Who has long term care insurance?

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LXEX55
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Who has long term care insurance?

Post by LXEX55 »

May I ask who the carrier is and any other details you would be comfortable in sharing?
The Broz
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Re: Who has long term care insurance?

Post by The Broz »

This is something I am considering down the road. I believe my mom has it currently, which could turn out to be a very wise decision.

I have had good experience with Zander on our term life purchases. I don't know if they do long term care, but I would suspect they do. I would check with them as a starting point. In fact, I would suggest placing a phone call to them. The reps that I have dealt with are extremely helpful and bend over backwards to ensure that they are helpful and doing what is in your best interest. So even if they do not sell this insurance, I bet they could point you in a good direction.
smitcat
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Re: Who has long term care insurance?

Post by smitcat »

LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Unfortunately it is irrelevant - the insurance that was available years back is no longer what they sell.
crefwatch
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Re: Who has long term care insurance?

Post by crefwatch »

Alas, that's true. Losses have been high for the carriers, especially because lapse rates have declined (that is, people are not dropping the policies over either time or rate increases ... ). This insurance "product" is "lapse supported." That is, they depend on customers tiring of the high premiums before they actually need care. If that doesn't happen, they have to charge more for the beginning.

My mother's company no longer writes LTC at all. They tried to pass the policy to another (big) company, but the NYS Dept. of Insurance gave us the chance to refuse, so the policy is now services by a different company from the one that has the actuarial exposure. Has not been a problem.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

smitcat wrote: Thu Jul 02, 2020 10:32 am
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Unfortunately it is irrelevant - the insurance that was available years back is no longer what they sell.

Half-true.
The same kinds of benefits are available that were available 20 years ago, only better.
1) New policies are priced more accurately.
2) Newer policies can protect your assets from Medicaid even if the policy runs out of benefits. It's called the Long-Term Care Partnership Program and it's available in 45 states.
oldfatguy
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Re: Who has long term care insurance?

Post by oldfatguy »

Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
smitcat
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Re: Who has long term care insurance?

Post by smitcat »

WoW2012 wrote: Fri Jul 03, 2020 12:36 pm
smitcat wrote: Thu Jul 02, 2020 10:32 am
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Unfortunately it is irrelevant - the insurance that was available years back is no longer what they sell.

Half-true.
The same kinds of benefits are available that were available 20 years ago, only better.
1) New policies are priced more accurately.
2) Newer policies can protect your assets from Medicaid even if the policy runs out of benefits. It's called the Long-Term Care Partnership Program and it's available in 45 states.
And the result is that you cannot rely on someone's past LTCi details to form any kind of an opinion for or against the insurance.
You will need to research for yourself what is available, the details and the relative costs.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
The average premium is $200 per month.
smitcat
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Re: Who has long term care insurance?

Post by smitcat »

oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
I would encourage anyone interested in LTCi to do their own research and get their own quotes rather than what I have read on this board.
That goes double if one or both spouses have their own business including more than one rental.
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Re: Who has long term care insurance?

Post by nisiprius »

smitcat wrote: Thu Jul 02, 2020 10:32 am
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Unfortunately it is irrelevant - the insurance that was available years back is no longer what they sell.
Exactly.

But, for your information, we bought ours in 2002 from John Hancock--which has changed its exact full legal name and domicile at least once, I think twice since then. We were very concerned about the possibility of premiums rising and retirement income falling, and the possibility that we would drop it because of affordability just when we needed it, so we bought a "ten-year premium" plan which completely paid it off in ten years, we no longer pay premiums and think we are now safe from premium increases. We were concerned about inflation, specifically inflation in long-term-care costs, and bought a plan in which the payment increased by 5% annually, compounded. We opted for a 6-year benefit period with a shared-care option (covering one person for twelve years if the other doesn't also need care), 180-day exclusion period (pay for 180 days before the policy begins to pay), and the minimum coverage amount to make it "qualified" under the state Medicaid plan. That only covers about 3/4th of the average cost in our state.

The grand total cost of premiums we paid to cover both of us was roughly equal to the 1.25 years' of the average cost of a nursing home in our state in 2002.

The 5%-compound-increasing daily benefit roughly doubled the price of the insurance. The ten-year-payment option roughly doubled the annual premium (but of course reduced the number of years the premium is paid).

I have no idea how good or bad this all is; fortunately we haven't needed to use it and frankly hope it will be wasted money. It's kind of irrelevant because the policy options we chose are no longer available.
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celia
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Re: Who has long term care insurance?

Post by celia »

I bought it through my employer about 20 years ago and the premiums have never increased. When I retired, I had to decide whether to keep it or not. At that time, I found the ‘rules’ for how to get them to pay and saved them for my PofA.
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ResearchMed
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Re: Who has long term care insurance?

Post by ResearchMed »

WoW2012 wrote: Fri Jul 03, 2020 12:42 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
The average premium is $200 per month.
This figure is pretty meaningless, as any premium will depend upon the age of the insured and the amount of coverage, and the type of coverage.

This is like saying those TV ads for life insurance for "$9.99 per month guaranteed coverage" is a good indicator of what life insurance will cost.
Note there is no indication on those ads about how much coverage one is getting, as one example, or of any "fine print".

I'll sell someone/anyone long term care insurance (well, I would, but I'd never pass the state licensing requirements!) for $200 per month:

You pay me $200 per month, and if you need long term care, I'll pay you $1 per month.
Oh, and there is a one-year waiting period, so that $2,400 minimum in premiums will cover an awful lot of months of claims at $1/month.
:annoyed

The full policy terms, in real life, are, er, rather important...

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oldfatguy
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Re: Who has long term care insurance?

Post by oldfatguy »

WoW2012 wrote: Fri Jul 03, 2020 12:42 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
The average premium is $200 per month.
Too rich for my blood
Alan S.
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Re: Who has long term care insurance?

Post by Alan S. »

If Covid or similar persists for long, the costs of operating LTC facilities could dwarf the effects of the actuarial pricing errors made earlier by the LTC industry. Govt assistance will be needed, including possible bailouts for LTC insurers, and at least partial legal immunity. At this point it is not possible to envision how this would unfold. LTC facilities cannot just disappear since they are a medical necessity of society.
shell921
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Re: Who has long term care insurance?

Post by shell921 »

oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
That's MY view also!
Escapevelocity
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Re: Who has long term care insurance?

Post by Escapevelocity »

The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
TravelforFun
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Re: Who has long term care insurance?

Post by TravelforFun »

LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
My LTC policy is provided by Unum. My wife and I pay $381 a month for approx. $10k and $6k a month coverage for my wife and me, respectively. We've bought this inflation adjusted policy in 2008 when I was 56 (wife was 52) and the premium at that time was $256 a month. We live in the Dallas - Fort Worth Area.

TravelforFun
Allan
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Re: Who has long term care insurance?

Post by Allan »

nisiprius wrote: Fri Jul 03, 2020 12:57 pm
smitcat wrote: Thu Jul 02, 2020 10:32 am
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Unfortunately it is irrelevant - the insurance that was available years back is no longer what they sell.
Exactly.

But, for your information, we bought ours in 2002 from John Hancock--which has changed its exact full legal name and domicile at least once, I think twice since then. We were very concerned about the possibility of premiums rising and retirement income falling, and the possibility that we would drop it because of affordability just when we needed it, so we bought a "ten-year premium" plan which completely paid it off in ten years, we no longer pay premiums and think we are now safe from premium increases. We were concerned about inflation, specifically inflation in long-term-care costs, and bought a plan in which the payment increased by 5% annually, compounded. We opted for a 6-year benefit period with a shared-care option (covering one person for twelve years if the other doesn't also need care), 180-day exclusion period (pay for 180 days before the policy begins to pay), and the minimum coverage amount to make it "qualified" under the state Medicaid plan. That only covers about 3/4th of the average cost in our state.

The grand total cost of premiums we paid to cover both of us was roughly equal to the 1.25 years' of the average cost of a nursing home in our state in 2002.

The 5%-compound-increasing daily benefit roughly doubled the price of the insurance. The ten-year-payment option roughly doubled the annual premium (but of course reduced the number of years the premium is paid).

I have no idea how good or bad this all is; fortunately we haven't needed to use it and frankly hope it will be wasted money. It's kind of irrelevant because the policy options we chose are no longer available.
I bought a very similar LTCI policy from John Hancock the same year, 2002, paid premiums for 10 years until the policy was paid up for life. I only purchased for myself, but I bought a lifetime policy, my cost was $3,750 per year. The last 2 years the premium increased a small amount. I paid for benefits of $150/day, increasing 5% a year, according to my calculations it would now pay $361/day. Like you I hope it will not be needed.

I was also able to pay for it via my company and deducted as an expense, so my personal net cost was 40% less. Not sure if this type of policy is still available, I suspect not.
Robert_007
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Re: Who has long term care insurance?

Post by Robert_007 »

I have heard from many sources that buying long term care insurance is a bad idea since insurers have changed the way they operate and offer contracts that allow them to increase the price randomly throughout the years. This is because many of insurers weren’t making much money since they failed to equate how long the policy holders will live.
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Re: Who has long term care insurance?

Post by WoW2012 »

ResearchMed wrote: Fri Jul 03, 2020 2:09 pm
WoW2012 wrote: Fri Jul 03, 2020 12:42 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
The average premium is $200 per month.


The full policy terms, in real life, are, er, rather important...

RM

I was illustrating absurdity by being absurd.

Someone saying, "the only people who can afford LTC insurance are those who don't need it" (while leaving out any specifics) is as ridiculous as someone saying, "a policy costs $200/month" (and leaving out the specifics).

I've provided ample examples in this forum of how much coverage can be purchased at what price for someone healthy enough to qualify for a traditional LTCi policy. If you've read my posts in the past, you've probably seen them.
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Re: Who has long term care insurance?

Post by WoW2012 »

Alan S. wrote: Fri Jul 03, 2020 5:37 pm If Covid or similar persists for long, the costs of operating LTC facilities could dwarf the effects of the actuarial pricing errors made earlier by the LTC industry. Govt assistance will be needed, including possible bailouts for LTC insurers, and at least partial legal immunity. At this point it is not possible to envision how this would unfold. LTC facilities cannot just disappear since they are a medical necessity of society.
1) Since COVID is killing people in nursing homes, that would be decrease long-term care insurance claims, not increase them.
2) Most people in nursing homes are on Medicaid, NOT long-term care insurance. From my experience, the majority of COVID cases are in Medicaid-funded facilities, NOT private pay facilities. My MIL's ALF does not take Medicaid (only long-term care insurance and cash). They have 160+ units. They've had ZERO COVID cases. The facility a few miles down the road is Medicaid-funded, has fewer residents and they've had 33 cases.
TheDDC
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Re: Who has long term care insurance?

Post by TheDDC »

WoW2012 wrote: Fri Jul 03, 2020 6:38 pm
Alan S. wrote: Fri Jul 03, 2020 5:37 pm If Covid or similar persists for long, the costs of operating LTC facilities could dwarf the effects of the actuarial pricing errors made earlier by the LTC industry. Govt assistance will be needed, including possible bailouts for LTC insurers, and at least partial legal immunity. At this point it is not possible to envision how this would unfold. LTC facilities cannot just disappear since they are a medical necessity of society.
1) Since COVID is killing people in nursing homes, that would be decrease long-term care insurance claims, not increase them.
2) Most people in nursing homes are on Medicaid, NOT long-term care insurance. From my experience, the majority of COVID cases are in Medicaid-funded facilities, NOT private pay facilities. My MIL's ALF does not take Medicaid (only long-term care insurance and cash). They have 160+ units. They've had ZERO COVID cases. The facility a few miles down the road is Medicaid-funded, has fewer residents and they've had 33 cases.
It’s high time for the entire SNF industry to be disrupted, possibly most should get shut down. The costs are unsustainable. $10k+ a month for a facility that sucks isn’t cutting it. Similar to what higher ed is going through now.

Medicare really should be paying for SNF care. That’s the best hope for them to keep the lights on long term.

LTC is also going to be shaken up necessarily and I would call it a poor investment. One should look into OPM as a source for LTC PDQ.

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Re: Who has long term care insurance?

Post by Chuck107 »

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Re: Who has long term care insurance?

Post by JoeRetire »

LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Mutual of Omaha.

Had it for over 5 years. Premiums have remained constant.
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WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

Robert_007 wrote: Fri Jul 03, 2020 6:16 pm I have heard from many sources that buying long term care insurance is a bad idea since insurers have changed the way they operate and offer contracts that allow them to increase the price randomly throughout the years. This is because many of insurers weren’t making much money since they failed to equate how long the policy holders will live.

Just google "Rate Stability Regulation" [crude language removed by admin LadyGeek]. Long-term care insurance policies purchased today have MUCH stricter pricing regulations than policies that were sold 15+ years ago. Long-term care insurance companies canNOT "increase the price randomly throughout the years."
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
Only 13% of the people who need long-term care are in nursing homes, according to the Congressional Budget Office.
See page 20, Exhibit 12 here:
https://www.cbo.gov/sites/default/files ... 3-ltc.pdf
Hence, nursing statistics are not a good predictor of risk.
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Re: Who has long term care insurance?

Post by WoW2012 »

shell921 wrote: Fri Jul 03, 2020 5:45 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
That's MY view also!

If you were able to find an affordable, good long-term care insurance policy, would you buy it?
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Re: Who has long term care insurance?

Post by WoW2012 »

LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Allianz
About $870,000 of long-term care benefits.
I bought it in 2009.
I've never had a rate increase.
SueG5123
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Re: Who has long term care insurance?

Post by SueG5123 »

Mutual of Omaha
Premiums about $2200 (66 yr old husband) and $2900 (62 yr old wife)
We bought the policies about 2 years ago. Shopped around a bit, but this met our needs better than every the federal employees version.
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Re: Who has long term care insurance?

Post by MDfan »

JoeRetire wrote: Fri Jul 03, 2020 8:16 pm
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
Mutual of Omaha.

Had it for over 5 years. Premiums have remained constant.
We also had Mutual of Omaha. Premiums for 2 (ages 59 and 56) was about $3100 total. We had the police for a couple pf years (no increases) but decided not to renew on advice of our fee-based planner. He said we could easily self-insure.
Escapevelocity
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Re: Who has long term care insurance?

Post by Escapevelocity »

WoW2012 wrote: Fri Jul 03, 2020 9:41 pm
Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
Only 13% of the people who need long-term care are in nursing homes, according to the Congressional Budget Office.
See page 20, Exhibit 12 here:
https://www.cbo.gov/sites/default/files ... 3-ltc.pdf
Hence, nursing statistics are not a good predictor of risk.
I forgot to mention in my earlier post, that I have a good bit of experience with this subject having served as my mom's POA when she developed dementia and had to go into ALF and eventually SNF. My Dad pre-deceased her but he had purchased a decent LTC policy thru his employer and it covered $120 per day in AL and $200 per day in SNF. She also had a survivors pension from his job as well as her SSA. Together, these amounts covered most of her Assisted living expenses and it was basically OK financially even though she had very little financial assets before all this happened.

What I really wanted to point out is that a lot of the "better" assisted living places wanted to see 2-3 years minimum of assets to cover full freight private pay arrangement in order to approve the move-in. They weren't so keen on the hodgepodge of funding sources that my Mom brought to the table for some reason even though it covered a long period of her care. It seems like they are usually cool with you moving in with a nice fat private pay revenue stream for a few years and the understanding (or in some states the law) is that once you are in there and if you run dry on money they need to let you stay or there is an understanding that you will be allowed to stay by transitioning to Medicaid. This is completely different challenge than trying to find a good facility when you are already poor and relying on Medicaid.

So, the takeaway for me is, why invest all these funds in LTC insurance? What's the point? Just make sure you have a nice juicy pile of cash (around $500k) available as you enter your decaying years and those facilities will be lining up to tap into it. If you never need to move into LTC then it's a win and if you do then you're pretty well set.

There is a complication to this that I should mention. Mom was in a fairly nice assisted living place but then she had a serious stroke and afterward was not approved to move back there because she was into a SNF level of care. If she had followed my strategy, she would have had no leverage finding a good SNF because the cash would have already run dry. With the LTC policy, the pension and the SSA, we were in a weird spot because altogether her income streams were insufficient to match the private pay SNF bill of $13K per month (she had been paying arouund $5-6 at the assisted living). So, I was forced to negotiate a discount with the SNF which worked to their advantage because it exceeded the Medicaid reimbursement rate. But this was all a big pain the ass and also reinforced my opinion that LTC policies really are almost more trouble than they are worth because they don't pay out enough to cover the entire cost of care.
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Re: Who has long term care insurance?

Post by shell921 »

WoW2012 wrote: Fri Jul 03, 2020 9:43 pm
shell921 wrote: Fri Jul 03, 2020 5:45 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
That's MY view also!

If you were able to find an affordable, good long-term care insurance policy, would you buy it?
No. My husband died 6+ years ago and I have done a lot of reading about LTC and agree with Escapevelocity's opinion that LTC policies really are almost more trouble than they are worth because they don't pay out enough to cover the entire cost of care.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

shell921 wrote: Sat Jul 04, 2020 8:20 am
WoW2012 wrote: Fri Jul 03, 2020 9:43 pm
shell921 wrote: Fri Jul 03, 2020 5:45 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
That's MY view also!

If you were able to find an affordable, good long-term care insurance policy, would you buy it?
No. My husband died 6+ years ago and I have done a lot of reading about LTC and agree with Escapevelocity's opinion that LTC policies really are almost more trouble than they are worth because they don't pay out enough to cover the entire cost of care.


My mother-in-law's policy covers the FULL cost of her assisted-living facility.
Long-term care insurance is like any other insurance.
If you buy a crappy policy (like Escape's family did) you'd be better off with no policy.
If you buy a good policy, like my mother-in-law, she had her pick of the best home care providers and the best facilities.
Just because someone was silly enough to buy a Yugo, doesn't mean I can't go buy a Lexus.
Escapevelocity
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Re: Who has long term care insurance?

Post by Escapevelocity »

WoW2012 wrote: Sat Jul 04, 2020 10:03 am
shell921 wrote: Sat Jul 04, 2020 8:20 am
WoW2012 wrote: Fri Jul 03, 2020 9:43 pm
shell921 wrote: Fri Jul 03, 2020 5:45 pm
oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
That's MY view also!

If you were able to find an affordable, good long-term care insurance policy, would you buy it?
No. My husband died 6+ years ago and I have done a lot of reading about LTC and agree with Escapevelocity's opinion that LTC policies really are almost more trouble than they are worth because they don't pay out enough to cover the entire cost of care.


My mother-in-law's policy covers the FULL cost of her assisted-living facility.
Long-term care insurance is like any other insurance.
If you buy a crappy policy (like Escape's family did) you'd be better off with no policy.
If you buy a good policy, like my mother-in-law, she had her pick of the best home care providers and the best facilities.
Just because someone was silly enough to buy a Yugo, doesn't mean I can't go buy a Lexus.
Ok, no need for the pomposity. From what I know, my Dad's policy was pretty standard for those policies at the time. I haven't researched these policies myself, but I've spoken to some folks who had less coverage than my Dad's policy or had lower lifetime benefit caps (hers was $365k which is not too bad). At least my Dad's premiums were fairly low I believe well under $100 per month for the 20 or so years he was paying the premiums.
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Re: Who has long term care insurance?

Post by nisiprius »

Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
You don't buy insurance to protect yourself against the average.
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Re: Who has long term care insurance?

Post by Escapevelocity »

nisiprius wrote: Sat Jul 04, 2020 10:25 am
Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
You don't buy insurance to protect yourself against the average.
Fully agree with that. I used the average as a baseline and proceeded to suggest that having enough liquid assets to fund 3X or more of that average was a sensible approach. Also, see my second post for more thoughts on this. Moving into a facility is quite easy as long as you have 3+ years of private pay assets and then if you turn into a long stay, the facilities will almost always let you stay as a Medicaid beneficiary.
mnnice
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Re: Who has long term care insurance?

Post by mnnice »

TravelforFun wrote: Fri Jul 03, 2020 5:58 pm
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
My LTC policy is provided by Unum. My wife and I pay $381 a month for approx. $10k and $6k a month coverage for my wife and me, respectively. We've bought this inflation adjusted policy in 2008 when I was 56 (wife was 52) and the premium at that time was $256 a month. We live in the Dallas - Fort Worth Area.

TravelforFun
Doesn’t Unum use their own doctor’s to determine if you can do your daily life activities assessment? Always seemed like a massive conflict of interest to me.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

Escapevelocity wrote: Sat Jul 04, 2020 10:29 am
nisiprius wrote: Sat Jul 04, 2020 10:25 am
Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
You don't buy insurance to protect yourself against the average.
Fully agree with that. I used the average as a baseline and proceeded to suggest that having enough liquid assets to fund 3X or more of that average was a sensible approach. Also, see my second post for more thoughts on this. Moving into a facility is quite easy as long as you have 3+ years of private pay assets and then if you turn into a long stay, the facilities will almost always let you stay as a Medicaid beneficiary.

My MIL's facility does not accept Medicaid. If you run out of money you have to find another facility. The best facilities don't accept Medicaid because Medicaid barely covers the facility's costs.

The point of having LTC insurance (instead of using your own assets) is particularly important for couples. Self-funding can have a negative impact on the healthy spouse's financial freedom.
dcabler
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Re: Who has long term care insurance?

Post by dcabler »

oldfatguy wrote: Fri Jul 03, 2020 12:38 pm Based on all the LTCI threads I've read on this board, it seems that the only people who can afford the insurance are those who do not need it.
We purchased ours because there is a history of Alzheimer's in my wife's family. Her mom, mom's twin sister, uncle, and great aunt all suffered. Given what I saw my in-laws go through, especially financially, I pray that we don't ever need but but happy we can actually afford it.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

nisiprius wrote: Sat Jul 04, 2020 10:25 am
Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
You don't buy insurance to protect yourself against the average.
True.
I've had over 100 clients use their LTCi policies and none of them ever needed "the average".
They either used less than a years worth of benefits
OR
They needed over 5 years of benefits.
My longest claim, so far, was almost 11 years.
He had early onset Alzheimer's. He recently passed away.

So far, my mother in law has needed care for over 3 years. And it looks like she could live for another 5 to 10 years! We don't know. Fortunately, her LTCi policy will last a few more years then we'll switch to the next phase for funding her long-term care.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

Escapevelocity wrote: Sat Jul 04, 2020 10:15 am From what I know, my Dad's policy was pretty standard for those policies at the time. I haven't researched these policies myself, but I've spoken to some folks who had less coverage than my Dad's policy or had lower lifetime benefit caps .

Why have you formed such strong opinions on a topic that you haven't researched?
Escapevelocity
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Re: Who has long term care insurance?

Post by Escapevelocity »

WoW2012 wrote: Sat Jul 04, 2020 11:06 am
Escapevelocity wrote: Sat Jul 04, 2020 10:29 am
nisiprius wrote: Sat Jul 04, 2020 10:25 am
Escapevelocity wrote: Fri Jul 03, 2020 5:54 pm The average stay in a nursing home is about a year. I think it is logical to self insure by having at least a few years of LTC covered with liquid assets (say half a million in today's dollars). if the stay ends up being a really long one, then I plan to let myself go bankrupt and rely on Medicaid (if I can't arrange for a self-directed exit).
You don't buy insurance to protect yourself against the average.
Fully agree with that. I used the average as a baseline and proceeded to suggest that having enough liquid assets to fund 3X or more of that average was a sensible approach. Also, see my second post for more thoughts on this. Moving into a facility is quite easy as long as you have 3+ years of private pay assets and then if you turn into a long stay, the facilities will almost always let you stay as a Medicaid beneficiary.

My MIL's facility does not accept Medicaid. If you run out of money you have to find another facility. The best facilities don't accept Medicaid because Medicaid barely covers the facility's costs.

The point of having LTC insurance (instead of using your own assets) is particularly important for couples. Self-funding can have a negative impact on the healthy spouse's financial freedom.
There are plenty of good facilities that do not accept Medicaid for new residents, but that do allow residents who outlive their assets to stay on a Medicaid arrangement. The shortfall incurred by having these patients at a certain percentage of their beds is baked into their cost model and in effect subsidized by the full pay folks. I bet if you were able to get an honest answer from your MIL's business manager that there are Medicaid beneficiaries at her facility. They don't go around trumpeting this information of course particularly to people with deep pockets.
Last edited by Escapevelocity on Sat Jul 04, 2020 11:20 am, edited 1 time in total.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

mnnice wrote: Sat Jul 04, 2020 10:35 am
TravelforFun wrote: Fri Jul 03, 2020 5:58 pm
LXEX55 wrote: Thu Jul 02, 2020 9:55 am May I ask who the carrier is and any other details you would be comfortable in sharing?
My LTC policy is provided by Unum. My wife and I pay $381 a month for approx. $10k and $6k a month coverage for my wife and me, respectively. We've bought this inflation adjusted policy in 2008 when I was 56 (wife was 52) and the premium at that time was $256 a month. We live in the Dallas - Fort Worth Area.

TravelforFun
Doesn’t Unum use their own doctor’s to determine if you can do your daily life activities assessment? Always seemed like a massive conflict of interest to me.

If a policy meets the federal guidelines (and most do), the claims process is initiated by ANY licensed healthcare practitioner certifying the need for assistance (as long as the licensed health care practitioner is not related to the insured.)

However, EVERY long-term care insurance company will send their own nurse to assess the insured. It's called "fraud prevention". And it protects the honest policyholders.

Every year my mother-in-law is visited by a nurse from John Hancock. The nurse gives her a cognitive test and observes her inability to perform basic functions. This annual re-certification of her claim is required by state and federal regulations.
mnnice
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Re: Who has long term care insurance?

Post by mnnice »

Unum does use their own doctor’s for disability claims. At least they did when my employer switched to them many years ago.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

mnnice wrote: Sat Jul 04, 2020 11:24 am Unum does use their own doctor’s for disability claims. At least they did when my employer switched to them many years ago.
We're talking about long-term care insurance, not disability insurance.
Long-term care insurance is regulated on a state AND federal level.
In order for a policy to meet the federal guidelines, it must allow ANY licensed healthcare practitioner to certify the need for assistance (as long as the licensed health care practitioner is not related to the insured.) Licensed healthcare practitioners include: physicians, nurses, clinical social workers, etc...
Luckywon
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Re: Who has long term care insurance?

Post by Luckywon »

mnnice wrote: Sat Jul 04, 2020 11:24 am Unum does use their own doctor’s for disability claims. At least they did when my employer switched to them many years ago.

They did not for a relative of mine in 2015. They accepted the medical reports and forms completed by my relative's physicians. It was not a borderline case-perhaps it depends on the case.
Escapevelocity
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Re: Who has long term care insurance?

Post by Escapevelocity »

Luckywon wrote: Sat Jul 04, 2020 11:34 am
mnnice wrote: Sat Jul 04, 2020 11:24 am Unum does use their own doctor’s for disability claims. At least they did when my employer switched to them many years ago.

They did not for a relative of mine in 2015. They accepted the medical reports and forms completed by my relative's physicians. It was not a borderline case-perhaps it depends on the case.
It's fairly ridiculous that these policies mandate re-certification for the most common forms of cognitive and functional impairment. I mean how likely or often does it happen that someone with Alzheimer's recovers their cognition or ability to perform their ADLs once they are certified to require the level of care in the first place?
02nz
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Re: Who has long term care insurance?

Post by 02nz »

My plan is to self insure via HSA and traditional IRA. Withdrawals from tIRA to pay for large medical/LTC expenses can be mostly tax-free. Of course tax laws can change, but there are no perfect solutions anyway.
RudyS
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Re: Who has long term care insurance?

Post by RudyS »

Just want to mention another alternative to the choice between LTCi and self-pay. Continuing Care Retirement Communities (CCRCs) are great if you can afford them. A type A community will have a stiff entrance fee, and monthly charge, but once in, starting in independent living, if you need further care such as assisted living or skilled nursing, it is included! You have to be healthy to get started. Here's one of several threads:
viewtopic.php?f=2&t=311473&p=5181671&hi ... c#p5181671

We moved into a CCRC a year ago, and are very satisfied. Arrangements during the COVID-19 crisis were quite good. There are thtreads in that aspect too.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

02nz wrote: Sat Jul 04, 2020 11:56 am My plan is to self insure via HSA and traditional IRA. Withdrawals from tIRA to pay for large medical/LTC expenses can be mostly tax-free. Of course tax laws can change, but there are no perfect solutions anyway.
1) When will you need long-term care?
2) For how long will you need long-term care?
3) For how long will your spouse live after you have passed away?
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