[2008] Does Long Term Care insurance make sense?

[Beaglemom3]

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.

 

[Liz Wolf-Spada]

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

 

[Jennie]

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!

 

[Rose Pink]

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.

 

[Kal]

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".

 

[vacationhopeful]

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.

 

[pgnewarkboy]

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.

 

[MULTIZ321]

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

 

[Passepartout]

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

 

[Jennie]

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.

 

[Jennie]

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

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

 

[pgnewarkboy]

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.

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.

 

[jmzf1958]

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

 

[MelBay]

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.....

 

[MelBay]

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

 

[vacationhopeful]

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.

 

[Timeshare Von]

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.

 

[Kal]

...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".

 

[vacationhopeful]

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.

 

[Timeshare Von]

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.

 

[Timeshare Von]

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.

 

[bogey21]

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

 

[Kal]

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?

 

[Kal]

...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.

 

[taffy19]

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

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.