cost will only go up as we age. Wow my Dads 87 and Moms 83 they still live at home. My wife's mom died last year at 86.  If we live to Average age of 78 That is thousands of dollars that we could use for our investments and retirement. So does long term Care insurance make sense?

Bob


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## charford (Sep 12, 2008)

It depends on your comfort level. Long term care costs about $200/day. Thats about $75000 per year. So, about 28 years of premiums would pay for 1 year of long term care for both of you or 14 years of long term care for one of you. Are you comfortable with the risk that if one of you requires care, that it may wipe out all of the assets for the other, who may live many years longer? 

I bought LTC insurance for myself after my dh died at the age of 42. When my children get older, I may drop it. I will likely move back to Canada as well - LTC costs there are about 1/2 what they are in the U.S.


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## SherryS (Sep 12, 2008)

Just let me say that my Mom, age 84, has Alzheimers and has been in assisted care for 2, going on 3, years now.  I am her only living child, and could not care for her on my own in my homes (Michigan and Florida).  In only one year of care, her long term care policy paid out an amount equal to all of her and my Dad's premiums paid since 1995 (10 years).

We don't know how many years she will live, but her long-term care policy is a true life-saver for her and for my family.


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## Kal (Sep 12, 2008)

noson7982 said:


> ...he then got a quote for us of $5,500 a year for coverage and this cost will only go up as we age...


 
There are various ways to structure a LTC policy that would substantially decrease the premiums.  I would get other quotes.

It all depends on the risk of various things happening:

*  Do you want to provide full care of a spouse, forever?

*  Do you want to risk loss of your investment savings?  $200 per day adds up very quickly when paying for long term care.


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## Laurie (Sep 12, 2008)

noson7982 said:


> Well he then got a quote for us of $5,500 a year for coverage and this cost will only go up as we age.


Shop around. It's true that it can save you $$ to purchase before the first person turns 60, so you have a good year+ to do your own research. There are so many variables, including max dollar amount of coverage per month, maximum number of months, waiting period, exactly what's covered (eg does it include home care?). 

Earlier this year my partner and I (56 and 59 at the time) purchased a shared policy which costs about $2500/yr, and probably/hopefully won't go up in cost, but benefits do increase with inflation. The coverage isn't the top amount, wouldn't cover the whole thing - but we made our best guestimate as to what we might need, what we could afford both in premiums and long-term care itself, with the goal of avoiding a devastating financial hit should LTC be needed. 

Genworth and John Hancock were very close in terms of coverage and cost in our case - we liked both policies. It helped that we had a great rep, who helped us go thru our hundreds of questions - much more thoroughly than the financial services guy who we started out with.

We followed the advice found on this bbs to apply to 2 companies at the same time (just in case one turns you down), and this gave us the option to choose from 2 companies after acceptance.

Our tax acct btw doesn't think LTC insurance makes financial sense - his advice was to get on the waiting lists of the best assisted living - retirement communities in our area.


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## caribbean (Sep 12, 2008)

You might want to look into the TYPE of policy. Sounds like he is quoting a policy that would cover you from onset to end of life. You can also get policies that cover you for 2-3-5 etc. years.  These are much lower in cost. 
According to research, the average stay in a nursing home is about 2.5 years, but can vary considerably. So you might want to go with a policy with a shorter term. 

That is what we did. We decided based on family history. Since it is cheaper the earlier you buy, when it was first offered, as optional coverage, through my work, I went with the maximum daily amount offered, $350/day, for both myself & hubby. Every time they offer increases, we take them. Thought being to purchase the high amount as young as possible. We are now up to about $400/day. Then when we get older, we may not be able to afford the increases, but hopeufully will still be ahead of the inflation game.

Also check how the policies work. We bought 4 years. How ours works is: the 4 years times $400/day times 365 days = $584,000. That is the total amount of coverage each of us has right now. If I were to go in right now and it costs $200/day, we can stay until the pot runs out, which would be 8 years. And say you are there due to an auto accident and you get better and go home, you can go back in at a later date and the clock starts ticking all over again back at $584,000. Also check to see if the plan allows for payment for in home services. Sometimes that can be less expensive.

Study up on the various options and then decide if it is right for you. In my case, we have no children, and I have longevity in my family. I'd like to pay someone to take care of me in my home, when the time comes, as long as I can stay there.


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## Charlie D. (Sep 12, 2008)

LTC is like any other insurance.  Will you ever have to actually use it??  Die suddenly and don’t need it.  The government offered LTC about 5 years ago and I researched pretty hard and did some soul searching.  Called nursing homes and extended care facilities to get their daily rates.  We are fortunate in Oklahoma in that the costs are lower than lots of other areas of the country.  I decided to hedge the gamble by getting $75 a day for 5 years with a 3-month delay which comes out of my pocket.  That would cover at the time about 75-80% of the daily cost.  I did not want to be taken care of at home.  I watched my wife try to take care of my dad-in-law for a year and a half before he passed. I would not wish that on anyone!!  

The amount goes up 5% a year to cover at least part of the inflation.  Monthly cost = $51 and that hasn’t gone up in 5 years.  The way I looked at it I was gambling less money but yet partially covering a good chunk of the potential cost.  Current coverage = $96 a day.  IF that will still cover 75%, that would leave about $32 a day to come out of our pockets for 5 years.  We can handle the $1,000 a month without putting the hurts on my wife.  The goal is to be able to get into at least a middle-of-the road assisted living facility if it is needed later on in life.

Charlie D.


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## CMF (Sep 12, 2008)

*I listened to the pitch and bit the bullet and laid out the cash.*

It is expensive for a reason: tons of folks will have to collect on the policies.

It's a very depressing subject all around. 

Charles


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## Icc5 (Sep 12, 2008)

*I'm 58, wife is 54*

We it starting about 5 years ago after I had 2 Aunt's that needed care.  Neither had a plan for long term care and we paid $48,000 from one Aunt's estate for the 13 months before she passed away.  Luckily she had this in her account.
The other Aunt also had funds and she stayed home with a home care person that cost aprox. $200,000 for the 3 years that she cared for and lived at my Aunt's.  
Neither of these happenings was expected.  The Aunt in the care home was jut there to recoup but she got worse and worse and this was with my Mom visiting her every day and my Mom felt my Aunt was well cared for.
The other Aunt was too comfortable just sitting and being waited on and basically, stopped moving and stopped living.
Everyone has to decide on their own.  I know though that in my case we decided we would do this and not drop it.  Rates were a little lower when we started and hopefully stay lower.
Bart


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## Hophop4 (Sep 12, 2008)

I purchased a LTC policy with Met Life after my MIL passed away.  After seeing the cost for her care we decided to get a policy.  My policy is a fixed premium and does not go up.  So look around.  I didn't think I would have to use it just yet but in Oct 2006 I had a cancerous tumor on my spine and had surgery.  I was in the hospital for 4 weeks....with no medical insurance.  I was 18 months shy of Medicare.  When I got out of the hospital I was not able to go home, was in a wheelchair with a backbrace and needed more physical therapy.  I went to an assistant living facility and my LTC Met Life policy paid for the facility.  They activated the policy while I was in the hospital and since it had a waiver of premium I did not have to pay the monthly premium.  To this day, I am still not paying the premium since I am receiving chemo treatments,  They do call me about every 6 months to check and as long as I am having treatments they continue to waive the premium.  So I am glad we had the policy.


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## vacationhopeful (Sep 12, 2008)

Ten years ago my Dad was paying almost $7,000 a month for nursing home care for 16 months til my Mom passed.  This was after 11 months of "cheap" in-home care - cheap only because we hired privately to get reliable, available, non-agency persons.  And this was after my Dad spent 4-5 years being the caregiver (cooking, cleaning, dressing, watching, helping).  My Mom was very passive and physically in good shape - my Dad was so scared she would live for another 20+ years in with dementia, like several of her aunts had.  He was afraid he would run out of money.

He realized too late for his wife about LTC insurance, but he brought it for himself when she first started going downhill.  Two years after she passed, we realized he was quickly sinking into that deep hole of dementia, also.  He couldn't do his income taxes, missed that minimum IRA withdrawal, etc and overdosed on asprin ... 7 days in the hospital.  We had to transport him out of state (to daughter #4)- as we knew a relative would fight us (his 5 kids) for conservatorship.  After an evaluation, his LTC kicked in 6 weeks later.  We then flew him 3,000 miles to a daughter's(#2) house for 6 months-2 days (non-resident in that state for estate reasons), inhouse care in his own home (6+ months) until he spent a month in bed - would not get up.  Then we moved in back to daughter#4 after we got the doctor to invoke the medical power of attorney.  It took us over a year of trying, as he would rally and know the date, president, who everyboby was, etc until we were back in  the car......  The doctor agreed that a considerable change in mental state had occurred because "he was too nice, and not his usual irritating self".  We moved him into a assisted living - which he recognized the architecture of building as a nursing home as I was pushing the wheelchair.  3 out of 4 of his daughters there in the driveway and he figures out the building.

He love it there, decided that 3 of the other residents were his wives(wife #1, wife #2 and wife #3), ordered them around like he did, and they all loved it.  He passed just 4+ months after arriving there.  

Of us 5 kids, we all have LTC insurance.  Until you see the burden and costs of this disease, you can not fathom the level of care and the disruption it has on the spouse, their children and grandchildren.   I can't even watch movies on this subject as the romantic/idealized portrayals are so far from the reality.  A recent PBS show (done 5 years ago, with a recent update) about a family being studied due to a genetic link study at U of Mass is excellant.  

We, all 5 of us, recommend LTC ... as even, PBS show has stated, the government does NOT have enough money to pay for all the custodial care that is quickly coming as the babyboomers age.


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## Aussiedog (Sep 12, 2008)

*I am a big fan*

I am a big fan of LTC insurance.  My mom pitched a fit for 10 years when she had to pay 2k per year for coverage.  She then needed that insurance for the next 10 years - her care would have cost 70k per year.

I think of LTC as true "life" insurance - it protects your lifestyle, your assets and your spouse.  

Some key points:

Women are more likely to need it than men as women are more likely to spend part of their retirement too frail to care for themselves.
Mid to late 50s tends to be the best time to buy - wait too long and it gets increasingly unaffordable AND if you develop a chronic disease before you apply you will often be rejected.
The average time that you may need this care used to be 3 years - it is now over 5.
If you are shopping for LTC make sure that you get at least 3 quotes.
Ignore the salesperson and get the longest elimination period the companies offer - it will take the price down.
Many companies offer couples a very large discount if both buy the policy - they know that overall costs are less because one spouse often cares for the first spouse to become ill.
An inflation escalator in the policy is an important feature
$5500 sounds too high - I bet they are quoting you a very short elimination period and a high daily rate.

Ann


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## John37130 (Sep 12, 2008)

*My advice to others ... buy it when you're young*

My dad had perfect health until his mid-70s.  Unexpectedly, he suffered a stroke and awoke one morning unable to speak.  Mom and dad had looked at LTC policies a few years before, but dad just couldn't bring himself to pay a couple thousand dollars a year considering how healthy they both were.  How things changed -- literally -- overnight!  Dad was incompacitated and unable to care for himself.  Mom took over the role of caregiver, which took a heavy toll on her.  

The family took out a LTC policy on mom shortly after dad had his stroke.  It was fortunate that we did because mom started suffering from dementia a few years later.  Both of them ended up in assisted living, and mom's policy ended up paying for the lion's share of the cost since they were sharing a room.  

After dad had his stoke, I had received information in the mail about LTC insurance.  I was very young at the time (early 30s), but it was so cheap I couldn't turn it down.  At the time, it was for 10 years of coverage at $125/day for an annual premium of $110!  (It was through Prudential Insurance Company and premiums were guaranteed to never go up unless I chose to increase the coverage.)  That was about 15 years ago, and I've been able to increase my coverage over the years.  It's now $214/day for 10 years, and the premium is $322 per year.  Shop around for coverage.  Costs vary greatly.  

If you ask the financial planning experts, they probably would have said that someone as young as me should never buy LTC insurance, but I disagree.  I believe the best time to buy insurance is when you are young and healthy.  You will be more likely to qualify for coverage, and you can lock in cheap rates.  (I have a sister who developed MS in her mid-40s.  She's not eligible for coverage now.)  At $322/ year, I feel it's such cheap insurance against something catastrophic that I can't afford not to have it.    After I got married, we also got a policy on my wife, although her's is a bit more expensive because she was a little older when she first applied.

Will I ever use it?  I hope not, but it does provide some peace of mind knowing that I have it.


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## GetawaysRus (Sep 12, 2008)

My wife and I (in our early 50s) purchased long term care insurance a few years ago after seeing a few of our friends develop medical issues that required long term nursing home care (and seeing all the difficulties that the other spouse went through).  For example, one friend (in his mid-50s) was involved in a severe motor vehicle accident and ended needing long term nursing care for several years before he finally died.  Sh..t happens - just because you are young doesn't mean you are immune to bad stuff.

My comments:
- I agree with the "shop around" comment.  There will be significant variation in policies.  You will need to choose an "elimination period" (the waiting period until the LTC policy kicks in) and an MDB (maximum daily benefit - the maximum daily amount that the policy will pay out).  Also, some policies allow you to choose inflation protection.  Our policy (from Genworth) has a 5% inflation adjustment each year.  That is not a freebie, of course.  But it does mean that our MDB rises by 5% per year to keep up with inflation. Companies that I remember we looked at included NY Life, Genworth, Mutual of Omaha, and Hancock.
- How much coverage to buy (the MDB) will depend upon your location.  Nursing home costs are not uniform around the USA.  You need to get some idea from a local agent how much coverage is reasonable for your area.
- If you are interested, I would suggest starting the process when you are young.  Both you and your partner will need to be qualified for the policy.  If you have pre-existing medical conditions, then phooey on you.  Both my wife and I are in good health, but she was rejected by the first carrier we tried (NY Life).  You usually get a discount on the cost if you purchase a policy for both parties from the same carrier, so we ended up having to reapply with a second company.  The process of applying can be grueling.  Genworth insisted on a very long and complex interview.  (Bottom line: it was a pain in the butt to obtain coverage even though we were around 50 and in good shape.  Expect that the insurance company will go through your medical records with a fine-tooth comb, and you are at risk of being disqualified if you have any pre-existing condition that they are unhappy about.)
- I think you want a policy that will cover not only nursing home care but home care services as well.  It is also desirable if your policy will cover assisted living.  You may not need nursing home care, but you might need assistance at home or you may need to move into assisted living as you age.
- Check into your tax situation.  I am self-employed.  Long term care is a tax deduction for those who are self employed.  That helps alot with the cost.


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## Laurie (Sep 12, 2008)

GetawaysRus said:


> you are at risk of being disqualified if you have any pre-existing condition that they are unhappy about


You are even at risk for being disqualified for stuff that would never occur to you as a pre-existing "condition" - I was almost disqualified for my weight being at the edge of "too low" for my height! (who knew that was a problem?)

And if you start before you have any health issues at all, you should qualify for a preferred rate, which probably saves 10%+.


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## Kal (Sep 12, 2008)

I have a good friend who plans to purchase LTC insurance for he and his wife but is "too busy" to get it in place. Besides he is concerned about the cost but realizes the importance of LTC.

His wife went to a MD about headaches and was told (without a written diagnosis) that she has beginning symptoms of MS. The MD was also concerned about the probability of alzheimers (her father is in the very late stages of alzheimers).

Now my friend is even more concerned about the costs as every year the premiums get higher (due to their ages). He will not take any action on the possible MS (head in the sand denial) AND he does not want a documented health issue which could cause her LTC application to be denied. In the meantime her symptoms of MS are progressively getting worse.

They don't have solid financial resources so he could be in a world of hurt.


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## Jennie (Sep 13, 2008)

A lot of excellent advice has been given here. I'll add a few points that haven't been mentioned.

AARP has an excellent free booklet that covers the topic in depth. Not everyone needs LTC insurance. For example, people who do not own a home and do not have large assets may qualify for government help if they need nursing home care. The Medicaid programs are different in every state. Even if one has a home and assets, if one partner needs nursing home care and the other spouse continues to live in the home, in most states a lien cannot be placed against the home and the spouse is able to keep about $80,000-100,000 of their joint assets. But the rest must be "spent down" for the nursing home care before the Medicaid coverage kicks in. These laws and rules do change from time to time so the overall situation must be assessed by a knowledgeable, honest professional. 

I was lucky enough to have such a person guide us when hubby and I explored the subject 8 years ago. He knew the ins and outs of all the different policies available through several major insurance companies. The main feature  he liked with one company was that if we both became insured on the same policy, once it was in effect for 5 years, if either of us died thereafter, the surviving spouse was covered for the rest of their life without having to pay any further premiums. He had already purchased the same policy for himself and his wife.

John Hancock took over the policy 3 years later but assured us that they would still be bound to provide that benefit (state law requires it). I'm not sure if that provision is still available. But it's worth finding out. We had talked to other salespeople before settling on this policy, and none of them ever told us such an option existed. 

We referred a lot of our relatives and friends to this salesperson but then he retired to Florida and gave up selling policies. He was doing it as a "retirement thing" to keep busy. (He had been a utility company executive in his "former life.") 

We didn't know who else to recommend until we attended an Open House night at a local Sunrise Assisted Living home (just wanted to look around "in case"  ). They had excellent speakers on a variety of subjects of interest to seniors. This included a very bright, compassionate female attorney (about age 35) who had been a psychotherapist and then became immersed in the needs of the elderly when she had to care for her own mother. So she went back to school and obtained a law degree, and now specializes in elder care issues. She is so knowledgeable and can guide one in ways you would never think about.

So perhaps asking a respected "home' in your area for the name of a person like this would be the best way to understand and select the options appropriate to your individual needs.

By the way, New York State has a provision that they will pick up the tab through the state Medicaid program if one has paid for a LTC policy and has exhausted 3 years of benefits.  (The insurance company has to be on an approved list, but most of the big companies are).  In other words, the patient is fully covered, as if they were indigent, without any of their personal assets being touched. Some, but not many, other states have a similar program. If it exists in your state, it's an important part of the decision making as to how much coverage you need. Oh, and the premiums paid can be deducted on a NYS tax return as a "credit" thus returning 20% of the premium paid each year.

So find someone who knows all these extra things that can make a big difference. We bought in our 50's so our premiums come to less than $2300. a year, and then we get that 20% tax break. I'm so glad we have it. We might not qualify if we had to apply now. They are very fussy about the applicant not having even slightly elevated blood pressure or cholesterol or being overweight.


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## mamiecarter (Sep 13, 2008)

*Maybe your financhal advisor gets paid if you buy*

Do your own research and buy on your own. Consider the possibility that your financial adviser gets a commission if you buy from the company he recommends. If you find out he does change advisers.


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## Rose Pink (Sep 13, 2008)

Jennie said:


> ... We might not qualify if we had to apply now. They are very fussy about the applicant not having even *slightly elevated blood pressure* or cholesterol or *being overweight*.


 
Well, that leaves DH and I out.  Maybe we'll get serious about getting healthier.


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## pranas (Sep 13, 2008)

Rose Pink said:


> Well, that leaves DH and I out.  Maybe we'll get serious about getting healthier.



Check with your employer. You may be able to get around these restrictions on a  policy bought through your employer.


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## Fern Modena (Sep 13, 2008)

If anybody thinking about getting long term care has worked for a government agency in California (or is the spouse or parent of such a person), they shoudl check out CalPers coverage at http://www.calpers.ca.gov .  Its pretty comprehensive, and reasonably priced.

Fern


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## Charlie D. (Sep 14, 2008)

That was one of the nice things about the government plan - no physical to sign up.


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## Liz Wolf-Spada (Sep 14, 2008)

Fern, that's what Sam and I have. We signed up in the very beginning of open enrollment, but then had to pay more to choose the better plan later on. We went for that for me, because I am 10 years younger, but for Sam it would have been very costly. I think I pay $165 a month and Sam is less than that, because when I upgraded they didn't grandfather me in at the age I had purchased the original policy, but made some concession (or something like that)
Liz


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## Fern Modena (Sep 14, 2008)

Liz,
Are you sure you are playing that much a month?  My payment is quarterly.  I pay more than you, but then, I'm older, too.

Fern



Liz Wolf-Spada said:


> Fern, that's what Sam and I have. We signed up in the very beginning of open enrollment, but then had to pay more to choose the better plan later on. We went for that for me, because I am 10 years younger, but for Sam it would have been very costly. I think I pay $165 a month and Sam is less than that, because when I upgraded they didn't grandfather me in at the age I had purchased the original policy, but made some concession (or something like that)
> Liz


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## Liz Wolf-Spada (Sep 14, 2008)

Fern, those payments are automatic and Sam says we're paying $300 a month. Mine was pretty cheap when I got it at 45, but because I upgraded at about 55 or so, it got more expensive. I have been thinking I need to contact them though, because they were going to split the difference in age from when I got it to when I changed to the newer option plan. I'm wondering if they have been overcharging me. I'm turning 60 in December, Sam's turning 70 in January, but we originally got it when it first started. We don't have the unlimited plan, but the one that has a 90 day deductible, coverage for nursing home care for 3 years, home health care included at 75% of nursing home care cost and our policy includes inflation protection.
Liz


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## Beaglemom3 (Sep 14, 2008)

I just signed up with John Hancock for a $150/day benefit x 6 years through a group policy. It's $85/month, but I have to see what the disqualifiers & limitatons are. I am 56.
The $250/day benefit is $145/month.

As a former practicing RN/NP who has done home care and went through all my Mother's money for her home care, trust me, it makes sense for many.
JMHPO/FWIW.


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## Liz Wolf-Spada (Sep 14, 2008)

Both my parents relied heavily on the policy they had purchased through Huntington Hospital in Pasadena. It also covered hospice, which we had for my dad this last few weeks. They still had to pay out of pocket for 24 hour home care, but it sure helped. One of the reasons I wanted to go with and stay with CalPers was my concern about a company that was large and financially sound and would be around for a long time.
Liz


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## Jennie (Sep 16, 2008)

Rose Pink said:


> Well, that leaves DH and I out.  Maybe we'll get serious about getting healthier.



My husband was 30 lbs. overweight when we started investigating the types of policies avalable (cost, benefits, etc...) Our agent/friend told us that because hubby was just 50 and had no health problems, and was employed for years at the same place and had an excellent attendance record--never ill or hopitalized, they _might_ accept him at the standard rate, or might offer him a higher non-preferred rate, or might turn him down altogether. And if they turned him down, other companies might do the same, just because a health insurance reporting agency listed the denial. 

We talked it over and decided that we would wait until he lost the excess weight before applying. I kept reminding him each day about resisting temptation. He developed a pattern of taking two steps forward and one step backward, but he reached the correct weight within 6 months  

So maybe this is the motivation you two need to become better prepared for the challenge of "aging gracefully". Good luck!


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## Rose Pink (Sep 16, 2008)

Jennie said:


> So maybe this is the motivation you two need to become better prepared for the challenge of "aging gracefully". Good luck!


 
Got the lab reports today.  Total cholesterol and LDL are up.  I am having my last night of binging.  Of course, I've had many last nights of binging.  I'd be 30 to 40 pounds lighter if I hadn't had so many "last nights." :hysterical: 

The annual benefits sign-up takes place in a month or two.  I'll look into whether we need a health screening to sign up with DH's work.  I've not done it before because it was so expensive but now that we aren't paying health and dental for the kiddies (all grown now), maybe I'll funnel that savings into LTC insurance.


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## Kal (Sep 17, 2008)

I might have to go on the "last night of binging" approach.  My recent total cholesterol has increased from 110 to 130 over the last 6-months.  Happily that's without any cholesterol reducing medication but just watching the intake.  The best reinforcement comes from my MD who says I'm the "lifestyle poster child".


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## vacationhopeful (May 29, 2010)

*Buying LTC policy ...*

Bringing this thread back to life as info is still current, IMHO.

There was another thread recently about the "lapband" medical procedure and I posted that I had chosen a 'change your eating habit' diet better than a year ago.  The reason was pretty much this thread and the need to get serious about planning for the later years in life.

I am reporting back my success!  In Feb 2010, I had a phone conversation with a LTC salesman who pointed out that I was perhaps _still_ 8-10 lbs too heavy to qualify for a decent LTC policy based on my height.  My next birthday was in April.  Beginning of April I went to a group presentation sponsored by USAA partners of John Hancock INS.  Followed up with the sales rep, who explained the tiers - Preferred (15% discount), Select (BaseLine), Class I (15% surcharge), Class II (30% surcharge).  I had my last 2 years of lab reports at both meetings to tap into immediate opinions.  There was all the usual options affecting price - per day benefit, elimination periods, term of coverage -- some of which are effected by the tier which you QUALIFY for due to your medical status.  

Some new info, which I had also NOT seen on this thread (related to John Hancock policies):
Smoking - forget it; you are not eligible. Can apply, if you have 2 years documented as a nonsmoker.
Losing weight - weight lost must be documented over AT LEAST a 2 years time period. Drastic weight loss in a shorter time frame will/can disqualify you.
Diabetic - will put you into the surcharge catagory. Pre-diabetic question is "are you taking ANY diabetic medication?"; if true, then you are diabetic; if not, then you are not diabetic.
They can give you your age IF you APPLY within 30 days after your last birthday (so I could have still signed up in mid MAY).
Yes, they will pull ALL your medical records. Might have RN come to your home/office to physically weight you, interview you, watch you perform tasks, etc.  Will 100% phone interview you for at least 30+ minutes.

Salesman said I might qualify for "Select" but most likely be "Class I" level as I have HBP (on meds) and take cholesteral meds and still wear Size 22-24W.  MY HBP is level, I watch my sugar & carbs intake like a HAWK, and my cholesteral meds are tolerated. I go every 4-5 months to the DR. I have been getting the blood work up every year for the last 4 years. Yes, I DID lose weight - down around 35lbs. My 120lb RN sister from California did say earlier this month that I look like I lost some weight. And I was even in the hospital overnight 14 months ago. My application age was 57.

After waiting 30+ days for the underwriters review, the Sales rep called me.  John Hancock will offer me a policy with a rating of "PREFERRED"!.  3 days later, I am still happy as can be. 

*So, I am posting this info to ENCOURAGE you all. *  Jennie posted about her husband's diet before applying.  I believe my good outcome also reflected routine preventive doctor's visits and blood workups - I care about my health.


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## pgnewarkboy (May 29, 2010)

My wife and I have LTC insurance for years.  My wife works in a facility that provides assisted living and adult daycare.  Most of the people have some form of dementia.  Some are only in their fifties with dementia.  I would never want my wife or children to try to care for me if I got dementia.  It is virtually an impossible task.

When looking at a LTC policy I think it is  important to get  one that will pay for non-nursing home care such as assisted living and adult day care.  Nursing homes should be pretty much the last option.

As part of the new health care law, there will be  insurance available for non-nursing home care.  It is not government funded or subsidized for payments.  It will be strictly an insurance program that is not for profit.  I am not aware of any details at this point except that it will get started in a few years and that you must pay premiums for x number of years before you can get the coverage.  It is worth monitoring to see what it turns out to be.


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## MULTIZ321 (May 29, 2010)

Another option for LTC insurance is to make a lump-sum payment for the policy and then not have on-going premiums.

An acquaintance took this option after doing extensive research and felt it was the best decision for his family.  

This option is not often mentioned and may require some digging to find info.
Not all insurance companies offer this feature and some states do not allow single-pay policies.  For more info and a good synopsis see http://www.longtermcare.gov/LTC/Main_Site/Paying_LTC/Private_Programs/LTC_Insurance/index.aspx

Richard


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## Passepartout (May 29, 2010)

pgnewarkboy said:


> As part of the new health care law, there will be  insurance available for non-nursing home care.  It is not government funded or subsidized for payments.  It will be strictly an insurance program that is not for profit.  I am not aware of any details at this point except that it will get started in a few years and that you must pay premiums for x number of years before you can get the coverage.  It is worth monitoring to see what it turns out to be.



I'm sure no expert on the upcoming healthcare programs, but it seems to me that the LTC insurance will become _available to pay into_ in 2014. Then you have to pay into it for 5 years before you can get benefits. So if this is correct, for those of us boomers in or near retirement, better plan on staying reasonably healthy until 2019ish and paying 5 year's premiums without benefits.

Then, as now, LTC insurance is unnecessary for the poor (they qualify for medicaid) or the wealthy- who can afford private care. LTC insurance is just for the middle class who have too much assets to be 'poor' and not enough to pay for their own care. 

Jim Ricks


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## Jennie (May 30, 2010)

It's important to discuss the pros and cons and various options with a person who specializes in eldercare counseling, usually an attorney. We attended an "Open House" community event at a local Sunrise Assisted Living home. There were break-out sessions with different experts. One was chaired by a a certified social worker with years of experience working with elderly people and their families. Too often they had not been advised of financial strategies that would have helped them obtain needed care without wiping out their life long savings. So this social worker attended law school at night and obtained a law degree. 

She shared so much information that is not generally known by attorneys who do not _specialize_ in elder law. 

I would think that most nursing homes could provide contact info for one or more local attorneys who have worked with their patients. They may offer a free or minimal cost consultation. Unlike sales people working on commission, I would hope the attorney would provide honest unbiased advice.

States may have laws that impact upon your decisions. For instance, in New York State, if a person has been in a hospital or nursing home for 3 years and the cost has been covered by their own private long term care insurance policy, then they automatically become eligible for Medicaid coverage from that point on without having to exhaust their savings ("spend down"). And the nursing home will almost always alllow them to remain at the facility even if they do not ordinarily accept Medicaid patients (due to the lower reimbursement rate). For this reason, we felt comfortable choosing a policy that covers a maximum of 3 years coverage. 

As mentioned above, if I were to need extensive in-patient care e.g. for a broken hip or back injury etc... and months of care were paid for by the LTC policy, and I recovered and went home, the "clock" would be re-set and I would be eligible for 3 full years of future care for another condition.  

Different companies offer different options. The more options you choose, the more expensive it is. I was 56 and hubby was 49 when we took out our policy. We pay $2200. per year altogether and there has been no increase in the premium during the 9 years we have had it. It had one great option that none of the other companies offered--if one of us dies first, the surviving spouse is covered for life without having to pay any further premiums. I have been told that this option is no longer available for new policies. 

When filing our New York State tax return, we receive a credit (not a deduction but a full credit) of 20% of the LTC premium, reducing our cost by $440. per year.

Our policy provides a fixed rate of $330. per day which may not be enough as the years go by. But the money we save by not having ever-increasing premiums will help pay the shortfall if we ever need it. Another good feature of our policy is that we can choose to have in-home care instead of being in a nursing home and the person or persons providing the care does not have to be a certified aide. We can choose a relative or friend and they will be paid the "going rate" charged by a certified agency in our area. I've been told that this benefit is no longer available to new policies, at least not with this company.


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## Jennie (May 30, 2010)

*Who's on first, what's on second (modern day version)*

http://assets.aarp.org/rgcenter/il/2006_13_ltci.pdf


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## pgnewarkboy (May 30, 2010)

Jennie said:


> It's important to discuss the pros and cons and various options with a person who specializes in eldercare counseling, usually an attorney. We attended an "Open House" community event at a local Sunrise Assisted Living home. There were break-out sessions with different experts. One was chaired by a a certified social worker with years of experience working with elderly people and their families. Too often they had not been advised of financial strategies that would have helped them obtain needed care without wiping out their life long savings. So this social worker attended law school at night and obtained a law degree.
> 
> She shared so much information that is not generally known by attorneys who do not _specialize_ in elder law.
> 
> ...



Thanks for this excellent and informative post.  Depending on a persons circumstances and income it might be advisable to get a LTC policy that has automatic inflation adjustments.  My policy has a 4% annual adjustment.  Another option was to "buy" additional insurance at a future date.  As long as you maintained payments continuously you could not be rejected for the additional dollar amount that you purchase.


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## jmzf1958 (May 30, 2010)

I am looking into long term care insurance.  I'm fifty-two years old and am on disability for carpal tunnel and back neck problems due to working as a court reporter for twenty-five years.  This disability does not prevent me from taking care of myself - I don't need help with daily living.  Do you think it's possible I could get long term care insurance, and any suggestions of what companies to look into?  Thanks.  Judy


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## MelBay (May 30, 2010)

jmzf1958:

Luckily we joined a group LTC through my husband's employer about 10 years ago, and when he retired last year we got to keep paying the premiums as part of the retiree group so they are very favorable.  I won't say what they are because everyone will hate me.  Ours is through John Hancock.

You want to look for a company with a good reputation and stellar financial ratings: https://www.johnhancockltc.com/Group/Main/About_John_Hancock/Financial_Ratings.aspx

I also get regular mailings through AARP for Genworth LTC - you might want to check into them.  

Do not foget our recent health care reform does address LTC issues, but not for a while.  Google 'CLASS Act long term care' for more details.  
http://seniorliving.about.com/b/2010/04/02/class-act-long-term-care-program-signed-into-law.htm

Not sure how this would impact you if you aren't working, but it might be worth your while to find some form of employment, if possible, in light of some of the premiums I've seen tossed out in this thread.  Off to count my lucky stars.....


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## MelBay (May 30, 2010)

Just found this NPR story that goes into pretty good detail:

http://www.npr.org/templates/story/story.php?storyId=125461417&sc=17&f=1001


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## vacationhopeful (May 30, 2010)

MelBay,
You live in Missouri.  The state where your policy is issued guides the rates for the most part due to the cost structures.  One of my siblings lives in Nebraska - where I bet the rates are even lower.  I really have no desire to live in NE in my old age.

I don't/won't hate you.  Missouri would NOT make my list of retirement places at this date.


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## Timeshare Von (May 30, 2010)

I guess I'm in a minority here.

We too (in our early 50's) recently went through the long term care insurance discussion w/ our financial planner as well.

If I'm so sick that I cannot live the quality of life I want, at home, I'm not going to want to live in some assisted living place with little to no real quality of life.

Do you watch Dexter?  I'll be looking for the Key Lime Pie exit strategy.

p.s.  The long term care policy for us, due to preexisting health issues and being overweight?  $750/month.  That takes away A LOT of today's quality of life (travel, etc) so I/we can remain alive in such a place?  No thanks.

Forgot to say, we do not have kids so that does make our situation a bit different than many, maybe even most.


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## Kal (May 30, 2010)

Timeshare Von said:


> ...That takes away A LOT of today's quality of life (travel, etc) so I/we can remain alive in such a place? No thanks.
> 
> Forgot to say, we do not have kids so that does make our situation a bit different than many, maybe even most.


 
Until such time that someone invents an "I'm out of here device", think thru the scenario of requiring long term care.  With no kids, the only option is for your significant other to be the full time care giver and nurse.  The job description would INCLUDE bed pan changing, and much worse.  Yes, the insurance premium takes away quality of life today, but think about the quality of life tomorrow for both patient and care giver.

Sounds like your only option is government provided Medicaid.  With that program you are limited to the very bottom-end of care facilities, e.g. "One Flew Over the Cuckoo's Nest".


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## vacationhopeful (May 30, 2010)

Yvonne,
Remember, my LTC policy covers home care with no exclusion period. Knee replacement would have an aide paid for while I recovered.  It also includes an amount to build a ramp in to the house or other adaptive equipment. 

I, too, have no children and also, no partner. My sister lives almost 3 hours away.

You (and your husband's/partner's) assets would have to be spent down for your care (or his care). My Dad was in a panic that his assets could not last to pay for his wife's care.  Nursing home care is over $75,000 per year; home care can be over $40,000 in my area. 

And LTC does cover custodial care for strokes, car accidents, slip & falls - many claimants are under 60 years old.


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## Timeshare Von (May 30, 2010)

I understand Linda & Kal . . . I'm just saying for me, the exit strategy is thought out and will not require LTC.

Like all insurance, you're looking at protecting assets based on some formula of risk assessment.  For me/us, insurance at the price we'd paid does not make sense.


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## Timeshare Von (May 30, 2010)

Kal said:


> Until such time that someone invents an "I'm out of here device" . . .



Really . . . no "device" is necessary.  There are plenty of ways to go out on your own terms.


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## bogey21 (May 30, 2010)

I have taken a different approach.  When I reached age 65 I bought into a CCRC (Continuing Care Retirement Community).  I have a 1 bedroom furnished (by me) apartment on the 11th floor with a large balcony overlooking the city.  

It has 3 levels of care from "you are on your own" down to assisted living (with an alzheimers unit).  Cost was around $65,000 up front with an all-in monthly charge of which about 40% is tax deductible as prepaid medical expenses.  It is 100% ready so when I need help getting around my children don't have to talk me into moving or find a place for me in a hurry.

I spend a week or two a year sleeping there.  When I am in town I try to eat about 3 meals a week in the main dining room (we have a great chef) in order to make sure I know as many people living there as I can.  I also get much of my mail delivered there so whenever I move in permanently I won't have a lot of address changing to take care of.

Yes, it is more expensive than LTC Insurance but I don't have the health concerns of buying a LTC Policy; there is no issue with how long my benefits will last; and I don't have the risks that go along with a LTC Policy like will the Insurance Company remain solvent?  Will there be a hassle when I want to start receiving benefits?  How much will the rates be increased?  How long do I receive benefits, etc?

If you want to leave an estate, you can pay a bigger up-front fee which is either partly of 100% refunded to your heirs depending how much you pay up-front.  

George


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## Kal (May 30, 2010)

Timeshare Von said:


> I understand Linda & Kal . . . I'm just saying for me, the exit strategy is thought out and will not require LTC.
> 
> Like all insurance, you're looking at protecting assets based on some formula of risk assessment. For me/us, insurance at the price we'd paid does not make sense.


 
If the exit strategy works, then fine.  But what if it doesn't?

Agree, the LTC premium is prohibitive, so just think about a scenario with a failed exit strategy leaving you in an extremely difficult situation.  Now what about executing the exit strategy by the remaining spouse post departure of the other spouse?


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## Kal (May 30, 2010)

bogey21 said:


> ...I have a 1 bedroom furnished (by me) apartment on the *11th floor with a large balcony* overlooking the city...


 
Sounds like you've got the "Timeshare Von Exit Strategy" available.


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## taffy19 (May 30, 2010)

MULTIZ321 said:


> Another option for LTC insurance is to make a lump-sum payment for the policy and then not have on-going premiums.
> 
> An acquaintance took this option after doing extensive research and felt it was the best decision for his family.
> 
> ...


This is exactly what we did over ten years ago. I remember that it would take us eleven years to break even and we have passed that. We are now ahead of the game if the company stays in business. You need to check that you are dealing with a company that is financially strong. Not all are according to the agent we dealt with. You can check their ratings very easily but that can change over time.

We had an independent insurance agent who wrote many LTC insurance policies. I believe that's all he did. He recommended three companies to us but I can't even remember the names now. My husband didn't qualify for one and I didn't qualify for the other company so we ended up with the third company with the option of buying the policy and pay it in full. 

We hope that we never have to use it but it gives us peace of mind. We have no family here so we are on our own and I wouldn't want to count on our Government either, if I can help it.

To make the policy more affordable, we have to pay the first 90 days ourselves but after that, we are insured until we die. Our benefits go up by 5% per year which may not be enough when inflation is higher.

My recommendation is to check this out while you are healthy. We must have been in our early sixties when we took the insurance out. I remember that they were very strict with blood pressure and osteoporosis.


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## Jennie (May 31, 2010)

iconnections said:


> I remember that they were very strict with blood pressure and osteoporosis.



My husband was 59 and "had never been sick a day in his life" as the saying goes. He was retiring from 30 years in a physically taxing law enforcement job, with months of unused sick leave that was paid to him in cash. But, he has been on medication for high blood pressure for years. There is a strong family history of it, yet most of his relatives on both sides live well into their 90's with no serious illnesses or disability.

His mother is now almost 94 with mild dementia but great physical health. Last year we returned to a timeshare resort to find that the elevator was not working. After waiting in the lobby for 1/2 hour for a repair person to arrive, Mom decided to walk up the 8 flights of steep stairs so that she would not miss a favorite tv program. We were "huffing and puffing" trying to keep up with her. She has had hypertension since adolescence but has never been in the hospital except for childbirth, and one incident of the flu last year (speedy recovery).

Hubby was accepted for LTC but with a 20% surcharge. My acceptance came within a week. His answer was delayed 2 months. Our agent (who was a personal friend) said that if hubby were older and had had any periods of hospitalization, however brief, he would probably not have been accepted at all.


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## Rose Pink (May 31, 2010)

Timeshare Von said:


> I guess I'm in a minority here.
> 
> We too (in our early 50's) recently went through the long term care insurance discussion w/ our financial planner as well.
> 
> ...


 
Your post struck a chord with me.  You are not in the minority.  Many people (most I would venture) say they do not want to be kept alive when quality of life becomes, not life, but prolonging death.  Very few of us choose life "no matter what the cost" when we are healthy and making out our advanced directives (living will)  And I've never heard anyone say they _want_ to live in a nursing home.

However, when it comes right down to it, we mortals are frightened of pain and dying and even those who have opted for a do-not-resuscitate directive will call for an ambulance in the middle of the night when the pain and loneliness and darkness become overwhelming.

I've seen it time and time again with my mother, my FIL, as well as patients in the nursing homes and hospitals where I have worked.  We may say we would rather die than live that way, but when it comes down to the wire, we very often grasp at life--no matter what the cost.

And, too, there is the issue of being able to make an informed choice.  If you should suffer a stroke or other injury that takes away your ability to make and eat "Key Lime Pie" you may end up in an extended care facility simply because no one else is going to place it in your feeding tube.

Having worked in nursing homes, I dread ever having to live in one.  And yet, statistics say many of us will end up there for one reason or another.  Maybe not as permanent residents but at least for some period of time.

Do I have LTC insurance?  No.  For the same reasons you gave--it is more than we feel we can spend given all the other "right now" needs we have.

It's a tough choice.


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## MuranoJo (Jun 1, 2010)

Kal said:


> Until such time that someone invents an "I'm out of here device", think thru the scenario of requiring long term care.  With no kids, the only option is for your significant other to be the full time care giver and nurse.  The job description would INCLUDE bed pan changing, and much worse.  Yes, the insurance premium takes away quality of life today, but think about the quality of life tomorrow for both patient and care giver.
> 
> Sounds like your only option is government provided Medicaid.  With that program you are limited to the very bottom-end of care facilities, e.g. "One Flew Over the Cuckoo's Nest".



This is a very similar argument I presented to hubby who was resisting getting LTC through my group John Hancock policy at work.  Honestly, it was a very reasonable cost, although I'm not sure how much it will go up if I retire.  (Kind of similar to the life insurance discussion we had years ago.)

I have seen what major health issues can cost a family financially and emotionally, and I felt this was something we just had to do.

Hubby's favorite saying used to be, "When I get to that point, just take me out to the desert and shoot me."  I told him he'd have to rig that up himself, as I wasn't going to help him.


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## Kal (Jun 1, 2010)

muranojo said:


> This is a very similar argument I presented to hubby who was resisting getting LTC through my group John Hancock policy at work. Honestly, it was a very reasonable cost, although I'm not sure how much it will go up if I retire. (Kind of similar to the life insurance discussion we had years ago.)
> 
> I have seen what major health issues can cost a family financially and emotionally, and I felt this was something we just had to do.
> 
> Hubby's favorite saying used to be, "When I get to that point, just take me out to the desert and shoot me." I told him he'd have to rig that up himself, as I wasn't going to help him.


 
I think many people think that way and just put their head in the sand on how are they really going to survive in serious, non terminal health.  Even more they just think their spouse will take care of them.  They don't begin to consider what situation (incl age and ability) the spouse will be in at that time.  Frankly, it's a very ugly choice where LTC insurance is too costly today and the cost of LTC is enormous later.

For me, I've had LTC insurance for many years, but even now I'm worried that the premiums will have to increase given the cost of health care on a broad scale.


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## MuranoJo (Jun 1, 2010)

Kal said:


> I think many people think that way and just put their head in the sand on how are they really going to survive in serious, non terminal health.  Even more they just think their spouse will take care of them.  They don't begin to consider what situation (incl age and ability) the spouse will be in at that time.  Frankly, it's a very ugly choice where LTC insurance is too costly today and the cost of LTC is enormous later.
> 
> For me, I've had LTC insurance for many years, but even now I'm worried that the premiums will have to increase given the cost of health care on a broad scale.



When people think through the real scenario of helping a loved one who is totally dependent on them, the first thing that crosses my mind is:  Would I want my spouse cleaning up after me, helping me to bed when he can barely walk himself, etc.?   I opted for a LTC that provides in-home support that keeps you close to loved ones as long as feasible.


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## Kal (Jun 1, 2010)

muranojo said:


> When people think through the real scenario of helping a loved one who is totally dependent on them, the first thing that crosses my mind is: Would I want my spouse cleaning up after me, helping me to bed when he can barely walk himself, etc.? I opted for a LTC that provides in-home support that keeps you close to loved ones as long as feasible.


 
PRECISELY!  That's exactly how my policy works.  Of course an important feature is what are the minimum criteria which must be met to trigger LTC coverage.  Mine requires 3 of the 5 basic daily functions.  Other policies require all 5.


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## pgnewarkboy (Jun 1, 2010)

*Ending it all vs LTC*

I don't see this as an either/ or situation.  I am surprised to see people who have severe problems, including some stages of dementia, that are glad to continue and enjoy their life for as long as they can.  They must, however, have help to do so.  There are many conditions, such as MS, that at some point qualify people for long term care but where the people still have their faculties and find some joy in life.


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## vacationhopeful (Jun 1, 2010)

When the elderly stay in their own houses, I have noticed that they become very isolated - esp if one of them is housebond or he/she lives alone.  When my Mom needed by Dad's "supervision", I had to have several forceful conversations with my sister (living 3,000 miles away) that she had 2 elderly parents. Putting Mom in a nursing home would not help Dad alone at the house.  I had arranged for companion care (babysitting to a large degree) for my Mom for a year, but my Dad greatly benefitted from the social interaction.


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## rapmarks (Jun 1, 2010)

my two aunts have long term care insurance, Genworth.  They are 88 year old twins.  In Jan, they moved to assisted living, but the 3rd floor has an alzheimer's unit.  the one aunt has alzheimer's , her insurance kicked in, for the rest of her life, she will receive a check toward the cost.  the other aunt does not have Alzheimer's, but has mild dementia.  she has her medication given to her, walks with a walker, falls constantly, has to be assisted in the shower, gets all her meals, etc, but the policy does not kick in because she does not need skilled nursing.  Her income is less than half of the cost so we have to pay the rest and also pay her premiums.  She definitely is in worse shape than many people in nursing homes. when they started the policy, the idea of assisted living didn't exist.


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## easyrider (Jun 1, 2010)

We are using Trans America LTC for my wifes parents. The cost is around $580.00 a month for both of them. The payouts are for different benefits at so much per day after an elimination period. Both have been in the nursing home a couple of times and both are living in their home with a care giver now. 
Even with the help this policy provides with expenses, it is more important to have some one designated to keep track of policy as it only pays when it is charged a bill. 

When a person grows older they go through what can be described as the dwindles. This can make it very hard to understand the volumes of paperwork involved in health care.

As a person ages and if they want to leave assets for a spouse or children the formation of a family trust or a corporation can protect these assets.

Long Term Care isn't needed as much, or at all, if a person impoverishes them self by gifting their assets to a trust. There is a five year look back and after that assets are safe from medical expenses. 

When you decide to establish a TRUST would depend on if you have LTC and your health. Some without good medical insurance or LTC get the TRUST going early, around 55, so by 60 their assets are protected.

If you died or became ill at 60 and your spouse had to pay all your bills it could lead them to bankruptcy fairly fast. 

That would be a bummer. So plan for the worst and hope for the best.


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## Zac495 (Jul 15, 2010)

We just got these quotes - We are both 51 - and this information (this is actually a friend who sells this - we are also looking through the school district I work for  - he is comparing a quote we got with them.
Hey Ellen,

I received the LTC quotes back from John Hancock, Genworth and Prudential.  Here are my comments/findings:

1) The group policy is offering a daily instead of a monthly benefit.  I'm not sure how much the premium difference would be, but monthly provides a better benefit.  An example is when someone is in need of care, they may not need it every day.  The days that care is needed maybe for a full day shift and cost greater than the $200/day policy limit.  By having a monthly $6,000 limit, it allows the person to greater control how the care is provided.  I would like to know what the group policy would charge if it were a monthly benefit instead.  The bottom of the quote does say it is available.

2) Regarding the inflation benefit, the group policy is offering a CPI (consumer price index) inflation option instead of 5% compound inflation normally recommended as we discussed.  The 5% compound is a more expensive benefit, but one that is very important to obtain.

3) To help control premiums, I normally recommend using a longer elimination period.  This does mean you would need to pay more out of pocket costs if/when a need arises, but I try to protect against the long-term need of my clients and they can afford a 6 or 12 month nursing home expense.  They want to protect against the 5-10 year need. 

With these two recommended changes ($6,000/mth instead of $200/day, and 5% compound inflation instead of CPI) the quotes for these three companies are as follows:

                        90 day elimination               6 mth elimination            12 mth elimination

Genworth =             $4,158                                 $3,906                            Need to Obtain (NTO)

Prudential =             $3,295                                NTO                                    NTO

John Hancock =         $5,066                                NTO                                    NTO

Please find out what the group plan would charge for those changes and the 90 day, 6 mth and 12 mth elimination periods.  I'll follow up with the brokerage firm to ask for additional quotes as noted as NTO above.

We can then reconvene after this info is obtained to determine how best for you to proceed.                                

If you have any other questions, please let me know.


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## MuranoJo (Jul 15, 2010)

I can't find the source right now, but I've read that the average nursing home stay is just a year.  Now, that's supposedly 'average,' but there definitely are exceptions--I have an Aunt-in-Law who is 97 now and has been in a nursing home now for about 5 years.


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## Zac495 (Aug 15, 2010)

Kal said:


> I think many people think that way and just put their head in the sand on how are they really going to survive in serious, non terminal health.  Even more they just think their spouse will take care of them.  They don't begin to consider what situation (incl age and ability) the spouse will be in at that time.  Frankly, it's a very ugly choice where LTC insurance is too costly today and the cost of LTC is enormous later.
> 
> For me, I've had LTC insurance for many years, but even now I'm worried that the premiums will have to increase given the cost of health care on a broad scale.



We are in the process of buying LTC (lazy us - we haven't filled out the paperwork yet - but we have it But I thought the premium was fixed??

We are choosing Genworth with 180 day "deductible" ... I think.
We are both 51 and very good health, weight, blood pressure, etc. I did have heart surgery as a kid,  but I'm totally fine.. Here's hoping. I think they said the policy would be about 3000 a year for both of us.

Editing - I didn't realize I posted recently... But this post is more about premiums going up or are they fixed.


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## Liz Wolf-Spada (Aug 15, 2010)

We bought into the California PERS program when it opened about 15 years ago. When they offered a new option with better benefits for "in home care", I chose to go to that plan and I was ticked that they wouldn't keep my cost at the age rate that I originally bought in. At that time, my husband was already 65, so changing to that better policy for him was prohibitive. They don't raise "your" individual policy, but they have raised the cost more than once over the years for all policy holders.
Liz


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## Kal (Aug 15, 2010)

Zac495 said:


> We are in the process of buying LTC (lazy us - we haven't filled out the paperwork yet - but we have it But I thought the premium was fixed??...


 
If you can get thru the first 5 basic health questions, you'll be fine, but if any of those have a YES answer, they won't issue a policy. The balance of questions will establish your premium rate.

My policy is by Genworth and they were the top rated company with a long history of never increasing premiums. We purchased the policy 10 years ago then a year ago they increased the premium by 20%. That was the first increase in at least 9 years (but much longer for others as I understand it). I don't know what increases will be made in the future but paying a higher hefty annual premium could hit the tipping point.

Our policy is a joint structure where either spouse can draw on it, but not both. Statistics show it is highly unlikely both spouses will need LTC simultaneously.


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## easyrider (Aug 15, 2010)

Kal said:


> Our policy is a joint structure where either spouse can draw on it, but not both. Statistics show it is highly unlikely both spouses will need LTC simultaneously.



My inlaws were both in and out of the nursing homes last year. The cost was arround $13,500.00 per month with them having to pay about $4000.00 and the LTC insurance picking up the rest. So far Transamerica has paid out over $160k on these policies. So far the inlaws have paid about $15k on premiums and $50k on co pays.  

At one time they would not have wanted to be a burden on anyone when their health dwindled but now they plan on living forever. We have hired a live in care giver for them costing about $36K per year. Other care they recieve is from an elder care company that comes in for 3-6 hours a day to give the live in care giver a break.

It cost a bunch to get old and stay home. I used to say just pull the plug if Im in the dwindle but now realize theres alot more to it. It sounds good at 50 but in reality it doesn't sound good at all after 70.imo


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## Rose Pink (Aug 15, 2010)

easyrider said:


> We have hired a live in care giver for them costing about $36K per year. Other care they recieve is from an elder care company that comes in for 3-6 hours a day to give the live in care giver a break.


36K is a bargain. Where did you find such a person? Is it a CNA? I've heard so many scare stories about abuse: physical, emotional and financial. I know good caregivers are out there, too. 
----------------------------------------------------------------------------------------

I have a friend who worked in a nursing home for many years. She told us to never make our children promise not to put us in a nursing home. She said that a nursing home may be the only responsible care and it isn't fair to make our children feel guilty about putting us in that care.

That said, I want to take another look at LTC insurance this fall when it comes time to sign up for next year's benefits. I'm afraid I've waited too long. I am not in good health and I think I'll get turned down.


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## cmh (Aug 15, 2010)

A couple of things about large group LTC plans......

Only One Guaranteed Acceptance Period  -  I've seen some post here that they'll look into it at their next benefits enrollment period.  Typically, employees have only 1 time for guaranteed acceptance - for new hires, when they're first eligible for all other benefits or for existing employees, when the group LTC plan is introduced initially. If you don't enroll during your one guaranteed acceptance period, then any time later, your acceptance is dependent of proof of good health.  So you want to take advantage of the initial enrollment period for you. Also, with many plans, you can apply any time of year by submitting an application with a completed health questionnaire, and if approved, coverage is effective the next month. So you don't have to wait until the annual benefits enrollment time once you've missed your initial offering.  In fact it may be a good time to consider LTCI when you are not distracted by other annual enrollment benefit decisions & their deadlines.

Do benefits or premiums change when you terminate or retire?  Fully portable plans, neither your benefits nor your premium changes when you terminate or retire; maybe the premium payments method changes from payroll deducted to a direct bill basis.


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## MuranoJo (Aug 16, 2010)

cmh said:


> A couple of things about large group LTC plans......
> 
> Only One Guaranteed Acceptance Period  -  I've seen some post here that they'll look into it at their next benefits enrollment period.  Typically, employees have only 1 time for guaranteed acceptance - for new hires, when they're first eligible for all other benefits or for existing employees, when the group LTC plan is introduced initially. If you don't enroll during your one guaranteed acceptance period, then any time later, your acceptance is dependent of proof of good health.  So you want to take advantage of the initial enrollment period for you.
> Do benefits or premiums change when you terminate or retire?



Execellent points.  With my company's large group LTC plan, they offered it many years ago open to all employees and employee families, including parents.  I tried to talk the family including in-laws into jumping on it, but we were quite a bit younger then and the in-laws refused to consider it, so we all passed on it.  Two years ago, they offered it again, and I jumped on it and drug hubby along (he had to go through a physical first).  The rates are very low compared to what I'm seeing posted here, but I am not positive if the premiums change if you retire, so need to follow up on that.  (Somehow was under the impression they wouldn't, but that's probably a dangerous assumption.)


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## Kal (Aug 16, 2010)

cmh said:


> ...Do benefits or premiums change when you terminate or retire? Fully portable plans, neither your benefits nor your premium changes when you terminate or retire...


 
I would read every word in the policy to verify it states the annual premium will never change.


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## cmh (Aug 16, 2010)

Kal said:


> I would read every word in the policy to verify it states the annual premium will never change.



I didn't say the premiums will never change.  Please reread my post.  People are often concerned that their rates or benefits change when they terminate or retire because that's what often happens for other group benefits like life insurance for example.  When someone terminates or retires, LTCI premiums & benefits do not change because someone leaves the group.

ALL LTC policies retain the right to increase rates if need be, although the cost is based on the age when entering the plan or buying benefits.  Many group plans also offer an initial rate guarantee period.  

If you look at the history of premium increases for individual policies vs group policies, you'll see it's the individual policies that have had the increases, not the large group plans.  Plus with a large group plan, you the have the benefit of being part of a large group with negotiating clout in the marketplace.


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## teachingmyown (Aug 16, 2010)

Long term care is pricey and sometimes necessary.  I hope that my Aunt and Uncle have it.  I'm not close enough to their situation to know for sure but they are at that point.  I'm guessing they are both in their mid-late 70's and they still both enjoy life and living, but with their medical conditions it isn't feasible for them to continue trying to live alone.  The center they are considering moving into charges $75per person per day.  With neither of them working (if they could work they wouldn't need assisted living arrangements) this will add up quickly.  Even so, it seems like a bargain compared to other quotes.  


Several years ago my mom and dad decided to pursue LTH coverage and made an appointment to speak with an agent.  The week before the apt dad had a mini-stroke.  It didn't leave a lot of physical damage (for which we are VERY grateful) but it certainly damaged their ability to acquire that coverage.


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## purplenook (Aug 25, 2010)

noson7982 said:


> So does long term Care insurance make sense?
> Bob



Of course, it does..

Here's a good explanation of LTCi - http://www.completelongtermcare.com/resources/what-is-ltci.aspx


Dunno why people think that LTCi is just a waste of money. Did they ever think of the financial disasters of becoming uninsured? Most of us are unaware of the future health problems or disabilities that could happen in the most unlikely time. It's better to get insured earlier than suffer for the rest of your life. 

Good thing about long term care insurance is it helps people protect their assets as well as protect their health. the average annual stay in nursing facilities costs a lot that could sweep your entire finances.

the best way to save on LTC is to plan ahead. Assess what your long-term care needs are, and weight your options. Always shop for a reliable insurance company. A good insurer will help you determine the best policy and will guide you through the entire planning process.


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## Cathyb (Aug 25, 2010)

*Great website*



purplenook said:


> Of course, it does..
> 
> Here's a good explanation of LTCi - http://www.completelongtermcare.com/resources/what-is-ltci.aspx
> 
> ...



Thank you for the informative website!


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## Fern Modena (Aug 25, 2010)

*Calpers LTC*

In Post #21 above, I mentioned Calpers LTC Insurance.  It is available to government employees in any jurisdiction in California (city, county, schools, etc) and their spouses and family members.

Besides having very low rates for good coverage, they also have a return of premium clause.  If you should die before the age of 75, you will get a part of your premium returned, based on your age and if you had any claims.  I know this is true, because they did this in Jerry's case.  

Fern


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## x3 skier (Aug 27, 2010)

I had term insurance through my employer. As I got older, the premiums increased slightly but the benefit decreased significantly. A simple choice for me was to switch paying for the term insurance and start applying it to LTC. 

Basically, I never missed the money and had better protection in case of the frailties of old age.

I do have the objective of dying of a heart attack while skiing as an avalanche is about to overtake me. Won't get to use the LTC but wild dreams seldom come true anyway. 

Cheers


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## Merilyn (Sep 2, 2010)

I have a policy with Genworth and I am so glad I got it. It never increases in cost but has an inflation rider so the benefit goes up each year. I saw my family care for  several members who needed constant care for months so I won't leave that expense to my family should I need help. My father had ALS and needed around the clock care for a very long time. They had to pay out of pocket for this because he didn't have long term care and wasn't on medicare. If you want to get it, don't wait until you have a medical problem. It cost a lot more then!


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## Zac495 (Dec 21, 2010)

*LTC and CLASS*

So we're still pondering the insurance. Hubby thinks we should wait. He said:
Oct 1, 2012 is when the government LTC program (Community Living Assistance Services and Supports (CLASS)). will start.  Since turning 52 is not a massive premium hike, should we wait a year to get more info (and save $3k)?

Does anyone know anything about this?


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## Black Diamond (Dec 21, 2010)

*45 and 47 y.o couple just enrolled with 10%*

My wife and I bought policies to cover each other at the age of 45 and 47 respectively.  It is through Prudential Insurance offered group policy as part of State employment without a physical.  It offerred a 10 % discount for couple.

I have seen the full benefits with my father that had Alzheimer, best way to protect one's estate from daily rates of assisted living and nursing facilities.


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## MommaBear (Dec 21, 2010)

I have been working in healthcare for 35 years and would not own a policy unless it was supplied by my employer. I have chosen to do a VUL, which is much less expensive than LTC and can help cover those costs if ever needed. I am also at liberty to use these funds to cover different needs than are covered by a LTC policy. Will it cover all my expenses? Absolutely not! That is why I have savings.

Many long term care policy benefits do not start until you have had 100 days of skilled care, which is a medicare (partly) covered benefit. After the first 20 days of medicare covered skilled care, out of pocket expenses are approx $120 per day. Some LTC policies do not start for 90 days to 180 days after the need has been certified and you have paid for out of pocket care. Make sure you know when your policy would start before you purchase it. I wish I knew more about the government proposal, but like any other plan, I am sure it will not fit everyone's needs. 

Only 5% of the population is in LTC at any given time. A lot of people pay huge sums of money into LTC insurance but only 36- 50% of those who pay in ever receive any part of that benefit. If you need it, and have paid into it, then great, but otherwise it is not useful. Look at your family history, your personal health history before you take a policy. Not one of my family members nor my husband's family has ever needed LTC. Many LTC policies ONLY cover nursing homes, not skilled facilities, assisted living or home care. Know what your policy offers and how infirm you need to be before you can access coverage.

These policies are huge money makers for those who sell them to you. It is in their interest for you to purchase this. My sister in law sold these policies for years for a major corporation and DID NOT buy one for her or her husband, because she knew what a bad investment it is. Rates for private insurance through the big companies may rise as much as 40% this year.


When searching the web for information, most of the sites that recommend these policies are sponsored by either the insurance or healthcare industry, and therefore have a huge bias. This link is to a Consumer Reports article. http://www.consumerreports.org/cro/...ance/overview/long-term-care-insucance-ov.htm Money Magazine also did a similar article.

Make the decision that is right for you and for your spouse and extended family. Me, I am with with x3 skiier who wants to go with the avalanche. My father was always hoping to be shot by a jealous husband. Both my husband and I have discussed this with each other and with our children and we have come up with a plan that is agreeable to all, will not over burden each other or our children and will allow us to live (and to die) with dignity.


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## pgnewarkboy (Dec 21, 2010)

*Does Long Term Care Make Sense*

For most people (Warren Buffet being the exception)  the answer is a resounding YES!  A debilitating illness will financially ruin any person or family.  It is that simple.  The odds are very high as you age that you will suffer from such an illness.  The only issue is what policy to buy.

Of course, they are only useful if you use them. (Duh).   Of course, insurance companies try to make money from them and therefore sell them! (another bigger DUH!)


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## Black Diamond (Dec 22, 2010)

*Variable Universal Life insurance??*



MommaBear said:


> I have been working in healthcare for 35 years and would not own a policy unless it was supplied by my employer. I have chosen to do a VUL, which is much less expensive than LTC and can help cover those costs if ever needed. I am also at liberty to use these funds to cover different needs than are covered by a LTC policy. Will it cover all my expenses? Absolutely not! That is why I have savings.



Life insurance, anything other than Level Term Insurance - 10 or 20 year term, is just as much a Profit-Maker for Insurance Salespersons as any.   "BUY TERM LIFE  AND INVEST THE REST"  says my Financial Advisor, who has advised me to "Start early and do pay-roll investments plus individual Roth IRA's, children's 529 and UTMA's, along with get a LTC policy prior to 50 and health issues cause un-insurability or premiums sky rocket.  He is not salesman of any of the policies or products that I have investments or insurance in.  He is simply an ADVISOR to sound decision making that my wife and I have heeded over the years.  We have a written will and are currently working in development of a Revocable Living Trust for all of our assets as additional protection from losses of our inheritance to the costs of elder care and estate tax issues down the road.  Can I suggest that you have an "ADVISOR" that works for YOU to advise you and then talk to the 'SALESMEN AND WOMEN " that ares sellers of the above products, *KEEP THESE TO PERSON APART FROM ONE ANOTHER- never mix the two types of persons and their jobs and duties to YOU!!*


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## Zac495 (Dec 22, 2010)

Black Diamond said:


> Life insurance, anything other than Level Term Insurance - 10 or 20 year term, is just as much a Profit-Maker for Insurance Salespersons as any.   "BUY TERM LIFE  AND INVEST THE REST"  says my Financial Advisor, who has advised me to "Start early and do pay-roll investments plus individual Roth IRA's, children's 529 and UTMA's, along with get a LTC policy prior to 50 and health issues cause un-insurability or premiums sky rocket.  He is not salesman of any of the policies or products that I have investments or insurance in.  He is simply an ADVISOR to sound decision making that my wife and I have heeded over the years.  We have a written will and are currently working in development of a Revocable Living Trust for all of our assets as additional protection from losses of our inheritance to the costs of elder care and estate tax issues down the road.  Can I suggest that you have an "ADVISOR" that works for YOU to advise you and then talk to the 'SALESMEN AND WOMEN " that ares sellers of the above products, *KEEP THESE TO PERSON APART FROM ONE ANOTHER- never mix the two types of persons and their jobs and duties to YOU!!*



So how do we find an advisor?


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## MommaBear (Dec 22, 2010)

Can I suggest that you have an "ADVISOR" that works for YOU to advise you and then talk to the 'SALESMEN AND WOMEN " that ares sellers of the above products, *KEEP THESE TO PERSON APART FROM ONE ANOTHER- never mix the two types of persons and their jobs and duties to YOU!!* [/SIZE][/QUOTE]


This was my advisor who suggested the VUL, which made sense to me because of my long term needs. He is also the one who advised LTC insurance, which I have elected not to get for the reasons stated in my other post. Advisors jobs are to advise and as consumers our jobs to decide what works and does not work for us. There is no "one size fits all", and what I also said in my post (as did you) is make sure you are getting your information from as unbiased a source as you can, not just the insurance field or those who provide the service.


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