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[2008] Does Long Term Care insurance make sense?

noson7982

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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
 

charford

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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.
 

SherryS

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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.
 

Kal

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...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.
 

Laurie

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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

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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.
 

Charlie D.

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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.
 

CMF

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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
 

Icc5

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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
 

Hophop4

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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.
 

vacationhopeful

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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

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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
 

John37130

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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.
 

GetawaysRus

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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.
 

Laurie

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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%+.
 

Kal

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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.
 

Jennie

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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.
 

mamiecarter

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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.
 

Rose Pink

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... 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.
 

pranas

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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.
 

Fern Modena

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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
 

Charlie D.

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

Liz Wolf-Spada

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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
 

Fern Modena

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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

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
 

Liz Wolf-Spada

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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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