More OT: Long term care insurance

[ripvanrando]

We took care of MIL for 5 years. 2.5 years in our home. 24/7. Dementia.

Take a look at the Medicaid approved facilities. No way. You basically have to be broke. No assets. They are dumps.

An option for some is to have in-home care several times per week. We paid for that to help us (twice per week, six hours per day). $25 per hour.


Decent assisted Living that was decent was more like $15k per month in NJ.

LTC insurance looks cheap at 65 years old but the premiums in your early 80's are 12-15k per year. No way I will buy one.

[reuben]

I bought an LTC policy a few years ago. One lump sum, nothing else. I don't remember tbe details anymore, but the policy I bought dovetails with my other assets/plans/expectations/hopes/fears, etc., which is very important. You don't want to be double covered in one area and completely uncovered in another.

It's from Pacific Life, FWIW.

[C40_guy]

Originally Posted by Ralph

So....In my opinion....if you are well off and can fund your own care, with what help Medicare gives....you don't need LT care Insurance.

Thanks Ralph, your comments were particularly helpful (among the many!)

I *expect* to have another solid ten years of good paying employment...(tech sector, RSU grants, etc.). If that is true, I can probably easily self insure. It would be helpful to know the target amount needed, which I know will vary a lot, and how best to protect it as it grows (need to talk to an estate attorney on that...probably some sort of trust...)

I'm dealing with a parental situation now where planning didn't happen. It's a **** show.

[Blown Reek]

Originally Posted by ripvanrando

My parents paid into LTC for decades. Surely more than 100K.

They paid out nothing.

On the flip side, the money my parents laid out in LTC insurance was probably the best investment they ever made because they by far cost the company multiple times more than they paid. Insurance is just that- insurance. You hope to not use it, but when it's there, you're glad you had it.

However, I'm planning on not getting old, so no need here.

[jamesdak]

Originally Posted by Dave

I'd rather be dead. I don't want thousands per month spent on avoiding the inevitable.

I'm with you. When I reach this point I'll be making one more trip to Montana to smack a grizzly in the nose.

[el cheapo]

The key to nursing home care is having enough $$$ saved to cover one year's stay while your loved ones spend down every financial resource that you have to qualify for Medicaid. This will get you into a NICE WELL RUN nursing home. Went down this road with my mom who had ALS and was surrounded by other residents who had paid a small fortune for LTC insurance. Cost us about $70,000 in 2012. Consult an elder care attorney to protect assets. Used a deed to safeguard the house from state claw back for Medicaid expenses.

[Dude]

I'm currently going through it. My mother has dementia and has a policy with genworth. It is a very generous policy in that she's covered up to $440/day for in home care or LTC facility. We're very fortunate - she can get the help she needs to keep her safe and the rest of the family is not cratered with burden. She paid about 5500/year for coverage. As someone earlier said it is a very good investment. The out of pocket we had to pay was around A LOT.

For her insurance to get approved she needed to demonstrate that she is in physical harm. She is very physically capable, no balance issues, not a fall hazard - insurance wouldn't cover her. It wasn't until she demonstrated her mental deficiencies were a danger. Tin foil in the microwave, plastic in the oven and a few small falls (in the snow) were enough to get the claim approved.

We also had to make sure the doctors were explicit that mom was a danger to herself - we asked her gen practitioner and her neurologist to say that she can not be left alone.

Without the policy, it would be really difficult for the rest of the family to support her. I'm happy to chat about it, DM me if you want to connect.

[saf-t]

Originally Posted by Blown Reek

On the flip side, the money my parents laid out in LTC insurance was probably the best investment they ever made because they by far cost the company multiple times more than they paid. Insurance is just that- insurance. You hope to not use it, but when it's there, you're glad you had it.

However, I'm planning on not getting old, so no need here.

My mom had LTC insurance which covered all kinds of things once she became pretty disabled, but it seemed to take a continual effort on the part of my siblings and me to get the company to pay. They eventually would, but if it had been just her, she likely wouldn't have gotten a penny.

[unterhausen]

Originally Posted by jamesdak

I'm with you. When I reach this point I'll be making one more trip to Montana to smack a grizzly in the nose.

The problem is when you get to that state you will be too confused to get there most likely. And your relatives won't want to help you. I saw that playing out with my MiL. She was fully gone mentally for at least 2 years and her kids were still using every effort to keep her alive. MiL had quite a bit of money saved up, and her care didn't really make a dent in it. Pretty good for a school librarian.

I definitely don't want to live in a state where my mind is gone. At least let me try to feed myself and let me go that way. Doesn't seem like a particularly bad way to go. A friend's dad went this way, he didn't want to live a life where he was constantly sick, always in the hospital, etc. Went on home hospice and was dead within a year.

I told my kids about my desires and they said, "why wait?" But I think when the time comes they will have trouble with it.

[Ralph]

In addition to what I said about our families' experience with wife's Mom, while Medicare doesn't pay for LT care.....it will pay for 20 days of care each 6 months. And many of us have health insurance in our retirement packages that provide an additional 80 days. (check yours out) So (for example) I do have 100 days of nursing (20 plus 80) care in my basic insurance package, and another 20 days later in same year that can be used. Don't know the exact statistics, but you usually are rehabed, get well, or die within 100 days. Most people anyway.

And while my MIL was a widow....in a joint situation....there are some work arounds (if you are sure who gets sick first). In Florida....spouse is allowed a vehicle and a home, some money, and prepaid funeral expense. So buy the wife an expensive car (in her name), fix up the house, etc....spend down what you can...Medicaid will get the rest (by making you pay your nursing home bill until you are down to $2000) before they begin paying. Again if you have an idea who gets sick first....transfer assets out of that person's name within 5 years of them getting sick (Florida has a 5 year claw back rule and beware of gift tax rules), and do what you can.

Men in our family usually go quick with heart attacks. Wives linger.

[jamesdak]

Originally Posted by unterhausen

The problem is when you get to that state you will be too confused to get there most likely. And your relatives won't want to help you. I saw that playing out with my MiL. She was fully gone mentally for at least 2 years and her kids were still using every effort to keep her alive. MiL had quite a bit of money saved up, and her care didn't really make a dent in it. Pretty good for a school librarian.

I definitely don't want to live in a state where my mind is gone. At least let me try to feed myself and let me go that way. Doesn't seem like a particularly bad way to go. A friend's dad went this way, he didn't want to live a life where he was constantly sick, always in the hospital, etc. Went on home hospice and was dead within a year.

I told my kids about my desires and they said, "why wait?" But I think when the time comes they will have trouble with it.

To be honest the mental issues are already kicking in from all my head injuries over the year. I fully expect to lose it as I'm already headed there literally. But my lucky reality is I've only got to get past a two or three year wait in worse case to get into a old soldiers home. Process is already mapped out and my kids have instructions.

The other reality is I'm a road cyclist and due at least 25 miles on 55 mph country roads with no shoulders daily. I figure it's just a matter of time before one of the many distracted drivers just take me out.

[paredown]

Originally Posted by tomato coupe

My wife's parents are in their mid 90s and are in an independent living facility. In addition to the facility expenses, they pay a few thousand each month for someone to come in and help them with various things. They have long term care insurance, and it has paid exactly $0 of their expenses. Nothing seems to be covered, and it is very difficult to find an arrangement where the insurance would actually pay for some of the expenses. It looks like they threw away a lot of money.

This is about where we are with my MIL. She bought a fairly expensive plan many years ago, paid in faithfully, and it was supposed to be a fixed benefit/fixed payment. Then the insurers persuaded the State of VA to allow them to change both the coverage and the payment amount. Now it has reduced coverage, a higher price and as far as we can tell, it is almost impossible to get the right combination of conditions so that she could actually have them cover some of her expenses. So far she has been making do with her BC/BS government health coverage and self-financing the gaps...

We are not holding out much hope that the insurance is even worth the paper it is printed on.

[ripvanrando]

Originally Posted by Blown Reek

On the flip side, the money my parents laid out in LTC insurance was probably the best investment they ever made because they by far cost the company multiple times more than they paid. Insurance is just that- insurance. You hope to not use it, but when it's there, you're glad you had it.

However, I'm planning on not getting old, so no need here.

Except.....the company did not pay out.

Read the policy and research the topic is all I can say.

I think LTC is a huge scam

[reuben]

Originally Posted by paredown

Then the insurers persuaded the State of VA to allow them to change both the coverage and the payment amount. Now it has reduced coverage, a higher price and as far as we can tell, it is almost impossible to get the right combination of conditions so that she could actually have them cover some of her expenses.

If your statement is accurate (and I have no reason to believe that it's not), this is the kind of stuff that makes me furious.

[benb]

One other thing from family experience.

There are ways to shield/give away/transfer money within the family to shield the elder's assets from needing to all be spent on nursing home care.

I will leave it up to each to decide whether you think that's ethical, but a good financial advisor & estate planning lawyer know how to play these games.

If your parents/grandparents had a LTC that paid out many times more than they paid in that's the perfect example why LTC is not long term solvent and new potential customers can't count on the same result. Lots of customers had that experience and the insurers can't sustain it.