Who has long term care insurance?

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WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

RudyS wrote: Sat Jul 04, 2020 12:13 pm 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.
Most CCRC's give significant discounts to those who own long-term care insurance.
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JoeRetire
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Re: Who has long term care insurance?

Post by JoeRetire »

MDfan wrote: Sat Jul 04, 2020 7:19 am
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.
By "self-insure" did he mean "just take the risk and assume you'll have the funds available if needed", or did he advise investing a specific amount in a separate account? If the latter, can you discuss the specifics?
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JoeRetire
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Re: Who has long term care insurance?

Post by JoeRetire »

WoW2012 wrote: Sat Jul 04, 2020 11:06 amThe best facilities don't accept Medicaid because Medicaid barely covers the facility's costs.
Seems like a bit of an over-generalization.

Some excellent facilities in my area accept Medicaid (not during initial admittance). I don't know what "the best" facility is.
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.
Agreed. It's a difficult assessment. For us, it's worth having.
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02nz
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Re: Who has long term care insurance?

Post by 02nz »

WoW2012 wrote: Sat Jul 04, 2020 12:43 pm
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?
Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

02nz wrote: Sat Jul 04, 2020 1:04 pm
WoW2012 wrote: Sat Jul 04, 2020 12:43 pm
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?
Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
02nz
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Re: Who has long term care insurance?

Post by 02nz »

WoW2012 wrote: Sat Jul 04, 2020 1:09 pm
02nz wrote: Sat Jul 04, 2020 1:04 pm
WoW2012 wrote: Sat Jul 04, 2020 12:43 pm
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?
Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Limoncello402
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Re: Who has long term care insurance?

Post by Limoncello402 »

I have a Genworth policy, and have had it about 9 years now. $3400 premium for me, a single person. Expensive but it is worth it to me.
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ResearchMed
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Re: Who has long term care insurance?

Post by ResearchMed »

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.

Blanket statements are always risky; a single counter example and....!?

At least in our state, at least several of the very best/most expensive (to date) facilities DO accept Medicaid for the Skilled Nursing (SN) section.
However, they always have a waiting list, and the "spots" almost always go to residents of the Assisted Living (ALF) section. I assume that there are occasional needs for someone in Independent Living (IL) to bypass the ALF level, and they'd also be accepted.
"Outsiders" who need to be on Medicaid from the start (or after a short time) probably wouldn't be able to get in, given the waiting list with those who do not need to "enter with Medicaid".

But someone who has run out of money in the ALF *would* get moved ASAP to SN, if they could qualify for Medicaid.
(Some of those who would indeed qualify for SN don't yet move there. Either they get "enough" help from the ample staff in the ALF section, or they may hire private assistants in addition to regular staffing at the ALF.)

We know this with certainty about one of the facilities, where MIL has been.
She has been in the ALF section for a few years, and has just been moved to SN, due to a new medical problem that has left her unable to stay at the ALF.
She has almost spent down her hefty savings, at full payment, and she will run out sooner, now that she is in the much more expensive SN section.
The facility already has DH starting the application process for Medicaid, as it can take a while, and the facility knows her financial status, e.g., that she'll be out of money soon.

They do NOT require that someone in Skilled Nursing leave if they need to change to Medicaid.
They are all set to handle those cases, either prior to moving from ALF to SN, or once someone is already in SN. MIL happens to be making the move just as the end of her savings are in view.

Indeed, when we were vetting facilities for MIL a several years ago, we did not encounter any facility that would toss someone out of Skilled Nursing if they ran out of money, although some would not accept *new* residents who needed Medicaid. Obviously, we don't have that information for all facilities in our state, but each one that we contacted would not do that.
Perhaps it is some state requirement? I don't know about that.

But the general statement that "The best facilities don't accept Medicaid because Medicaid barely covers the facility's costs" is not true.

However it is true that Medicaid payments don't come close to covering the actual cost of the Skilled Nursing care, which is now just about $20k/month.
(Assisted Living starts at about half that, and goes up from there if one has more than the smallest apartment. Yes, we are in a VHCOL area, but even so, those figures really astonished us when we began looking.)

We have recently submitted an application for the Independent Living section of this facility, and put it in the "not for a few years yet" category. We may well end up not landing there until we need ALF or SN level of care; impossible to predict.
So we are planning accordingly, with these costs in mind. DH has a very good LTC policy through work, and it will continue at group rates when he retires. (Very good employer!)

ETA: I see that JoeRetire has posted a similar response.

RM
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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 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?
What % of income would you consider to be affordable?
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Ben Mathew
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Re: Who has long term care insurance?

Post by Ben Mathew »

Escapevelocity wrote: Sat Jul 04, 2020 11:18 am 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.
I read an article in the New York Times recently that suggests there is some risk to relying on Medicaid for long term care even after you are in the facility. Basically, the nursing home can try hard to evict you to make room for higher paying customers.

‘They Just Dumped Him Like Trash’: Nursing Homes Evict Vulnerable Residents
Nursing homes have long had a financial incentive to evict Medicaid patients in favor of those who pay through private insurance or Medicare, which reimburses nursing homes at a much higher rate than Medicaid. More than 10,000 residents and their families complained to watchdogs about being discharged in 2018, the most recent year for which data are available.
Kennedy
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Re: Who has long term care insurance?

Post by Kennedy »

ResearchMed wrote: Sat Jul 04, 2020 1:50 pm
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.

Blanket statements are always risky; a single counter example and....!?

At least in our state, at least several of the very best/most expensive (to date) facilities DO accept Medicaid for the Skilled Nursing (SN) section.
However, they always have a waiting list, and the "spots" almost always go to residents of the Assisted Living (ALF) section. I assume that there are occasional needs for someone in Independent Living (IL) to bypass the ALF level, and they'd also be accepted.
"Outsiders" who need to be on Medicaid from the start (or after a short time) probably wouldn't be able to get in, given the waiting list with those who do not need to "enter with Medicaid".

But someone who has run out of money in the ALF *would* get moved ASAP to SN, if they could qualify for Medicaid.
(Some of those who would indeed qualify for SN don't yet move there. Either they get "enough" help from the ample staff in the ALF section, or they may hire private assistants in addition to regular staffing at the ALF.)

We know this with certainty about one of the facilities, where MIL has been.
She has been in the ALF section for a few years, and has just been moved to SN, due to a new medical problem that has left her unable to stay at the ALF.
She has almost spent down her hefty savings, at full payment, and she will run out sooner, now that she is in the much more expensive SN section.
The facility already has DH starting the application process for Medicaid, as it can take a while, and the facility knows her financial status, e.g., that she'll be out of money soon.

They do NOT require that someone in Skilled Nursing leave if they need to change to Medicaid.
They are all set to handle those cases, either prior to moving from ALF to SN, or once someone is already in SN. MIL happens to be making the move just as the end of her savings are in view.

Indeed, when we were vetting facilities for MIL a several years ago, we did not encounter any facility that would toss someone out of Skilled Nursing if they ran out of money, although some would not accept *new* residents who needed Medicaid. Obviously, we don't have that information for all facilities in our state, but each one that we contacted would not do that.
Perhaps it is some state requirement? I don't know about that.

But the general statement that "The best facilities don't accept Medicaid because Medicaid barely covers the facility's costs" is not true.

However it is true that Medicaid payments don't come close to covering the actual cost of the Skilled Nursing care, which is now just about $20k/month.
(Assisted Living starts at about half that, and goes up from there if one has more than the smallest apartment. Yes, we are in a VHCOL area, but even so, those figures really astonished us when we began looking.)

We have recently submitted an application for the Independent Living section of this facility, and put it in the "not for a few years yet" category. We may well end up not landing there until we need ALF or SN level of care; impossible to predict.
So we are planning accordingly, with these costs in mind. DH has a very good LTC policy through work, and it will continue at group rates when he retires. (Very good employer!)

ETA: I see that JoeRetire has posted a similar response.

RM
RM,
I'm curious as to if the facility puts it in a written contract that the resident can stay using medicaid if she runs out of money after paying privately for the 2-3 year period? Further, what happens if the resident has such an agreement but then needs hospitalization for a period of time? Does the facility save the resident's bed or guarantee that they will take her back after hospital discharge under the same terms?

Finally, would you suggest for someone who has only funds for 2-3 years of private pay and that needs only assisted living at present to only consider facilities that also offer SNF? Otherwise, I can see that she would limit her SNF options to those that accept medicaid patients at first admission should the need for higher level care arise. Any thoughts on that?
Gadget
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Re: Who has long term care insurance?

Post by Gadget »

I struggle to see how it wouldn't be much better to fund an HSA if you're young and earmark it as a long term care plan. Invest it in the market and pretend it doesn't exist for years unless you fall on hard times and have a medical emergency. When I looked at pricing for LTC plans for us in our 30s, they seemed crazy expensive. The only downside is that I get old and don't need it and lose all the medical receipts I've digitally saved, or become cognitively impaired to where I forget I've been saving medical receipts for years. In that scenario I'd have a giant tax bomb for my heirs, but tax bombs in retirement are usually only issues for those who have won the game.

If you're older, then there's probably more of a decision to make. Plus, older generations didn't have an HSA for long enough to have the compound growth work in their favor. So I do see the market for them.
TravelforFun
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Re: Who has long term care insurance?

Post by TravelforFun »

WoW2012 wrote: Sat Jul 04, 2020 12:43 pm
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?
These are the questions that caused us to decide to get LTCi.

TravelforFun
mrc
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Re: Who has long term care insurance?

Post by mrc »

We had LTCi. We dropped our policy this year. We were considering modifying our gold-plan policy to reduce the premiums, but discovered: 1) We can afford to self insure an amount at least equal to what are state guarantee association would cover if the company went under. 2) That the max benefit amount of a modified policy is about equal to the state guaranteed amount (c. $300K). The original policy (unlimited benefit, 5% inflation, plus other perks) would have covered anything bad that happened to one or both of us. The modified policy would not cover the extreme (but more unlikely) long term event. It was clear last year (and seems even more likely now) that premiums were going to rise much more than we anticipated when the policies issued. We had piece of mind when we were younger that a catastrophic injury wouldn't wipe out the other. But we're older now, and both retired, so we stopped.
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Shackleton
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Re: Who has long term care insurance?

Post by Shackleton »

Hubby and I have LTCI. Total cost is $2500/yr for 90 elimination period and what is currently $230/day coverage up to $300k each with 5% inflation. My mom had similar coverage and ended up receiving $480k in benefits over the last 8 years.
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tj
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Re: Who has long term care insurance?

Post by tj »

I have the LTCFeds policy. It costs me $33.00/pay period which feels like basically nothing. I bought it at 33.

It covers up to $450/day for up to 1825 days. 90 day waiting period.

I will have Future Purchase Options offered every other year if I want to increase the coverage, but the benefit per day seems more than sufficient at this point in time.

If I remember correctly, if I had chosen an unlimited benefit period instead of 5 years, the premium would have been about double. They changed LTCFeds from 2.0 to 3.0 at some point during my first year in the government, I don't think they even offer an unlimited benefit period anymore. Perhaps I should have chosen unlimited since i can afford it.
Needtoknow
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Re: Who has long term care insurance?

Post by Needtoknow »

I am 60 and have a long term policy with Genworth, that currently covers 4 years of comprehensive coverage. I have had it for 9 years and with a recent 40% increase and now pay $2613 per year. My wife, 46, also has the same policy and it’s $2102 per year. This amount means little unless you know what it includes. We each currently have $310 per day coverage which translates to $453,000 total coverage this increases annually by 5%. We have a 90 elimination periods but there is no 90 day wait if We are receiving home health care which counts towards the 90 days. Most people Get home care at first. Our policies pay for both ADL’S and SNF’S and will pay for private duty nurses in the nursing home if needed. It also allows me to modify my home with equipment to meet my needs if I need handle bars in the bathroom and other necessities for my condition. Lastly, if one of us dies, the other’s policy is paid off.

I’m not rich and I’m not poor but I want to protect my assets for my wife. This type of care is costly. In California, you’re looking at about $10k - 12k per month. I’m relocating to Texas for retirement and it will be less between $5000 - $8000 per month. We all need to do what’s best for our individual situations.
smitcat
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Re: Who has long term care insurance?

Post by smitcat »

RudyS wrote: Sat Jul 04, 2020 12:13 pm 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.

There is continued concern with CCRC's future solvency. These are vary hard to research and assess going out into future years.
A couple of general articles here:
https://www.kiplinger.com/article/retir ... irees.html
https://www.toptal.com/finance/fundrais ... ities-ccrc
RudyS
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Re: Who has long term care insurance?

Post by RudyS »

smitcat wrote: Sun Jul 05, 2020 6:48 am
RudyS wrote: Sat Jul 04, 2020 12:13 pm 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.

There is continued concern with CCRC's future solvency. These are vary hard to research and assess going out into future years.
A couple of general articles here:
https://www.kiplinger.com/article/retir ... irees.html
https://www.toptal.com/finance/fundrais ... ities-ccrc
Good comment, and a real concern. It is necessary to do thorough due diligence before signing up. Our CCRC provided a disclosure packet with financial statements, audit report, etc. It is operated by a large religion-based non-profit in our area which has other facilities here. And the entrance fee is 90% refundable when we leave (one way or another). As always, past performance is not a guarantee of future results.
hirlaw
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Re: Who has long term care insurance?

Post by hirlaw »

My wife and I both have Genworth policies that we purchased about 15 years ago (we are mid-60's). At the time, I believe Genworth (at that time GE) and John Hancock were the two major players.

My only concern is Genworth's solvency. It is in serious financial trouble. Current ratings are: Fitch: CCC (Substantial credit risk); Moody's: Caa1 (poor); A.M. Best: C++ (marginal).

My state's insurance guaranty fund is limited to $300k, which would only cover about 2 years of care.
Redlion
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Re: Who has long term care insurance?

Post by Redlion »

I considered it at one time, but there is too much uncertainty, and insurance companies often will not pay having the process go through years of litigation.
Additionally, I have no immediate heirs,and if I become mentally or physically incapacitated its not going to make much difference if I am broke .
I suppose if the Financial objective is to to leave assets to heirs it might be worth considering.
mrc
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Re: Who has long term care insurance?

Post by mrc »

My parents-in-law bought into a first rate (expensive) CCRC in the mid-90s. The arrangement was set up to let them move to higher levels of assistance should the need arise, from independent living all the way to nursing care. The monthly "rent" increased with the level of care. Their apartment was very nice and they could cook in their kitchen, or go to a dining room for meals. My wife and I planned to do the same, it was such a nice way to handle giving up housekeeping.

FIL died in '97 and MIL lived there after remarrying another resident. When her new spouse died in 2007, MIL was still active and capable. But over that time, the CCRC cut services and made changes that would have disappointed FIL. He thought she was taken care of for life, but when MIL left for a different (memory care unit) facility, the place would have been unrecognizable.

One example is at the beginning, there was a medical staff on site, and available 24X7. At the end, a doctor visiting weekly, and if anything happened, clients were transported to a local ED. Imagine the difference in cost between going downstairs in the morning, and an ambulance ride to the ED. Another example was the assisted living unit, which touted a program to regain function with the aim of moving back into the independent living apartment. But the time MIL moved to that unit, it was simply a warehouse, understaffed, with over-medicated patients.

What this taught us is there was much more to simply financing end-of-life care: finding a decent facility—at any cost—was the real challenge.
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UpperNwGuy
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Re: Who has long term care insurance?

Post by UpperNwGuy »

RudyS wrote: Sat Jul 04, 2020 12:13 pm 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.
Not all CCRCs have had the same good experiences during the COVID-19 crisis. The mother of a good friend of mine lived in the assisted living section of a high-end CCRC in the Washington DC metro area, got COVID-19 in April, and died from it. I think a lot of the variation between facilities has to do with the amount of physical separation between the independent living, assisted living, skilled nursing, and memory care sections of the CCRC. A lot has to do with the strictness of the policies implemented. (My father's former facility in South Carolina shut down all of its communal areas and dining rooms and delivered all meals to the apartments of the residents.) And a lot of it is just pure luck.
boglefannyc
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Re: Who has long term care insurance?

Post by boglefannyc »

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 wife and I are in the process of applying for a shared partnership policy with Mutual of Omaha. Our reason for wanting to purchase LTCI is that we have no family where we are living and I have a pension and will have the much higher SSA income. If I were to require LTC and had no insurance, my wife would be left with much less income and I worry that a long nursing home stay may drain our assets eventually.
WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

Escapevelocity wrote: Sat Jul 04, 2020 11:42 am
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?

The re-certification every 12 months is a federal regulation that has been law for over 20 years.
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Re: Who has long term care insurance?

Post by WoW2012 »

02nz wrote: Sat Jul 04, 2020 1:36 pm
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Yes, the older policies had major pricing issues.
Policies available for sale to today are much better than the older policies now that the Rate Stability Regulation is in effect in 41 states and 45 states have approved Long-Term Care Partnership Programs.
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Re: Who has long term care insurance?

Post by Escapevelocity »

WoW2012 wrote: Mon Jul 06, 2020 10:02 am
Escapevelocity wrote: Sat Jul 04, 2020 11:42 am
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?

The re-certification every 12 months is a federal regulation that has been law for over 20 years.
I wasn't questioning the fact of it. I was ridiculing that it's a requirement.
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Re: Who has long term care insurance?

Post by WoW2012 »

ResearchMed wrote: Sat Jul 04, 2020 1:50 pm
WoW2012 wrote: Sat Jul 04, 2020 11:06 am


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.

Blanket statements are always risky; a single counter example and....!?

At least in our state, at least several of the very best/most expensive (to date) facilities DO accept Medicaid for the Skilled Nursing (SN) section.
However, they always have a waiting list, and the "spots" almost always go to residents of the Assisted Living (ALF) section. I assume that there are occasional needs for someone in Independent Living (IL) to bypass the ALF level, and they'd also be accepted.
"Outsiders" who need to be on Medicaid from the start (or after a short time) probably wouldn't be able to get in, given the waiting list with those who do not need to "enter with Medicaid".

But someone who has run out of money in the ALF *would* get moved ASAP to SN, if they could qualify for Medicaid.
(Some of those who would indeed qualify for SN don't yet move there. Either they get "enough" help from the ample staff in the ALF section, or they may hire private assistants in addition to regular staffing at the ALF.)

We know this with certainty about one of the facilities, where MIL has been.
She has been in the ALF section for a few years, and has just been moved to SN, due to a new medical problem that has left her unable to stay at the ALF.
She has almost spent down her hefty savings, at full payment, and she will run out sooner, now that she is in the much more expensive SN section.
The facility already has DH starting the application process for Medicaid, as it can take a while, and the facility knows her financial status, e.g., that she'll be out of money soon.

They do NOT require that someone in Skilled Nursing leave if they need to change to Medicaid.
They are all set to handle those cases, either prior to moving from ALF to SN, or once someone is already in SN. MIL happens to be making the move just as the end of her savings are in view.

Indeed, when we were vetting facilities for MIL a several years ago, we did not encounter any facility that would toss someone out of Skilled Nursing if they ran out of money, although some would not accept *new* residents who needed Medicaid. Obviously, we don't have that information for all facilities in our state, but each one that we contacted would not do that.
Perhaps it is some state requirement? I don't know about that.

But the general statement that "The best facilities don't accept Medicaid because Medicaid barely covers the facility's costs" is not true.

However it is true that Medicaid payments don't come close to covering the actual cost of the Skilled Nursing care, which is now just about $20k/month.
(Assisted Living starts at about half that, and goes up from there if one has more than the smallest apartment. Yes, we are in a VHCOL area, but even so, those figures really astonished us when we began looking.)

We have recently submitted an application for the Independent Living section of this facility, and put it in the "not for a few years yet" category. We may well end up not landing there until we need ALF or SN level of care; impossible to predict.
So we are planning accordingly, with these costs in mind. DH has a very good LTC policy through work, and it will continue at group rates when he retires. (Very good employer!)

ETA: I see that JoeRetire has posted a similar response.

RM

Thank you for pointing out my error. Going forward I will say: "The best assisted-living facilities don't accept Medicaid."
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Re: Who has long term care insurance?

Post by WoW2012 »

oldfatguy wrote: Sat Jul 04, 2020 1:52 pm
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?
What % of income would you consider to be affordable?

That's a great question. I'd say:
1% to 2% if buying a policy under the age of 50.
2% to 3% if buying a policy between the ages of 50 to 60
3% to 4% if buying a policy between the ages of 60 to 70

Or, another way to look at it is:
if a couple can share $1,000,000 of long-term care insurance for an annual premium that is less than two-one-thousandths of their net worth, that's probably a good value.
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Re: Who has long term care insurance?

Post by WoW2012 »

Redlion wrote: Sun Jul 05, 2020 11:32 am ...and insurance companies often will not pay having the process go through years of litigation.
Filing all types of insurance claims is hard. That's why my doctor's office files my medical insurance claims and my dentist's office files my dental claims.

1st, it's important to buy a policy that meets the federal guidelines. The federal gov't created specific criteria for qualifying for benefits.
2nd, since most long-term care insurance claims begin at home, have an experienced home care agency file your long-term care insurance claim for you. That's what we did when my mother-in-law needed to use her policy. I didn't file claims paperwork. The home care agency handled everything and the claim was approved in only 3 weeks. All we had to do was sign a couple of HIPAA forms and give them to the home care agency manager along with her policy information.
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Re: Who has long term care insurance?

Post by willthrill81 »

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.
Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
02nz wrote: Sat Jul 04, 2020 1:36 pm
WoW2012 wrote: Sat Jul 04, 2020 1:09 pm
02nz wrote: Sat Jul 04, 2020 1:04 pm
WoW2012 wrote: Sat Jul 04, 2020 12:43 pm
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?
Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Bingo. Most LTCi will run out of benefits if the insured needs nursing home care for three years. It's true that very few will need more than that, but there is still a sort of 'bet' being made that those buying the policies won't need care of that level for that period of time. Policies are available that basically eliminate this downside risk, but they come with a commensurate price tag.

Our plans for dealing with the possibility of needing to pay for LTC are very similar to yours (i.e. HSA, traditional IRAs). Current tax law allows for pretty favorable use of tax-deferred funds to pay for significant LTC expenses.

And for those reading this thread who aren't aware, WoW2012 sells LTCi.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings
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Re: Who has long term care insurance?

Post by smitcat »

willthrill81 wrote: Mon Jul 06, 2020 10:34 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.
Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
02nz wrote: Sat Jul 04, 2020 1:36 pm
WoW2012 wrote: Sat Jul 04, 2020 1:09 pm
02nz wrote: Sat Jul 04, 2020 1:04 pm
WoW2012 wrote: Sat Jul 04, 2020 12:43 pm

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?
Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Bingo. Most LTCi will run out of benefits if the insured needs nursing home care for three years. It's true that very few will need more than that, but there is still a sort of 'bet' being made that those buying the policies won't need care of that level for that period of time. Policies are available that basically eliminate this downside risk, but they come with a commensurate price tag.

Our plans for dealing with the possibility of needing to pay for LTC are very similar to yours (i.e. HSA, traditional IRAs). Current tax law allows for pretty favorable use of tax-deferred funds to pay for significant LTC expenses.

And for those reading this thread who aren't aware, WoW2012 sells LTCi.
"And for those reading this thread who aren't aware, WoW2012 sells LTCi."
Additionally for those reading this thread WoW2012 has left no way to contact him on the board ...never has as far as I can tell.
I have found that much of WoW's previously posted information has value even though I have no treason to purchase LTCi.

IMHO - if you are interested in LTCi please do your own research and get your own quotes especially if you own your own business.
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Re: Who has long term care insurance?

Post by 02nz »

willthrill81 wrote: Mon Jul 06, 2020 10:34 am Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
I think there was an earlier thread discussing just this problem with LTCi. As I see it, current LTCi is a bit like auto insurance that has zero deductible but a low cap on coverage, say $25K. It's not very useful, because I can afford to self-insure for those risks (of course, the state requires me to have liability insurance). I need my auto insurance to cover cases that would cause a financial catastrophe.

I don't know the LTCi market well enough to understand why the kind of coverage that so many of us would pay of doesn't exist. Perhaps after the insurers got the pricing wrong early on, they are hesitant to create new products and face what they anticipate could be similar risks.
Last edited by 02nz on Mon Jul 06, 2020 10:54 am, edited 1 time in total.
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Re: Who has long term care insurance?

Post by willthrill81 »

smitcat wrote: Mon Jul 06, 2020 10:45 am And for those reading this thread who aren't aware, WoW2012 sells LTCi.
Additionally for those reading this thread WoW2012 has left no way to contact him on the board ...never has as far as I can tell.
I have found that much of WoW's previously posted information has value even though I have no treason to purchase LTCi.[/quote]

I not saying that his information is incorrect, but it's important for people to know if someone has a potentially big conflict of interest when providing advice.
smitcat wrote: Mon Jul 06, 2020 10:45 amIMHO - if you are interested in LTCi please do your own research and get your own quotes especially if you own your own business.
I 100% agree. For business owners who can deduct much of the cost of LTCi, it can make a lot more financial sense.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings
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Re: Who has long term care insurance?

Post by WoW2012 »

willthrill81 wrote: Mon Jul 06, 2020 10:34 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.
Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
02nz wrote: Sat Jul 04, 2020 1:36 pm
WoW2012 wrote: Sat Jul 04, 2020 1:09 pm
02nz wrote: Sat Jul 04, 2020 1:04 pm
WoW2012 wrote: Sat Jul 04, 2020 12:43 pm

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?
Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Bingo. Most LTCi will run out of benefits if the insured needs nursing home care for three years. It's true that very few will need more than that, but there is still a sort of 'bet' being made that those buying the policies won't need care of that level for that period of time. Policies are available that basically eliminate this downside risk, but they come with a commensurate price tag.

Our plans for dealing with the possibility of needing to pay for LTC are very similar to yours (i.e. HSA, traditional IRAs). Current tax law allows for pretty favorable use of tax-deferred funds to pay for significant LTC expenses.

And for those reading this thread who aren't aware, WoW2012 sells LTCi.

Will says: "Most LTCi will run out of benefits if the insured needs nursing home care for three years."
Wow says: That's 100% false.

Will says: LTCi policies with long elimination periods (e.g. three years) aren't available
Wow says: That's 100% false.

Will says: And for those reading this thread who aren't aware, WoW2012 sells LTCi.
Wow says: That's 100% true which anyone can see if they read my profile.
memberlist.php?mode=viewprofile&u=41642
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Re: Who has long term care insurance?

Post by WoW2012 »

smitcat wrote: Mon Jul 06, 2020 10:45 am
"And for those reading this thread who aren't aware, WoW2012 sells LTCi."
Additionally for those reading this thread WoW2012 has left no way to contact him on the board ...never has as far as I can tell.
I have found that much of WoW's previously posted information has value even though I have no treason to purchase LTCi.

IMHO - if you are interested in LTCi please do your own research and get your own quotes especially if you own your own business.

Thank you, smitcat.
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Re: Who has long term care insurance?

Post by oldfatguy »

WoW2012 wrote: Mon Jul 06, 2020 10:22 am
oldfatguy wrote: Sat Jul 04, 2020 1:52 pm
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?
What % of income would you consider to be affordable?

That's a great question. I'd say:
1% to 2% if buying a policy under the age of 50.
2% to 3% if buying a policy between the ages of 50 to 60
3% to 4% if buying a policy between the ages of 60 to 70

Or, another way to look at it is:
if a couple can share $1,000,000 of long-term care insurance for an annual premium that is less than two-one-thousandths of their net worth, that's probably a good value.
Those numbers certainly seem like a reasonable cost for such insurance, but would not be affordable for me without cutting back or eliminating something else - most likely retirement savings. The same is true for life insurance, disability insurance, etc. Seems like the primary target for LTCI are those with substantial assets to protect.
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Re: Who has long term care insurance?

Post by willthrill81 »

02nz wrote: Mon Jul 06, 2020 10:51 am
willthrill81 wrote: Mon Jul 06, 2020 10:34 am Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
I think there was an earlier thread discussing just this problem with LTCi. As I see it, current LTCi is a bit like auto insurance that has zero deductible but a low cap on coverage, say $25K. It's not very useful, because I can afford to self-insure for those risks (of course, the state requires me to have liability insurance). I need my auto insurance to cover cases that would cause a financial catastrophe.

I don't know the LTCi market well enough to understand why the kind of coverage that so many of us would pay of doesn't exist. Perhaps after the insurers got the pricing wrong early on, they are hesitant to create new products and face what they anticipate could be similar risks.
TMK, long elimination periods are not available because they have been forbidden by states' regulators. The reasoning seems to be that among the general populace, few are capable of self paying for just several years of LTC, so people might be tempted to buy a policy that wouldn't be helpful to them. WoW2012 has said in other threads that when such policies were available, they were rarely sold, so the LTCi industry probably didn't push back when regulators made the change.

Nonetheless, I still think that there would be a market for such a product.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings
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Re: Who has long term care insurance?

Post by WoW2012 »

02nz wrote: Mon Jul 06, 2020 10:51 am
willthrill81 wrote: Mon Jul 06, 2020 10:34 am Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
I think there was an earlier thread discussing just this problem with LTCi. As I see it, current LTCi is a bit like auto insurance that has zero deductible but a low cap on coverage, say $25K. It's not very useful, because I can afford to self-insure for those risks (of course, the state requires me to have liability insurance). I need my auto insurance to cover cases that would cause a financial catastrophe.

I don't know the LTCi market well enough to understand why the kind of coverage that so many of us would pay of doesn't exist. Perhaps after the insurers got the pricing wrong early on, they are hesitant to create new products and face what they anticipate could be similar risks.

Long-term care insurance policies with a loooooooooooooonnnnnnnnnnng elimination period ARE available.

365 day elimination period. Check!
730 day elimination period. Check!
1095 day elimination period. Check!
1460 day elimination period. Check!
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Re: Who has long term care insurance?

Post by willthrill81 »

WoW2012 wrote: Mon Jul 06, 2020 10:54 am
willthrill81 wrote: Mon Jul 06, 2020 10:34 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.
Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
02nz wrote: Sat Jul 04, 2020 1:36 pm
WoW2012 wrote: Sat Jul 04, 2020 1:09 pm
02nz wrote: Sat Jul 04, 2020 1:04 pm

Far off in the future for me, which is one reason I don't want to buy into an uncertain LTC market now.
Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Bingo. Most LTCi will run out of benefits if the insured needs nursing home care for three years. It's true that very few will need more than that, but there is still a sort of 'bet' being made that those buying the policies won't need care of that level for that period of time. Policies are available that basically eliminate this downside risk, but they come with a commensurate price tag.

Our plans for dealing with the possibility of needing to pay for LTC are very similar to yours (i.e. HSA, traditional IRAs). Current tax law allows for pretty favorable use of tax-deferred funds to pay for significant LTC expenses.

And for those reading this thread who aren't aware, WoW2012 sells LTCi.

Will says: "Most LTCi will run out of benefits if the insured needs nursing home care for three years."
Wow says: That's 100% false.
Prove it.

I'm referring to most policies in force right now, not all the various types of LTCi available.
WoW2012 wrote: Mon Jul 06, 2020 10:54 amWill says: LTCi policies with long elimination periods (e.g. three years) aren't available
Wow says: That's 100% false.
Which type of policy does that? TMK, state regulators don't allow them to exist.
WoW2012 wrote: Mon Jul 06, 2020 10:54 amWill says: And for those reading this thread who aren't aware, WoW2012 sells LTCi.
Wow says: That's 100% true which anyone can see if they read my profile.
memberlist.php?mode=viewprofile&u=41642
And most here don't go around reading the profiles of thousands of posters on this board.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings
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Re: Who has long term care insurance?

Post by smitcat »

willthrill81 wrote: Mon Jul 06, 2020 10:53 am
smitcat wrote: Mon Jul 06, 2020 10:45 am And for those reading this thread who aren't aware, WoW2012 sells LTCi.
Additionally for those reading this thread WoW2012 has left no way to contact him on the board ...never has as far as I can tell.
I have found that much of WoW's previously posted information has value even though I have no treason to purchase LTCi.
I not saying that his information is incorrect, but it's important for people to know if someone has a potentially big conflict of interest when providing advice.
smitcat wrote: Mon Jul 06, 2020 10:45 amIMHO - if you are interested in LTCi please do your own research and get your own quotes especially if you own your own business.
I 100% agree. For business owners who can deduct much of the cost of LTCi, it can make a lot more financial sense.
[/quote]

'I not saying that his information is incorrect, but it's important for people to know if someone has a potentially big conflict of interest when providing advice."
No problems - but there is no way he is able to solicit anything from me ,I know as I have tried.
There have been other posters on this site driving traffic to their respective websites as well, and no one seems to mind for the most part.
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Re: Who has long term care insurance?

Post by WoW2012 »

oldfatguy wrote: Mon Jul 06, 2020 10:55 am
WoW2012 wrote: Mon Jul 06, 2020 10:22 am
oldfatguy wrote: Sat Jul 04, 2020 1:52 pm
WoW2012 wrote: Fri Jul 03, 2020 9:43 pm
shell921 wrote: Fri Jul 03, 2020 5:45 pm

That's MY view also!

If you were able to find an affordable, good long-term care insurance policy, would you buy it?
What % of income would you consider to be affordable?

That's a great question. I'd say:
1% to 2% if buying a policy under the age of 50.
2% to 3% if buying a policy between the ages of 50 to 60
3% to 4% if buying a policy between the ages of 60 to 70

Or, another way to look at it is:
if a couple can share $1,000,000 of long-term care insurance for an annual premium that is less than two-one-thousandths of their net worth, that's probably a good value.
Those numbers certainly seem like a reasonable cost for such insurance, but would not be affordable for me without cutting back or eliminating something else - most likely retirement savings. The same is true for life insurance, disability insurance, etc. Seems like the primary target for LTCI are those with substantial assets to protect.

If you can't afford to maximize your retirement contributions each year, then you shouldn't consider long-term care insurance. Maximizing your retirement contributions is a lot more important than long-term care insurance.
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willthrill81
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Re: Who has long term care insurance?

Post by willthrill81 »

smitcat wrote: Mon Jul 06, 2020 11:01 am There have been other posters on this site driving traffic to their respective websites as well, and no one seems to mind for the most part.
The solicitation of business or even attempts to drive traffic to one's own site are not allowed on the forum. For instance, Jim Dahle of The White Coat Investor site cannot even provide links to his own blog.
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Re: Who has long term care insurance?

Post by neilpilot »

WoW2012 wrote: Mon Jul 06, 2020 10:05 am
02nz wrote: Sat Jul 04, 2020 1:36 pm
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Yes, the older policies had major pricing issues.
Policies available for sale to today are much better than the older policies now that the Rate Stability Regulation is in effect in 41 states and 45 states have approved Long-Term Care Partnership Programs.
We started John Hancock group policies in 1999, when we were 49. The policies include a 5% annual inflation rider, so the benefits have done reasonably well keeping up with our possible needs. The original JH literature indicates a fixed annual premium.

So far, our annual premium has remain steady at the original $800/year each. Do you happen to know if JH has attempted to raise premiums on FIXED premium policies? The annual 5% inflation rider has increased each policy's coverage in 2020 to $696k, $280 daily for nursing home, and $140 daily for assisted living.
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Re: Who has long term care insurance?

Post by smitcat »

willthrill81 wrote: Mon Jul 06, 2020 11:03 am
smitcat wrote: Mon Jul 06, 2020 11:01 am There have been other posters on this site driving traffic to their respective websites as well, and no one seems to mind for the most part.
The solicitation of business or even attempts to drive traffic to one's own site are not allowed on the forum. For instance, Jim Dahle of The White Coat Investor site cannot even provide links to his own blog.
OK I thought so too but ...there are a number of examples like just this year a poster was linking just about every post he made to his site thru a 'calculator'. As far as I can tell it is happening.
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willthrill81
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Re: Who has long term care insurance?

Post by willthrill81 »

smitcat wrote: Mon Jul 06, 2020 11:07 am
willthrill81 wrote: Mon Jul 06, 2020 11:03 am
smitcat wrote: Mon Jul 06, 2020 11:01 am There have been other posters on this site driving traffic to their respective websites as well, and no one seems to mind for the most part.
The solicitation of business or even attempts to drive traffic to one's own site are not allowed on the forum. For instance, Jim Dahle of The White Coat Investor site cannot even provide links to his own blog.
OK I thought so too but ...there are a number of examples like just this year a poster was linking just about every post he made to his site thru a 'calculator'. As far as I can tell it is happening.
It's not a perfect system, but if you report that to the mods, I believe that they'll address it quickly.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings
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Re: Who has long term care insurance?

Post by smitcat »

willthrill81 wrote: Mon Jul 06, 2020 11:11 am
smitcat wrote: Mon Jul 06, 2020 11:07 am
willthrill81 wrote: Mon Jul 06, 2020 11:03 am
smitcat wrote: Mon Jul 06, 2020 11:01 am There have been other posters on this site driving traffic to their respective websites as well, and no one seems to mind for the most part.
The solicitation of business or even attempts to drive traffic to one's own site are not allowed on the forum. For instance, Jim Dahle of The White Coat Investor site cannot even provide links to his own blog.
OK I thought so too but ...there are a number of examples like just this year a poster was linking just about every post he made to his site thru a 'calculator'. As far as I can tell it is happening.
It's not a perfect system, but if you report that to the mods, I believe that they'll address it quickly.
Yes - I did report it to the mods at the time.
mrc
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Re: Who has long term care insurance?

Post by mrc »

WoW2012 wrote: Mon Jul 06, 2020 10:54 am Will says: And for those reading this thread who aren't aware, WoW2012 sells LTCi.
Wow says: That's 100% true which anyone can see if they read my profile.
memberlist.php?mode=viewprofile&u=41642
WoW, why doesn't your signature (the disclaimer) appear on ever one of your posts?
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WoW2012
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Re: Who has long term care insurance?

Post by WoW2012 »

willthrill81 wrote: Mon Jul 06, 2020 11:01 am
WoW2012 wrote: Mon Jul 06, 2020 10:54 am
willthrill81 wrote: Mon Jul 06, 2020 10:34 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.
Very true. Unfortunately, since LTCi policies with long elimination periods (e.g. three years) aren't available, the bulk of the premiums are going toward paying for 'average' use of LTC. Few on this forum at least couldn't self-pay for three years of LTC (significantly more than what's typically needed) for themselves and their spouse, especially considering that the lion's share of LTC is not provided in very expensive nursing homes.

If LTCi with a long elimination period was available, many here would be very interested in buying it, including me.
02nz wrote: Sat Jul 04, 2020 1:36 pm
WoW2012 wrote: Sat Jul 04, 2020 1:09 pm

Then you don't have a plan.
You've placed a bet.
Here's someone who retired at the age of 40 and is not yet 50. Yet, his retirement is at risk because his wife, who's younger than he is, will likely need long-term care in the very near future.

http://www.early-retirement.org/forums/ ... 00432.html
There are no risk-free solutions. Buying LTC insurance mitigates some risks and takes on others. And the LTC insurance market is too volatile for those other risks to be worth it to me.
Bingo. Most LTCi will run out of benefits if the insured needs nursing home care for three years. It's true that very few will need more than that, but there is still a sort of 'bet' being made that those buying the policies won't need care of that level for that period of time. Policies are available that basically eliminate this downside risk, but they come with a commensurate price tag.

Our plans for dealing with the possibility of needing to pay for LTC are very similar to yours (i.e. HSA, traditional IRAs). Current tax law allows for pretty favorable use of tax-deferred funds to pay for significant LTC expenses.

And for those reading this thread who aren't aware, WoW2012 sells LTCi.

Will says: "Most LTCi will run out of benefits if the insured needs nursing home care for three years."
Wow says: That's 100% false.
Prove it.

I'm referring to most policies in force right now, not all the various types of LTCi available.
WoW2012 wrote: Mon Jul 06, 2020 10:54 amWill says: LTCi policies with long elimination periods (e.g. three years) aren't available
Wow says: That's 100% false.
Which type of policy does that? TMK, state regulators don't allow them to exist.
WoW2012 wrote: Mon Jul 06, 2020 10:54 amWill says: And for those reading this thread who aren't aware, WoW2012 sells LTCi.
Wow says: That's 100% true which anyone can see if they read my profile.
memberlist.php?mode=viewprofile&u=41642
And most here don't go around reading the profiles of thousands of posters on this board.

The Benefits of Long-Term Care Insurance and What They Mean for Long-Term Care Financing
You can download the document here:
https://www.ahip.org/the-benefits-of-lo ... financing/
They studied all LTCi policies purchased between 1994 and 2014.
Page 5, Section 1 reads as follows:
"We have conducted an analysis of policies sold over the past two decades, and it shows that in 2014 the average daily benefit amount for in-force
policies is $138 and the average duration of coverage is 5.3 years."

Keep in mind, they did NOT include in that average the policies that have an unlimited benefit period.


Regarding long elimination periods, SOME states don't allow them. But many states do. In most states you can buy a traditional LTCi policy with an elimination period as long as 4 years (that's 1,460 days).

In 48 states you can buy a traditional LTCi policy with a lifetime/unlimited benefit period.
In 50 states you can buy a traditional LTCi policy where a couple shares 15 years of benefits.
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Re: Who has long term care insurance?

Post by MDfan »

JoeRetire wrote: Sat Jul 04, 2020 12:49 pm
MDfan wrote: Sat Jul 04, 2020 7:19 am
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.
By "self-insure" did he mean "just take the risk and assume you'll have the funds available if needed", or did he advise investing a specific amount in a separate account? If the latter, can you discuss the specifics?
It was the former. He said that with our expected level of assets, we could afford to pay for it ourselves.
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