Long Term Care Insurance

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Buster65
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Long Term Care Insurance

Post by Buster65 »

Hello I am wondering who out there has LTC Insurance and at what age did you get it and with what carrier?
I am 55 in good health and probably can self insure but I'd like others to weigh in.
whunter3333
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Re: Long Term Care Insurance

Post by whunter3333 »

Excellent question and LTC insurance is controversial....I bought it...here is my reasoning....The value of the LTC meant that the insurer was counting on paying out to about only one in three people. So I rationalized that I was one of those three people....One person is dead of an accident before they need it (if it is me, I don't care about the return), One person doesn't need it - they live to a very ripe old age and die peacefully [and healthily?] in their sleep (Again, if it is me, I don't care about the return). And finally, the third person, needs it, uses it and benefits from it (If this is me, I am grateful). So by my calculation, the return I was getting from my premium investment (if I needed it) was about 9% which seems pretty good to me. I think this neglected the cost of regular inflation cutting into the 9% and definitely did not include the medical/health care inflation really cutting into the 9%.
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willthrill81
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Re: Long Term Care Insurance

Post by willthrill81 »

Buster65 wrote: Thu Feb 25, 2021 4:02 pm Hello I am wondering who out there has LTC Insurance and at what age did you get it and with what carrier?
I am 55 in good health and probably can self insure but I'd like others to weigh in.
What is your level of assets (e.g., invested assets, home value)?

Those with $2 million or more can very likely self-insure LTC with ease.
“Good and ill have not changed since yesteryear; nor are they one thing among Elves and Dwarves and another among Men.” J.R.R. Tolkien, The Lord of the Rings
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GerryL
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Re: Long Term Care Insurance

Post by GerryL »

I bought my policy about 20 years ago when I was 53. I felt it was important in my case since I am a solo and have a family history of Alzheimer's.

I chose a policy without a time limit for in-home or institutional care (although switched to 3-year limit on in-home care a few years ago to keep an increase down). As I age, I will likely cut back on those benefits because 1) there will be less time to cover if I need it and 2) my portfolio is healthy enough to fill in the gaps. I will be content if I never need to file a claim.

Each person's situation is going to be different.
Topic Author
Buster65
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Re: Long Term Care Insurance

Post by Buster65 »

Thanks for the reply's. Can you tell me who the carrier was that you bought LTC through?
GJ48
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Re: Long Term Care Insurance

Post by GJ48 »

Buster65 wrote: Fri Feb 26, 2021 1:38 pm Can you tell me who the carrier was that you bought LTC through?
I have a policy with Northwestern Mutual that I took out at age 58. My wife had a policy with TIAA/CREF/MetLife she took out at age 60.
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laughlinlvr
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Re: Long Term Care Insurance

Post by laughlinlvr »

How about $2 million and a LTC policy?
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TravelforFun
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Re: Long Term Care Insurance

Post by TravelforFun »

Buster65 wrote: Thu Feb 25, 2021 4:02 pm Hello I am wondering who out there has LTC Insurance and at what age did you get it and with what carrier?
I am 55 in good health and probably can self insure but I'd like others to weigh in.
I bought our policy from Unum in 2008 when we were 56 (me) and 52 (wife). I paid $2,952 a year in 2008 and $4,567 a year now. We would receive max monthly coverage of $6,841 (me) and $10,262 (wife) if we need it. I'm fine if we never have to use our LTC benefits ... kind of like I'm fine if my house never burns down.

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KansasDoc
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Re: Long Term Care Insurance

Post by KansasDoc »

I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
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JoeRetire
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Re: Long Term Care Insurance

Post by JoeRetire »

Buster65 wrote: Thu Feb 25, 2021 4:02 pm Hello I am wondering who out there has LTC Insurance and at what age did you get it and with what carrier?
59
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MikeG62
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Re: Long Term Care Insurance

Post by MikeG62 »

Buster65 wrote: Thu Feb 25, 2021 4:02 pm Hello I am wondering who out there has LTC Insurance and at what age did you get it and with what carrier?
I am 55 in good health and probably can self insure but I'd like others to weigh in.
We don't have it as we have elected to self insure.

The topic of LTC insurance may have more individual threads on this forum than any other single topic. Run a search on LTC insurance (upper right side of page) and be prepared to settle in and read for hours. I think you'll learn more from that than from the number of responses you will receive to this thread.
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1grl1by
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Re: Long Term Care Insurance

Post by 1grl1by »

I'm a Federal employee and signed up for Fed LTC when I was 40. I had just been dx'd with a lung disease that generally leaves people incapacitated and then kills them. At that time, I could get the Fed LTC without medical underwriting.

We bought my dh a policy from Mutual of Omaha when he turned 60, that seemed the tipping point of premium/payout for us. It was also the year that we paid a substantial amount in care for his father who had dementia and could no longer be cared for at home. This was in the midst of dh having several health issues come to light, and finishing paying for 2 children to finish college.

It may or may not be a financial decision that is worth it in either the short run or the long run, but it's a decision that currently lets us sleep at night.

As it turns out, advances in medical science has turned my lung condition from deadly to chronic and controlled with expensive medication, and I'm now a 21 year survivor, something that was unheard of at the time I was dx'd.
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JoeRetire
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Re: Long Term Care Insurance

Post by JoeRetire »

1grl1by wrote: Sat Feb 27, 2021 8:14 am As it turns out, advances in medical science has turned my lung condition from deadly to chronic and controlled with expensive medication, and I'm now a 21 year survivor, something that was unheard of at the time I was dx'd.
Congratulations! That's nice to hear. :happy

Advances in medicine in recent years are nothing short of amazing. I know from personal experience that cancer treatments have come a long, long way.
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brooklynboy
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Re: Long Term Care Insurance

Post by brooklynboy »

wife and i both have LTC. we purchased it through AARP at ages 55 or so. the idea is to provide some flexibility in managing our affairs should we need care. actual care costs often far exceed the rates posted for various facilities. we found with our parents that an aide can make a huge difference in comfort and quality of life, and can prolong the period of time during which you live at home vs an assisted living facility, and how long you can live in an assisted living facility vs a nursing home. people have surprisingly long lifetimes: dont underestimate your longevity, and dont underestimate the cost of living to advanced ages. you hope you dont need this coverage, but if you do, you get your money back rapidly. as stated by another here, it is sort of like fire (or car) insurance in that respect.
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GerryL
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Re: Long Term Care Insurance

Post by GerryL »

Buster65 wrote: Fri Feb 26, 2021 1:38 pm Thanks for the reply's. Can you tell me who the carrier was that you bought LTC through?
Mine is with Lincoln Benefit Life. I went through a broker.
L82GAME
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Re: Long Term Care Insurance

Post by L82GAME »

We’re in the process of applying for a policy for my wife who turns 56 this year. Her mother and father are diagnosed with likely Alzheimer’s and dementia, respectively. Her maternal grandfather died from Alzheimer’s. Looking at MoO policy via a broker. I’m seven years younger than my wife so sitting tight for now and focusing instead on a LTCi policy for her.
"Simplify, simplify, simplify! I say, let your affairs be as two or three, and not a hundred or a thousand…” - Thoreau
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Shackleton
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Re: Long Term Care Insurance

Post by Shackleton »

Hubby and I have LTC policies through Genworth. Total cost is $2500/yr. I’m 54 and he’s 65. 90 day elimination period and $215/day. Net worth is $2.5M, but $1M is home equity.
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WolfgangPauli
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Re: Long Term Care Insurance

Post by WolfgangPauli »

KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
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WoW2012
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Re: Long Term Care Insurance

Post by WoW2012 »

KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.


#1) Long-term care insurance has NOTHING to do with medical care. Very old long-term care policies (pre-1997) used a concept called "medical necessity" to determine if a policy would pay benefits. It was ambiguous. Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

#2) Instead of asking your physician if you qualify for benefits under a long-term care insurance policy, ask a home care agency. The larger home care agencies have systems in place which they've developed over the past 2 decades for filing and getting long-term care insurance claims approved. When my mother-in-law needed to use her policy, we used Amada Senior Care. They got her LTCi claim approved in 3 weeks. No hassles. We did nothing. They did everything.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WoW2012
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Re: Long Term Care Insurance

Post by WoW2012 »

WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.

Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WoW2012
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Re: Long Term Care Insurance

Post by WoW2012 »

L82GAME wrote: Sat Feb 27, 2021 7:35 pm We’re in the process of applying for a policy for my wife who turns 56 this year. Her mother and father are diagnosed with likely Alzheimer’s and dementia, respectively. Her maternal grandfather died from Alzheimer’s. Looking at MoO policy via a broker. I’m seven years younger than my wife so sitting tight for now and focusing instead on a LTCi policy for her.
If your wife has had both parents diagnosed with some form of dementia, she will be declined by most long-term care insurance companies. MOO will decline her. Which company will insure her will depend primarily upon the ages at which her parents were diagnosed. You need to find an LTCi specialist for her.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
leftcoaster
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Re: Long Term Care Insurance

Post by leftcoaster »

A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
leftcoaster
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Re: Long Term Care Insurance

Post by leftcoaster »

WoW2012 wrote: Sun Feb 28, 2021 11:44 am
L82GAME wrote: Sat Feb 27, 2021 7:35 pm We’re in the process of applying for a policy for my wife who turns 56 this year. Her mother and father are diagnosed with likely Alzheimer’s and dementia, respectively. Her maternal grandfather died from Alzheimer’s. Looking at MoO policy via a broker. I’m seven years younger than my wife so sitting tight for now and focusing instead on a LTCi policy for her.
If your wife has had both parents diagnosed with some form of dementia, she will be declined by most long-term care insurance companies. MOO will decline her. Which company will insure her will depend primarily upon the ages at which her parents were diagnosed. You need to find an LTCi specialist for her.
What about one parent? And what is the optimal age for buying a policy?
KansasDoc
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Re: Long Term Care Insurance

Post by KansasDoc »

WoW2012 wrote: Sun Feb 28, 2021 11:42 am
WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.

Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
My point exactly. And as a physician I must certify if a person needs help with ADLs. And the insurance company still denies coverage.

Unless the person with such a policy also has a health law lawyer or elder law lawyer at the ready to force a company to abide by the policy...you are throwing money down the drain with a LTC policy. [well likely a majority. Read the fine print and individual situations may vary]
WoW2012
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Re: Long Term Care Insurance

Post by WoW2012 »

KansasDoc wrote: Sun Feb 28, 2021 12:02 pm
WoW2012 wrote: Sun Feb 28, 2021 11:42 am
WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.

Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
My point exactly. And as a physician I must certify if a person needs help with ADLs. And the insurance company still denies coverage.

Unless the person with such a policy also has a health law lawyer or elder law lawyer at the ready to force a company to abide by the policy...you are throwing money down the drain with a LTC policy. [well likely a majority. Read the fine print and individual situations may vary]

If long-term care insurers were denying so many claims, why then, in 2020, did 285,059 people receive $12,909,947,878 of benefits from their long-term care insurance companies. (Google "NAIC Long Term Care Insurance Experience Report" if you think I'm making those numbers up.)

For those readers who don't know, there are 6 ADL's:
bathing, dressing, eating, toileting, transferring (getting into/out of bed/chair), and maintaining continence

Do physicians help their patients get into and out of the shower?
Do physicians help their patients get on and off the toilet and perform associated personal hygiene?
Do physicians help their patients get dressed and undressed every morning and every night?
Do physicians help their patients get into and out of a chair or bed?

That's why it's better to have the home care agency file the long-term care insurance claim. The home care agency is the one providing the type of care that qualifies for benefits. The home care agency is more qualified to certify the need for ADL's than the physician.



wow2012
Last edited by WoW2012 on Sun Feb 28, 2021 12:24 pm, edited 1 time in total.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WoW2012
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Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

leftcoaster wrote: Sun Feb 28, 2021 12:02 pm
WoW2012 wrote: Sun Feb 28, 2021 11:44 am
L82GAME wrote: Sat Feb 27, 2021 7:35 pm We’re in the process of applying for a policy for my wife who turns 56 this year. Her mother and father are diagnosed with likely Alzheimer’s and dementia, respectively. Her maternal grandfather died from Alzheimer’s. Looking at MoO policy via a broker. I’m seven years younger than my wife so sitting tight for now and focusing instead on a LTCi policy for her.
If your wife has had both parents diagnosed with some form of dementia, she will be declined by most long-term care insurance companies. MOO will decline her. Which company will insure her will depend primarily upon the ages at which her parents were diagnosed. You need to find an LTCi specialist for her.
What about one parent? And what is the optimal age for buying a policy?
If you have one parent who was diagnosed with some form of dementia then you are likely able to qualify for long-term care insurance, but some companies would not give you a preferred health discount.

The best time to buy a long-term care insurance policy is when you have enough assets/income to lose to justify the cost of the policy.
There are some 65 year olds who should NOT own long-term care insurance.
There are some 40 year olds who should own long-term care insurance.

Since anyone can become disabled at anytime, it's not an age issue, it's a risk management issue.


Personal story:
My brother is 61. Our mother is 85. Her ability to function independently reached a critical point early last year and it was not safe for her to remain home alone anymore. My brother helped move her from her home (of 30+ years) to an assisted-living facility near his home. In the middle of helping our mother transition, his wife was diagnosed with a severe form of cancer. She's only 51. The cancer (and the treatments) have made her very weak and she has required assistance at home for several months while she fights the cancer. They also have two children (early teen years) and my brother works full-time. He's a licensed healthcare practitioner. He's gotten some help from one of our stepsisters (but they are busy caring for their mother who has dementia). He's also gotten some help from their church family. It would have been great if his wife had had a long-term care policy. It would have taken a HUGE load off of my brother. It's tough enough to see the love of your life going through a decline in health. But to add to that all of the other responsibilities he has. I don't know how he's managing. It's not about age. It's about managing a healthcare risk that can occur at any age for a variety of reasons.
Last edited by WoW2012 on Sun Feb 28, 2021 1:10 pm, edited 1 time in total.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
KansasDoc
Posts: 35
Joined: Sun Jul 21, 2019 7:44 pm

Re: Long Term Care Insurance

Post by KansasDoc »

WoW2012 wrote: Sun Feb 28, 2021 12:18 pm
KansasDoc wrote: Sun Feb 28, 2021 12:02 pm
WoW2012 wrote: Sun Feb 28, 2021 11:42 am
WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.

Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
My point exactly. And as a physician I must certify if a person needs help with ADLs. And the insurance company still denies coverage.

Unless the person with such a policy also has a health law lawyer or elder law lawyer at the ready to force a company to abide by the policy...you are throwing money down the drain with a LTC policy. [well likely a majority. Read the fine print and individual situations may vary]

If long-term care insurers were denying so many claims, why then, in 2020, did 285,059 people receive $12,909,947,878 of benefits from their long-term care insurance companies. (Google "NAIC Long Term Care Insurance Experience Report" if you think I'm making those numbers up.)

For those readers who don't know, there are 6 ADL's:
bathing, dressing, eating, toileting, transferring (getting into/out of bed/chair), and maintaining continence

Do physicians help their patients get into and out of the shower?
Do physicians help their patients get on and off the toilet and perform associated personal hygiene?
Do physicians help their patients get dressed and undressed every morning and every night?
Do physicians help their patients get into and out of a chair or bed?

That's why it's better to have the home care agency file the long-term care insurance claim. The home care agency is the one providing the type of care that qualifies for benefits. The home care agency is more qualified to certify the need for ADL's than the physician.



wow2012
I welcome you to my office to sign the forms marked “physician” to certify these findings.

I speak from my experience.
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

KansasDoc wrote: Sun Feb 28, 2021 12:48 pm

I welcome you to my office to sign the forms marked “physician” to certify these findings.

I speak from my experience.
:confused :confused :confused :confused :confused
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
smitcat
Posts: 8622
Joined: Mon Nov 07, 2016 10:51 am

Re: Long Term Care Insurance

Post by smitcat »

KansasDoc wrote: Sun Feb 28, 2021 12:02 pm
WoW2012 wrote: Sun Feb 28, 2021 11:42 am
WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.

Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
My point exactly. And as a physician I must certify if a person needs help with ADLs. And the insurance company still denies coverage.

Unless the person with such a policy also has a health law lawyer or elder law lawyer at the ready to force a company to abide by the policy...you are throwing money down the drain with a LTC policy. [well likely a majority. Read the fine print and individual situations may vary]
"Unless the person with such a policy also has a health law lawyer or elder law lawyer at the ready to force a company to abide by the policy...you are throwing money down the drain with a LTC policy."
Not in our case - sorry to hear your area has these issues.
L82GAME
Posts: 600
Joined: Sat Dec 07, 2019 9:29 am

Re: Long Term Care Insurance

Post by L82GAME »

WoW2012 wrote: Sun Feb 28, 2021 11:44 am
L82GAME wrote: Sat Feb 27, 2021 7:35 pm We’re in the process of applying for a policy for my wife who turns 56 this year. Her mother and father are diagnosed with likely Alzheimer’s and dementia, respectively. Her maternal grandfather died from Alzheimer’s. Looking at MoO policy via a broker. I’m seven years younger than my wife so sitting tight for now and focusing instead on a LTCi policy for her.
If your wife has had both parents diagnosed with some form of dementia, she will be declined by most long-term care insurance companies. MOO will decline her. Which company will insure her will depend primarily upon the ages at which her parents were diagnosed. You need to find an LTCi specialist for her.
Thanks WoW2012. We are going through a LTCi specialist/broker and no concerns so far RE: declination. She may be asked to complete a cognitive test, but no warning signs from broker, nor from MoO, thus far.
"Simplify, simplify, simplify! I say, let your affairs be as two or three, and not a hundred or a thousand…” - Thoreau
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

L82GAME wrote: Sun Feb 28, 2021 1:01 pm
WoW2012 wrote: Sun Feb 28, 2021 11:44 am
L82GAME wrote: Sat Feb 27, 2021 7:35 pm We’re in the process of applying for a policy for my wife who turns 56 this year. Her mother and father are diagnosed with likely Alzheimer’s and dementia, respectively. Her maternal grandfather died from Alzheimer’s. Looking at MoO policy via a broker. I’m seven years younger than my wife so sitting tight for now and focusing instead on a LTCi policy for her.
If your wife has had both parents diagnosed with some form of dementia, she will be declined by most long-term care insurance companies. MOO will decline her. Which company will insure her will depend primarily upon the ages at which her parents were diagnosed. You need to find an LTCi specialist for her.
Thanks WoW2012. We are going through a LTCi specialist/broker and no concerns so far RE: declination. She may be asked to complete a cognitive test, but no warning signs from broker, nor from MoO, thus far.
If both of her parents have been diagnosed with some form of dementia, MoO will decline her application. Here's a copy/paste from the MoO underwriting guide:

Family History (biological parents or siblings) of any form of Dementia,
including but not limited to Alzheimer’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
maximum benefit period 5 years,
$5,000 maximum monthly benefit

2 or more relatives (biological parents or
siblings) with any type of dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D


The S stands for Select (which means no preferred health discount).
The D stands for Decline.

You should have the "specialist" cancel the MoO application ASAP because your wife will be declined. Then find a real LTCi specialist who knows what they are doing.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
L82GAME
Posts: 600
Joined: Sat Dec 07, 2019 9:29 am

Re: Long Term Care Insurance

Post by L82GAME »

WoW2012 wrote: Sun Feb 28, 2021 1:18 pm You should have the "specialist" cancel the MoO application ASAP because your wife will be declined. Then find a real LTCi specialist who knows what they are doing.
Thank you, again. I’ve just followed-up with the broker. It appears that you a LTCi specialist, per your signature?
"Simplify, simplify, simplify! I say, let your affairs be as two or three, and not a hundred or a thousand…” - Thoreau
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

L82GAME wrote: Sun Feb 28, 2021 1:58 pm
WoW2012 wrote: Sun Feb 28, 2021 1:18 pm You should have the "specialist" cancel the MoO application ASAP because your wife will be declined. Then find a real LTCi specialist who knows what they are doing.
Thank you, again. I’ve just followed-up with the broker. It appears that you a LTCi specialist, per your signature?
Yes, I am an LTCi specialist. But no one on this forum knows who I am or how to contact me. And I do not accept messages from anyone through this forum.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
L82GAME
Posts: 600
Joined: Sat Dec 07, 2019 9:29 am

Re: Long Term Care Insurance

Post by L82GAME »

WoW2012 wrote: Sun Feb 28, 2021 2:02 pm
L82GAME wrote: Sun Feb 28, 2021 1:58 pm
WoW2012 wrote: Sun Feb 28, 2021 1:18 pm You should have the "specialist" cancel the MoO application ASAP because your wife will be declined. Then find a real LTCi specialist who knows what they are doing.
Thank you, again. I’ve just followed-up with the broker. It appears that you a LTCi specialist, per your signature?
Yes, I am an LTCi specialist. But no one on this forum knows who I am or how to contact me. And I do not accept messages from anyone through this forum.
Would you mind pointing me to a legit resource to find a LTCi specialist? Thank you.
"Simplify, simplify, simplify! I say, let your affairs be as two or three, and not a hundred or a thousand…” - Thoreau
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

L82GAME wrote: Sun Feb 28, 2021 2:06 pm
WoW2012 wrote: Sun Feb 28, 2021 2:02 pm
L82GAME wrote: Sun Feb 28, 2021 1:58 pm
WoW2012 wrote: Sun Feb 28, 2021 1:18 pm You should have the "specialist" cancel the MoO application ASAP because your wife will be declined. Then find a real LTCi specialist who knows what they are doing.
Thank you, again. I’ve just followed-up with the broker. It appears that you a LTCi specialist, per your signature?
Yes, I am an LTCi specialist. But no one on this forum knows who I am or how to contact me. And I do not accept messages from anyone through this forum.
Would you mind pointing me to a legit resource to find a LTCi specialist? Thank you.

Since the moderators have no way of knowing if I'd be referring you to one of my websites, they would consider my referral an act of solicitation which would result in my being banned from the forum.

Maybe some of the participants of this forum can refer you to LTCi specialists they have worked with.

FYI, most of the "specialists" that you contact will try to get your wife to buy a life insurance policy with a "long term care rider". Those policies are usually not a good value. In many cases those policies are outright terrible.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WolfgangPauli
Posts: 520
Joined: Sun Aug 23, 2015 8:28 am

Re: Long Term Care Insurance

Post by WolfgangPauli »

WoW2012 wrote: Sun Feb 28, 2021 11:42 am
WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.


Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
Right, I agree, but you are now buying policies today that you likely will not need (if at all) for 30+ years. How do you know the same thing will not happen? Changes in health care practices will likely do the exact same thing to policies written now that were written in the '80s.

This is just an example so let's not discuss this one example but it is an example of what can happen. A "LTC" / Nursing Home facility is specifically licensed for and defined state by state. So, back in the '80s, if you were in the situation my parents are in today you would clearly have gone to a "nursing home" and the insurance would pay. The definition of that is a location that is licensed as a nursing home and has a Dr. / RN on staff 24x7.

Well, health care has changed. Because of medicines, technology and the general change in who can administer care (i.e LPN etc.) they are living in a location which no longer is required to be a "nursing home".

So, the same likely will happen 30 years from now. The policies written today have definitions in them (Like any contract, any word that is Capitalized has a very specific meaning and it is defined in the contract) and the care you will likely receive 30 years from now has not even been invented yet. And, so you are betting on something being perfectly defined which has not even been invented yet. That, I do not like.
Twitter: @JAXbogleheads | EM: JAXbogleheads@gmail.com
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

WoW2012 wrote: Sun Feb 28, 2021 12:50 pm
KansasDoc wrote: Sun Feb 28, 2021 12:48 pm

I welcome you to my office to sign the forms marked “physician” to certify these findings.

I speak from my experience.
:confused :confused :confused :confused :confused
Long-term care insurance claims do NOT require a physician's certification.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

WolfgangPauli wrote: Sun Feb 28, 2021 8:40 pm
WoW2012 wrote: Sun Feb 28, 2021 11:42 am
WolfgangPauli wrote: Sat Feb 27, 2021 10:19 pm
KansasDoc wrote: Fri Feb 26, 2021 9:48 pm I won't get LTC insurance.

I'm a physician and most of my patients that need benefits from their LTC carrier have a hard time extracting agreed to benefits.

It's not like insurance for a wrecked car or burned down house. The 'need' for LTC is in the eye of the beholder and the insurance company has every incentive not to pay out benefits.

I advice any one with means to self insure for LTC to do so.
This is my exact experience. My parents have paid into a policy since the late 1980s. When they needed it most (age 90 and 92) the policy holder ran us through the ringer and kept denying and denying. Further, as a person posted above, as they got much older (and more likely to need it) the policy had huge premium increases and so we had to reduce benefits to keep the premium affordable.

If you can, really work hard to self insure. The world of health care is changing and you likely will need some sort of care which has not even been invented yet and therefore will not be covered in an insurance policy that is contemplated today.

Finally, the trend will be home health care and aging in home. A lesson from COVID19 is most people will not want to go into one of those places. They cannot get the right help, they are constantly having issues and unless you can afford the ones that are like the Ritz (Which you LTC will likely not pay for) the best thing you can do is work like heck to just stay out of them.
Has your cell phone improved since the 1980's?
Long-term care insurance has improved also.
A LOT.


Nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or have very limited home care benefits.

So, if my choice was buying one of those old crappy policies or self-insuring, I'd self-insure.

Fortunately, in 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of "medical necessity" to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits. Policies purchased before 1997 are mostly junk because of language like "medical necessity" and other restrictions put on those policies.

FYI, most LTCi policies allow for 100% of the benefits to be used for care at home. Due to COVID, we moved my mother-in-law out of her beautiful assisted living facility (which was fully paid for by her LTCi policy). There were no cases of COVID in her facility, but we moved her out because they were not allowing socialization. We brought her to live with us and her LTCi policy is covering the full cost of the home health aides we have here 8 hours every day. Her LTCi policy even paid to modify the bathroom with a walk-in shower and grab bars throughout her part of the house.
Right, I agree, but you are now buying policies today that you likely will not need (if at all) for 30+ years. How do you know the same thing will not happen? Changes in health care practices will likely do the exact same thing to policies written now that were written in the '80s.

This is just an example so let's not discuss this one example but it is an example of what can happen. A "LTC" / Nursing Home facility is specifically licensed for and defined state by state. So, back in the '80s, if you were in the situation my parents are in today you would clearly have gone to a "nursing home" and the insurance would pay. The definition of that is a location that is licensed as a nursing home and has a Dr. / RN on staff 24x7.

Well, health care has changed. Because of medicines, technology and the general change in who can administer care (i.e LPN etc.) they are living in a location which no longer is required to be a "nursing home".

So, the same likely will happen 30 years from now. The policies written today have definitions in them (Like any contract, any word that is Capitalized has a very specific meaning and it is defined in the contract) and the care you will likely receive 30 years from now has not even been invented yet. And, so you are betting on something being perfectly defined which has not even been invented yet. That, I do not like.

Wolfgang, your comment would be 100% correct if the year was 1998. As I mentioned previously, nearly every long-term care insurance policy purchased before 1997 isn't worth the paper it was written on. They included ambiguous language like, "medical necessity". They required 3-day prior hospital stays. Many of those earlier policies excluded alzheimer's and dementia. Most of them didn't pay for care at home or had very limited home care benefits.

Your parents bought a Yugo.
Just because your parents bought a Yugo doesn't mean every long-term care policy is a Yugo.

In 1997, the federal government set standards for long-term care insurance benefit triggers. These standards do not allow the use of ambiguous terminology to determine if one qualifies for benefits. The policy can only use the Activities of Daily Living or a cognitive impairment to determine when the policyholder qualifies for benefits.

However, the regulations that took effect in 1997 did NOT change/improve the policies that were sold before 1997. The consumer protections that were enacted in 1997 did NOT help your parents because the consumer protections did NOT apply to policies purchased before 1997.

The regulations enacted in 1997 clearly defined the benefit triggers. That has resulted in over 1,000,000 people receiving over $100 Billion of long-term care insurance benefits over the past 20 years.

The ADL's are: bathing, dressing, eating, toileting, maintaining continence and transferring (getting out of and into a bed or chair).

I'm pretty sure that 30 years from now bathing, dressing, eating, toileting, maintaining continence, and getting out of a bed/chair will still mean what they mean today.

That's why the benefit triggers were changed. The regulators wanted clarity and they got it when they passed these regulations in 1996.

And, fortunately, since most people want to receive their care at home, the definition of "home" will still mean "your residence" 30 years from now.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
TravelforFun
Posts: 2370
Joined: Tue Dec 04, 2012 11:05 pm

Re: Long Term Care Insurance

Post by TravelforFun »

WoW2012 wrote: Mon Mar 01, 2021 12:02 am
WoW2012 wrote: Sun Feb 28, 2021 12:50 pm
KansasDoc wrote: Sun Feb 28, 2021 12:48 pm

I welcome you to my office to sign the forms marked “physician” to certify these findings.

I speak from my experience.
:confused :confused :confused :confused :confused
Long-term care insurance claims do NOT require a physician's certification.
I always appreciate your information.

For the people who think they will self insure, this is what has happened to my next-door neighbors. They decided to save money and not get an LTCi policy when I got mine and we had discussions about it. They told me they would self insure. Well, a few months ago, the wife got a stroke and is now disable. Instead of getting a home care aide to help with her daily activities, they decided to save money and try to take care of things by themselves. The husband constantly has to help the wife with the walking, going to the bathroom, dressing and stuff. I can see the stress and strain on the husband and it's dragging him down. I hope he would get some help soon.

TravelforFun
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

TravelforFun wrote: Mon Mar 01, 2021 12:25 am
WoW2012 wrote: Mon Mar 01, 2021 12:02 am
WoW2012 wrote: Sun Feb 28, 2021 12:50 pm
KansasDoc wrote: Sun Feb 28, 2021 12:48 pm

I welcome you to my office to sign the forms marked “physician” to certify these findings.

I speak from my experience.
:confused :confused :confused :confused :confused
Long-term care insurance claims do NOT require a physician's certification.
I always appreciate your information.

For the people who think they will self insure, this is what has happened to my next-door neighbors. They decided to save money and not get an LTCi policy when I got mine and we had discussions about it. They told me they would self insure. Well, a few months ago, the wife got a stroke and is now disable. Instead of getting a home care aide to help with her daily activities, they decided to save money and try to take care of things by themselves. The husband constantly has to help the wife with the walking, going to the bathroom, dressing and stuff. I can see the stress and strain on the husband and it's dragging him down. I hope he would get some help soon.

TravelforFun
Every week I get a voicemail or an email like this: "I need to get long-term care insurance for my husband right away. Please contact me as soon as possible." Inevitably, the husband had a stroke or a broken hip or whatever.... and there's nothing I can do to help them. Thank you TravelforFun for sharing your story. Please share it with all your friends and family on social media.

9 times out of 10 the husband says, "We're going to self-insure." Then he has a stroke or gets dementia and his wife (or daughter or daughter-in-law) becomes his primary caregiver because they don't want to spend the money on the care. "But I'll force my family to spend the money hiring caregivers." In reality, at that point, the one needing the care is not the decision maker anymore.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
JS-Elcano
Posts: 420
Joined: Wed Jun 10, 2020 7:29 pm

Re: Long Term Care Insurance

Post by JS-Elcano »

leftcoaster wrote: Sun Feb 28, 2021 12:01 pm A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
But aren't most (all?) LTCi policies that one can buy these days limited to a certain maximum benefit of somewhere around 500k? So, If one has that amount available in their retirement portfolio, why would it be such an issue to pay rather than insure?
sandramjet
Posts: 372
Joined: Thu Oct 23, 2014 11:28 pm

Re: Long Term Care Insurance

Post by sandramjet »

WoW2012 wrote: Sun Feb 28, 2021 2:13 pm Since the moderators have no way of knowing if I'd be referring you to one of my websites, they would consider my referral an act of solicitation which would result in my being banned from the forum.

Maybe some of the participants of this forum can refer you to LTCi specialists they have worked with.

FYI, most of the "specialists" that you contact will try to get your wife to buy a life insurance policy with a "long term care rider". Those policies are usually not a good value. In many cases those policies are outright terrible.
So how do you tell if a LTCi specialist is any good?
User avatar
JoeRetire
Posts: 10760
Joined: Tue Jan 16, 2018 2:44 pm

Re: Long Term Care Insurance

Post by JoeRetire »

KansasDoc wrote: Sun Feb 28, 2021 12:02 pm My point exactly. And as a physician I must certify if a person needs help with ADLs. And the insurance company still denies coverage.

Unless the person with such a policy also has a health law lawyer or elder law lawyer at the ready to force a company to abide by the policy...you are throwing money down the drain with a LTC policy. [well likely a majority. Read the fine print and individual situations may vary]
That wasn't the case at all with my sister-in-law.

She was in MA, not KS. Perhaps that matters.
This is the kind of day that almost makes you feel good to be alive.
Katietsu
Posts: 5531
Joined: Sun Sep 22, 2013 1:48 am

Re: Long Term Care Insurance

Post by Katietsu »

JS-Elcano wrote: Mon Mar 01, 2021 12:51 am
leftcoaster wrote: Sun Feb 28, 2021 12:01 pm A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
But aren't most (all?) LTCi policies that one can buy these days limited to a certain maximum benefit of somewhere around 500k? So, If one has that amount available in their retirement portfolio, why would it be such an issue to pay rather than insure?
This is the problem that I have with LTC policies. Nobody insures for the catastrophic risk of 15 years at the highest level of care. It seems that the only option for actual LONG term care is a substantial net worth or Medicaid.
smitcat
Posts: 8622
Joined: Mon Nov 07, 2016 10:51 am

Re: Long Term Care Insurance

Post by smitcat »

sandramjet wrote: Mon Mar 01, 2021 12:52 am
WoW2012 wrote: Sun Feb 28, 2021 2:13 pm Since the moderators have no way of knowing if I'd be referring you to one of my websites, they would consider my referral an act of solicitation which would result in my being banned from the forum.

Maybe some of the participants of this forum can refer you to LTCi specialists they have worked with.

FYI, most of the "specialists" that you contact will try to get your wife to buy a life insurance policy with a "long term care rider". Those policies are usually not a good value. In many cases those policies are outright terrible.
So how do you tell if a LTCi specialist is any good?
You could search Wow's threads on this subject like this one here.....
viewtopic.php?f=2&t=340380&p=5835432#p5835432
smitcat
Posts: 8622
Joined: Mon Nov 07, 2016 10:51 am

Re: Long Term Care Insurance

Post by smitcat »

Katietsu wrote: Mon Mar 01, 2021 9:09 am
JS-Elcano wrote: Mon Mar 01, 2021 12:51 am
leftcoaster wrote: Sun Feb 28, 2021 12:01 pm A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
But aren't most (all?) LTCi policies that one can buy these days limited to a certain maximum benefit of somewhere around 500k? So, If one has that amount available in their retirement portfolio, why would it be such an issue to pay rather than insure?
This is the problem that I have with LTC policies. Nobody insures for the catastrophic risk of 15 years at the highest level of care. It seems that the only option for actual LONG term care is a substantial net worth or Medicaid.
No, the tail end %'s are not really insurable. But if you do have 5-8 years covered it does give you plenty of planning and lead time to figure out a reasonable approach.
neilpilot
Posts: 4028
Joined: Fri Dec 04, 2015 1:46 pm
Location: Memphis area

Re: Long Term Care Insurance

Post by neilpilot »

JS-Elcano wrote: Mon Mar 01, 2021 12:51 am
leftcoaster wrote: Sun Feb 28, 2021 12:01 pm A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
But aren't most (all?) LTCi policies that one can buy these days limited to a certain maximum benefit of somewhere around 500k? So, If one has that amount available in their retirement portfolio, why would it be such an issue to pay rather than insure?
You may be correct when looking at "policies that one can buy these days" but that certainly isn't the case for our grandfathered coverage.

We have assets far in excess of our current LTCi policy. Current coverage limits are about $730k for each of us, and they increase due to a 5% inflation rider. Hopefully we will never need to use either policy, but I see it as irrelevant that we might exceed the policy limit or have assets available in lieu of LTC coverage.

Our LTCi premiums remain exceedingly reasonable, and have not increase since the start of coverage in 1999 when we were both 49. If we eventually collect even a fraction of the coverage limit, our ROI would far exceed any of our other speculative investments.
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

JS-Elcano wrote: Mon Mar 01, 2021 12:51 am
leftcoaster wrote: Sun Feb 28, 2021 12:01 pm A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
But aren't most (all?) LTCi policies that one can buy these days limited to a certain maximum benefit of somewhere around 500k? So, If one has that amount available in their retirement portfolio, why would it be such an issue to pay rather than insure?

I hope you have more than $500K in your portfolio, but let's assume you only have $500K in your portfolio. If you need $500K of care and you pay for it from your savings, then you are left with no money.

If you have $500K of long-term care insurance, and you need $500K of care, then you'll use up all the benefits in the policy and then you'll still have $500K in your portfolio.

Also, if you live in a state that has a long-term care partnership program, every dollar the policy pays in benefits protects one dollar of you assets from Medicaid. You could protect most/all of your assets and have Medicaid pay for your care. You wouldn't have to spend down your savings.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

sandramjet wrote: Mon Mar 01, 2021 12:52 am
WoW2012 wrote: Sun Feb 28, 2021 2:13 pm Since the moderators have no way of knowing if I'd be referring you to one of my websites, they would consider my referral an act of solicitation which would result in my being banned from the forum.

Maybe some of the participants of this forum can refer you to LTCi specialists they have worked with.

FYI, most of the "specialists" that you contact will try to get your wife to buy a life insurance policy with a "long term care rider". Those policies are usually not a good value. In many cases those policies are outright terrible.
So how do you tell if a LTCi specialist is any good?
Do this:

1) google "long term care insurance specialist (your state)" or something like that.
2) skip over all the ads (at the top and bottom of the results page)
3) click on the top 30 links that are not ads
4) after clicking through those links, ignore the the websites that don't give a specific name of the LTCi specialist (those sites just collect leads and sell them to agents)
5) ignore the websites that don't list the agent's license number(s)
6) ignore the websites that emphasize that the agent sells annuities and life insurance "in addition to" long-term care
7) ignore the websites where the agent is licensed to sell securities
8) ignore the website if there is no picture of the agent
9) after weeding through all these garbage sites, you'll be left with less than 5 sites.
10) read through portions of each website and see how educational they are
11) then contact each agent via email and speak with each one over the phone.
12) then follow your gut.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
WoW2012
Posts: 1093
Joined: Sun Dec 23, 2012 11:28 am

Re: Long Term Care Insurance

Post by WoW2012 »

Katietsu wrote: Mon Mar 01, 2021 9:09 am
JS-Elcano wrote: Mon Mar 01, 2021 12:51 am
leftcoaster wrote: Sun Feb 28, 2021 12:01 pm A friend’s wife was diagnosed with a condition requiring her to enter assisted living with the highest level of support. The cost is $10,000/month.

Sobering for those looking to self-insure.

This in the Bay Area, where they also had apparently serious issues getting home health aides to show up.
But aren't most (all?) LTCi policies that one can buy these days limited to a certain maximum benefit of somewhere around 500k? So, If one has that amount available in their retirement portfolio, why would it be such an issue to pay rather than insure?
This is the problem that I have with LTC policies. Nobody insures for the catastrophic risk of 15 years at the highest level of care. It seems that the only option for actual LONG term care is a substantial net worth or Medicaid.
There are policies that have an unlimited benefit period (except in New York).
45 states have long-term care partnership programs which can protect 100% of your assets even if you exhaust the policy's benefits.
Couples can share large benefit amounts. My wife and I have $880,000 of benefits that can be used by either of us or shared between the two of us. Today, a few companies sell up to 16 years of shared benefits for couples.
But, there is TREMENDOUS value in even a "small" policy.
My mother-in-law bought a policy with "3 years of benefits". She's been on claim for almost 4 years now and, at the rate she's using the benefits, she won't run out of benefits for at least another 2 years. So, her "3 year policy" will end up being at least 6 years of benefits.

If she didn't have the policy, we would have been forced to sell two of her rental properties and we would have had to pay ~$100,000 in capital gains taxes. Fortunately, we avoided that. While she was in the assisted-living facility, the policy covered almost all of her living expenses (except for her gifts and new clothes and dining out). We were able to save most of her income during that time. Now, she's living with us and we're saving even more of her money than we were before. We've invested a lot of her money in dividend paying stocks and when her policy runs out of benefits, she'll never run out of money because her pensions, social security, rental income, and the dividend income will more than cover her costs, even if she's in a very high-end nursing facility.

The "3 year policy" gave us a lot of options and added a significant boost to her financial independence.
Disclaimer: I am a licensed insurance professional and am certified as a long-term care insurance specialist.
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