<p>Trying to get many aspects of our life together and have started to talk LTC. Do we need it? How does coverage work? And how does one compare plans? We keep getting literature from various alumni and professional groups with their “group” plans. When meeting with a rep what should we know going into this? Thanks for any input.</p>
<p>This is a good basic explanation:
[Understanding</a> Long-Term Care Insurance - Picking the Right Policy - AARP](<a href=“http://www.aarp.org/health/health-insurance/info-06-2012/understanding-long-term-care-insurance.html]Understanding”>Making Sense of Your Long-Term Insurance Options)</p>
<p>Thanks! I also was poking around the federal employee site for LTC and it seemed fairly comprehensive. Not that I work for the federal government but the information was laid out nicely.</p>
<p>Wikipedia is your friend …</p>
<p><a href=“https://en.wikipedia.org/wiki/Long-term_care_insurance[/url]”>https://en.wikipedia.org/wiki/Long-term_care_insurance</a></p>
<p>Just keep this in mind - LTC is a gamble. The insurance carrier is betting that you’ll get hit by a bus or, for any other reason, will never need any long term care. You are betting that you are going to live into very old age and will have assests that you want to protect.</p>
<p>It’s your choice. No one knows whats going to happen.</p>
<p>4 things I’ve learned about LTC insurance:</p>
<p>1) It makes sense for those who can afford to pay the insurance premiums for the next 30 years, but for whom the cost of long-term care could wipe out their assets. If you can’t afford the insurance premiums, or if you have plenty of assets and could afford the cost of long-term care, then LTC insurance doesn’t make sense for you.</p>
<p>2) For whose assets and income make them sensible candidates for LTC insurance (see 1 above), you could think of it as bequest insurance. If leaving something for your kids is important for you, then LTC insurance can help you feel certain that there will be something left for them even if you need long-term care.</p>
<p>3) From some companies you get a big discount if both husband and wife purchase a policy together. We were going to get a policy only on my wife, but by my getting a very inexpensive policy (~$175/yr), we saved about $1,750 per year on her policy (I think it was a 40% discount).</p>
<p>4) The cost of LTC insurance is driven by 4 major factors: the daily benefit, the waiting period, the length of time benefits will be payable and whether there is inflation coverage. The most expensive policy will have a large daily benefit ($200+/day), a short waiting period (30 or 90 days), a long length of the benefits (5 years +) and generous inflation coverage (5%/yr).</p>
<p>Dadx3~ Perfect! I think I can at least talk and surely “listen” more intelligently now. Thanks for all suggestions.</p>
<p>My husband had the foresight to purchase Long Term Care Insurance when we married 22 years ago. Now that my parents are in a retirement village, and could possibly need assisted living, we got out our policy to see what it really covers. It will not cover assisted living. Neither does Medicaid. It will cover nursing home care, but you need to meet the criteria for nursing home care, the same as you would for Medicaid. </p>
<p>So essentially, we could have our nursing home care taken care of, instead of using our life savings. That’s if our health is such that we would need to go to a nursing home. If we need assisted living care, we hope to hire care takers to come to the home, but you never know whether that will be a viable action when the time comes.</p>
<p>The real issue, as we see it, is finding a room at a reputable nursing home. Most, if not all, of the reputable nursing homes in our area, are in retirement communities, and they give first dibs to their residents. Since their residents have paid a premium for their residence, they can make a lot more money from them. The nursing homes in the area that do have room are the ones that no one wants to send their loved one to.</p>
<p>One of the major driving forces for my father to move to a retirement community was so he didn’t have to go to the dreaded home in our county that admits anyone. The two times he has been placed in nursing care, the cost was around $300 a day.</p>
<p>Many people are lining up to move to these reputable retirement communities so that they are guaranteed to be taken care of should their health deteriorate. But for people like my husband and I who don’t want to do that, our future is much more uncertain.</p>
<p>I was looking into this just a bit recently and looked through the plans for companies who are approved by our state’s board of insurance. </p>
<p>The first thing I noticed was that each plan had long list of what exactly benefits were offered with prices for various ages at starting policy and costs for upgrading the policy in various ways, so that all seemed very upfront.</p>
<p>However, the two upgrades I was most interested in did NOT have prices listed for any company and one would have to call and talk with a rep to find these out. I didn’t get that far, but assume it’s exorbitant.</p>
<ol>
<li><p>All polices were keyed to today’s prices, with no benefit increase over time. An inflation upgrade was not quoted.</p></li>
<li><p>Assisted living coverage was not included in basic policy and price quotes not listed.</p></li>
</ol>
<p>Like all insurance the expected value of purchasing the insurance is negative or the company would not be selling the insurance … so the question is the cost worth the risk protection.</p>
<p>In our case we are in position to handle most old age scenarios like 3-4 years of nursing home care … unless we both needed nursing home care for a long time (like 10 years). That was not the risk we were most concerned about. </p>
<p>We got our LTC insurance when we were young, about 50, and this protects us and our kids education if we get in a situation like one of gets in an accident and is paralyzed for life at 50. For us, that is the one scenario that could wipe us out and wipe out our plans to support our kids through college … so it is the risk we insured ourselves against.</p>
<p>PS - our policy does have inflation coverage and covers home care, assisted living, and nursing home care … and my parent’s policy does also.</p>
<p>bluejay - Thanks for starting this thread. </p>
<p>dadx3 - That’s good information. From time to time I’ve tried getting “a handle” on LTC. I’ve had precious little success. How much does it cost? What does it cover? It isn’t easy getting affirmative answers to these questions. (In contrast, “No” responses are comparatively easy to get!) I’m one of those tiresome customers who needs to understand the long-term commitment/benefit. With LTC I’m still trying to get there.</p>
<p>My H does work for the federal government. When they were trying to urge their employees to purchase it a few years back, I thoroughly studied the issue. It is VERY helpful, as indicated above, IF you have the assets to pay the premiums for as many years as you need before you need to use it but not good if you will need the assets for other expenses (like college, mortgage, living expenses).</p>
<p>I did actually go and speak with MetLife to see if my understanding of long term care insurance was correct. They were one of the preferred vendors the federal government mentioned among the materials we received and we had gotten their brochures.</p>
<p>I read all the materials cover to cover. One thing that IS required is that for benefits to kick in under all the policies I read, you have to not be able to perform a stated number of the “activities of daily living,” (ADL). I looked over the ADLs, which include: transferring from bed to chair, bathing, toileting, eating, and a few other VERY basic things. It did NOT include shopping, cooking, cleaning (home or room), or other basics. I confirmed this with the MetLife folks.</p>
<p>It IS handy for folks who have been paralyzed for any reason (or with limited mobility) or end up with dementia so they don’t remember how or are unable to do these things. For folks who don’t have those issues but could use an assistant to help them get groceries, run errands, cooking or cleaning, you are better off saving your assets and paying for them as you see fit. I have had many relatives who could have used help as they aged to make their lives more comfortable–some had LTC insurance and others didn’t. The one aunt who was dying painfully and slowly from lung cancer was unable to get ANY coverage until the last month of her life, even though she had paid premiums for many decades. </p>
<p>My folks who are in their 80s would not qualify either, and unless one of them has any paralysis (or gets dementia) are unlikely ever to–they preferred investing in a single premium life insurance policy, payable upon death to give to their heirs. My aunt who is in her 90s likewise would not qualify, even though she could certainly use help in remembering things, getting errands run, cooking and cleaning, and even remembering to take medications and eat.</p>
<p>We have opted NOT to purchase LTC when it was 1st being promoted for federal employees and now we do not qualify, as I have a health condition that is progressive and chronic. Ironically, all the folks I have read of with this condition continue to be able to perform ADLs up until the day they die anyway. We have no regrets and do have assets to pay for the services we want and need rather than LTC deciding if we qualify and what we can get (if anything) under its policy.</p>
<p>There are others on CC who have purchased it and are glad because it has helped with their LTC expenses, after they are able to get insurer to agree that there is coverage and it does apply.</p>
<p>
</p>
<p>That is unfortunate because, as you see from other posts, LTC insurance can (and should) cover various forms of care.</p>
<p>
</p>
<p>That is not true.
I’ve been through this.
Unfortunately it is much more complicated than that.
There are little or no specific federal rules about Medicaid and assisted living.
It is up to individual states.
And a state may issue a “waiver” to Medicaid support of assisted living.
And it can also even be up to the individual facilities themselves.
Some may choose to accept Medicaid payments and some may not.
It is a very confusing system with byzantine rules and tons of paperwork.</p>
<p>More info here:</p>
<p>[When</a> Will Medicaid Pay for a Nursing Home or Assisted Living? | Nolo.com](<a href=“http://www.nolo.com/legal-encyclopedia/when-will-medicaid-pay-nursing-home-assisted-living.html]When”>When Does Medicaid Pay for a Nursing Home, Assisted Living, or Home Health Care? | Nolo)</p>
<p>[Medicaid</a> Assisted Living Beneifts ? Does Medicaid Pay for Assisted Living? - Assisted Living Today](<a href=“http://assistedlivingtoday.com/2012/03/medicaid-assisted-living-benefit/]Medicaid”>AssistedLiving.org | AssistedLiving.org)</p>
<p>^ Connecticut has a Pilot Program that pays Assisted Living fees for a few state Medicaid recipients. The program only covers certain costs, which may be problematic since you need to “spend down” to qualify for Medicaid here. I don’t know anyone served by the Pilot Program, so treat my comments as hearsay.</p>
<p>[MEDICAID</a> COVERAGE OF ASSISTED LIVING SERVICES](<a href=“http://cga.ct.gov/2009/rpt/2009-R-0300.htm]MEDICAID”>http://cga.ct.gov/2009/rpt/2009-R-0300.htm)</p>
<p>
I recently got down to the details on coverage for an elderly relative who had an LTC plan.</p>
<p>In the case of this plan (Transamerica), it’s not quite so black and white. This plan wouldn’t cover general assisted living but if one met a certain criteria of certain required assistance, then it would cover it. They have that criteria well defined.</p>
<p>It makes some sense if you think about it. Pretty much ‘anyone’ can go into an assisted living facility if they want to. People go into one for various reasons. Some do it because they absolutely need to due to their disabilities and level of assistance they require and others do it because they feel more secure even though they don’t really require much in the way of assistance (at least not yet). </p>
<p>An insurance company doesn’t want to have to cover the situation where someone enters an assisted living facility yet doesn’t need much in the way of assistance. This category of person could end up in the assisted living facility for years whereas the people who need a much higher level of assistance usually don’t. It’s all about actuarials and stats and the insurance companies don’t want to lose money.</p>
<p>There’s a bit of a dance/equation between Medicare, Assisted living, skilled nursing, hospitalization, LTC insurance. And then Medicaid (welfare) is yet another factor.</p>
<p>In this particular case the situation was very close to drawing from the LTC but didn’t make it all the way to that point. The insurance company made out okay on that one.</p>
<p>Another point - if you get LTC for yourself make sure the appropriate people know about it - i.e. your kids or other family members. By the time you typically need to draw from it you may not have all of your current cognitive skills and may need them to act on your behalf and this includes making the premium payments. Elderly people often get confused and absent minded regarding paying bills and if a payment or tow are missed then that LTC plan they’ve been paying for over the course of many years might default right about the time it’s needed.</p>
<p>Thank goodness my mother had the foresight to purchase LTC. She was diagnosed with primary peritoneal cancer in 2009 and was able to remain in her own condo, with health care aides for two shifts per day, paid by LTC (be sure to use a company your LTC covers). She paid for the third shift. That enabled her to stay in her own home since my sisters and I live in two different corners of the country, and she lived in Buffalo. We took turns flying in every three weeks or so, and that way there was usually one of us around. While she was being treated her premiums were suspended. She died in the summer of 2011. </p>
<p>I decided I should also purchase LTC and called in the fall of 2012. By the time I was ready to purchase, I was diagnosed with breast cancer, but again will be eligible this fall if all stays well. My husband bought it years ago, and I wish I had, too.</p>
<p>My mother didn’t have to worry about finances the whole year and a half that she was sick, and got to die at home, as she wished, with terrific aides to help her.</p>
<p>I will try to buy it this winter.</p>
<p>There may be some helpful information in this old thread: <a href=“http://talk.collegeconfidential.com/parent-cafe/998152-long-term-care-insurance.html[/url]”>http://talk.collegeconfidential.com/parent-cafe/998152-long-term-care-insurance.html</a></p>
<p>I found it helpful when I was researching the subject. At the time, it felt like an overabundance of caution to purchase a policy at the age of 50. Now I am tremendously relieved to have done it since I would no longer qualify.</p>
<p>Wow, I said much the same thing 3 years ago as I did up thread. At least I’m consistent!</p>
<p>Also be sure to check the requirements in your own individual state. Insurance is regulated by state law, and many states have different regulations.</p>
<p>For example, in Massachusetts, LTC is required to cover both assisted living and home health aides, at least at a certain level. And if you have coverage of at least $125 per day for two years, and then qualify for Medicaid, your primary residence is protected from any Medicaid lien (they can’t use your home after death to recoup your Medicaid payments). So in MA, it often is a good idea to have the LTC even at the basic level just to protect the home from the lien.</p>
<p>Other states may have different requirements for coverage.</p>
<p>My parents have/had LTC. My father died at home with my mother and I providing hospice care, aided by the local VN/hospice organization. (About whom I cannot say too many good things. They are wonderful.) He never used a cent of LTC, although he had definitely had issues with ADL for a few months before that: Medicare paid for hospice services. Because he had had prostate cancer by the time they got it, the terms of his policy were different from my mother’s. My mother’s policy has a shorter waiting period, and will pay a family member for providing care at home. Luckily, her health is excellent at 90, and she continues to live in her own house and is totally self-sufficient, other than help from H and I with her financial affairs.</p>
<p>My in laws have LTC, which they pay for because they want to stay in their own home no matter what happens. They are in their late 80’s, and my FIL has Parkinson’s. They consider the monthly payment well worth it in terms of peace of mind.</p>
<p>My dad lost his LTC when the large auto company from which he retired cut retiree benefits. My mom was ill by that time, and they couldn’t afford the premiums after the company stopped its plan. In the end, Dad couldn’t bring Mom home when she was dying because he couldn’t afford the full time care she would have needed (as it turned out, she went into a hospice facility with a sliding fee scale and died about 16 hours after she arrived, so it all worked out). Dad would have purchased LTC if he could have afforded it.</p>
<p>I worked for a year for an employee benefit consulting firm. The owners were not fans of LTC, and the insurers we worked with had gotten out of the business because it wasn’t a money maker. H & I want to buy LTC once we hit 60. We think it’s wise.</p>