Long Term Care Insurance

<p>Is there anyone here who can give me the basics on long tern care insurance? I've had a wake up call watching someone blowing through their life savings on nursing home costs.</p>

<p>What is the best age to first look into buying long term care insurance? If you buy a policy though a job, can you normally convert it to a personal policy when you leave/retire?</p>

<p>The advice I've heard is that long-term care insurance makes sense for those with a middling amount of financial assets. If you are poor, you can't afford long-term care insurance and will go on Medicaid right away should you need long-term care. If you are wealthy enough to afford the $60,000 - $100,000 per year cost of nursing home care, you don't need long-term care insurance. It's those in the middle who should consider it.</p>

<p>There are several things to consider when choosing long-term care insurance - do you want inflation coverage (if so how much)? - how long a period should the insurance cover? - what is the waiting period before the insurance starts paying? Insurance that covers all inflation, lasts for a lifetime of care, and pays from day 1 is very expensive.</p>

<p>In general, the earlier (younger) you purchase the insurance, the lower the cost. Don't know about converting from group to individual policies, but it doesn't seem like a good idea to get a policy you could not convert if you left your job for some reason.</p>

<p>Everything I've read suggests that between 60-62 is the sweet spot.</p>

<p>haven't heard from, mini, in many a moon. Welcome back.</p>

<p>We have only one child. Not going to burden him with our old age care. I took care of a family friend, then my FIL, and now my mother and father and MIL. Fortunately there are siblings involved and we can afford to spend time with with our parents. However, the time involvement is very great. </p>

<p>We had DS in our late 30's. DS is now 25 and unattached. We hope that he will be in a relationship by age 30, and grandchilden by 35. That would put us at 75yo. We don't think he can be involved with his children, his spouse, his career and US by time we are 85+ and he is 40. </p>

<p>I don't like the opportunities of Medicaid. We got LTC at age ~52. Premiums have increased twice but still affordable.</p>

<p>Read the fine print - have them explain it to you-make sure it covers care for dementia diseases and care in the home......</p>

<p>LTC coverage is usually pretty limited. I guess sooner or later virtually everyone will need nursing care. Because almost everyone will need the care and it is very expensive, LTC is not like an insurance policy against infrequent accidents. Basically, you put money into the fund and when money is needed you have coverage equivalent to what you put in, plus some interest, minus hefty fees from the "insurance" agency. Looking forward to the high medical costs of the elderly I realize there is no way I can save enough to self pay. At a certain point, if I live long enough, I will be dependent on the VA or Medicare/Medicaid.</p>

<p>This guide should help:</p>

<p><a href="http://www.ltcfeds.com/documents/files/naic_shoppers_guide.pdf%5B/url%5D"&gt;http://www.ltcfeds.com/documents/files/naic_shoppers_guide.pdf&lt;/a&gt;&lt;/p>

<p>The LTC policy I have is not as described by edad. It is a policy where you pay an annual premium and then have coverage up to a daily maximum for a stated time period (for example, up to $250 a day at a nursing home or $150 a day for home care, for a maximum of 10 years). You are eligible for benefits if you cannot perform at least two of the functions listed - bathing, toileting, eating, etc.</p>

Everything I've read suggests that between 60-62 is the sweet spot.


<p>I've always heard 50-55. The problem with waiting too long is if you develop any sort of major health problem, you can become uninsurable - forever. That includes cancer, heart disease, neurological diseases, diabetes, etc. My husband was diagnosed with MS when he was 40 and he can't get LT health care insurance nor additional life insurance.</p>

<p>Look for a policy that not only covers nursing home care but also home health. Even if you don't need a nursing home, chances are if you live long enough you will need some sort of home health or hospice care.</p>

<p>I have a policy like Dadinator's. The important thing to remember is Medicare does not pay for a skilled nursing home and Medicaid generally only pays for it if you spend down most of your assets (including selling your home in some states). This can leave the other spouse with little to nothing to live on. The other thing is most decent nursing homes will only take a set number of Medicaid patients, so it is often difficult to get into a nice one unless you have the assets to pay $50,000 a year and up.</p>

<p>The hospital I work at has to place patients in nursing homes all the time (too frail to be sent home, etc) and many, many times the patient has to be sent out of state become all the nursing homes nearby have taken their allotment of Medicaid patients.</p>

<p>I guess because of my husband's inability to get insurance coupled with working at the hospital and with the nursing home the hospital owns, I'm a big proponent of getting long-term health care insurance. Have seen too many people either wiped out financially or are unable to get the necessary care for a parent because of a lack of insurance. It's easier and cheaper to get when you are younger. My insurance company (John Hancock) has not raised premiums in many years. I got my policy a few years ago through my employer with a guaranteed issue if you took it when you were first hired. If I were to try and get it now, most likely I would have to have a physical.</p>

<p>The policy I have seen in our office that seems best is Lincoln Life MoneyGuard. It has a living benefit for health care OR a death benefit.</p>

<p>For instance, we have a client who put $100k into the policy in his 70s, he will either receive over $100k as a death benefit or up to $200k in health care benefits. You can also start younger and pay in to build up that lump sum.</p>

<p>Look for a policy that allows you to choose your own in-home caregivers rather than going through an agency, and preferably one with a monthly limit rather than a daily limit. I've done the remote caregiver deal with my mom, my father-in-law, and am still doing it with my mother-in-law. The quality of folks from the agencies is very, very, variable, and the turnover is really high. We've had better luck finding well qualified caregivers privately -- and even paying them better than the agencies do, and paying all of the payroll taxes, it still comes out less expensively than using the agencies. Also, be careful what kind of credentials they may require of a caregiver -- in many cases a person may simply need fairly unskilled help with several (three or more) activities of daily living -- they don't need to have a nurse's aid or similarly certified person.</p>

<p>I'd also agree with the suggestion of getting the policy by your mid-fifties. We've had two friends develop serious problems now in their later fifties when both had been avid exercisers and very healthy people until that time. In my opinion it is much better to get a policy with a longer elimination period that provides higher coverage once it kicks in than it is to try and get one that starts after only 30 days. Paying out-of-pocket that first few months can be painful, but the much larger benefit after benefits start is well worth it.</p>

<p>I have heard that 60 is the best time to get LTC insurance, but I am thinking that 55 is better. My father lost his LTC when the company from which he retired did away with the group policy he had been paying into for years. He was suddenly without any LTC insurance & couldn't get any for my mom ... and yes, just a few months later, Mom got pretty sick. He did have a Medicare supplemental insurance that he purchased, and it paid for my mom's rehab center. It didn't pay for home care when she was dying, though, so we chose to pay for her to be in a hospice. My in laws decided that they needed LTC insurance a bit late in the game (mid 70s). MIL got it at a decent rate; FIL has Parkinson's & it took some looking to find an insurer that would cover him. The premiums are expensive, but my in laws feel it's important to have that insurance. Given these situations, I think LTC should be purchased at a relatively young age ... and it needs to be portable (since many employers today lack scruples when it comes to keeping the promises they gave their retirees when they showed them the door).</p>

<p>What I have seen in researching makes me favor $200/day currently, but it is best to have it inflation-indexed (that is more expensive, though). A policy that allows in home care & your choice of care providers is very important.</p>

<p>Thank you for all the responses, and also for the link Dadinator. I need to get educated on the basics before I look into pricing, etc. </p>

<p>Its been so hard to see someone I love go though the stress of a spouse with major health problems compounded by the stress of not having the financial resources to deal with the illness long term.</p>

<p>I got a John Hancock policy this year. I really wanted a policy for just ALF/SNF care (like teachers in my area can get), but the plans all came with home health care. From experience, I'd much prefer to hire my own aides, rather than use agency ones. I used an agent that only does LTC policies, and seems all plans include all 3. The price factor was to include inflation, 3, 5 or lifetime care, and the $ amount per day.</p>

<p>Dadinator, "the daily maximum for a stated period of time" is how the "insurance" company limits the payouts so they are assured that they make a profit. Typically, the stated payout time period will increase in relation to the amount of money you pay into the policy. I have two different LTC policies and they both work the same way. In each case I would be better off to merely save the money on my own.</p>

<p>edad, my policy is different than yours. </p>

<p>In my case, when you take out the policy, you elect what the maximum daily amount is and the time period and that determines your annual premium.</p>

<p>For example, if you elect $150 a day with a 5 year maximum, than your annual premium is $x. If you elect $200 a day max with a 10 year max, than your annual prremium is $y.</p>

<p>There is no method to pay in more money and than have your benefits change.</p>

<p>Mine is a straight insurance policy - these are the benefits, this is the annual premium.</p>

<p>Apparently, your policy is different.</p>

<p>I got LTC thru a professional association rathar than the employer. That way I carry it with me at all times. I made sure it covers home care and nursing home and I picked a lower per day rate. I figured I would have to be a case of spagetti brains to use LTC and by then what would I care?</p>

<p>My parents have had LTC coverage for about 20 years, for which they paid a lot of money. Recently my father died without collecting a dime's worth of services. My mother and I provided home care, and then home hospice care, and Medicare paid for hospice agency support and supplies. Before that, she could have gotten limited home care assistance through Medicare, but was too stubborn to do it. </p>

<p>I would suggest that when you are evaluating policies you make sure to consider two things: how long the "exclusion" period is, and whether the policy covers home health care. Another consideration is whether the policy will reimburse a family member for providing those home services (not skilled nursing care, but help with bathing, dressing, and so forth). Some will, some won't. </p>

<p>An exclusion period of 60-90 days may lower the premium, but for many people it will mean that you are never able to use the services, even though you may need them. Someone told us that 3 months is a typical survival time for a person who is ill enough to need care. Apparently the people who live for long periods of time in a debilitated state are the exception, rather than the rule. (I don't think this applies in cases of dementia, though, just illness.)</p>

<p>Glad to find this thread. DH and I have been comparing the plan offered by his employer to a plan available from USAA. We've decided to go with the latter and were going to submit an application this weekend but I want to read the booklet that dadinator posted first. Thank you.</p>

<p>Be sure to CAREFULLY read ALL the terms of any policy you are considering. My aunt paid for her LTC policy for decades, literally. She died of lung cancer and tho she really could have used and benefitted from help, her policy refused to pay benefits because she could still slowly & painfully perform the activities of daily living and therefore didn't qualify for benefits until toward the very end of her life. By then, she qualified for hospice, which was fully covered by Medicare, so again, her LTC policy didn't have to pay benefits.</p>

<p>I am uninsurable, due to a health condition I was diagnosed with at age 42. In any case, many patients with my condition still can perform all activities of daily living until close to the time of their death, so again insurer keeps premiums & doesn't have to pay benefits.</p>