Long-Term Care

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Topic Author
Dave C.
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Long-Term Care

Post by Dave C. »

LTC has been getting some bad press lately (Hancock's rate increase), but I am seriously looking at a Genworth policy anyway.

I am 59 and my wife is 58. We are prime candidates for LTC, our portfolio at retirement around 2016 will be a bit north of 1 million, including 401K, IRA's, pension, SS, and assorted taxable accounts.

Is Omama-care going to seriously affect LTC? Are the projected health care changes expected in 2014 going to change the value of LTC?

Has LTC priced itself into a very narrow potential market? Do many of you Boglehead types own LTC policies?

Those are my easy questions, I'll save the others in case I get a few responses.

:roll: :roll:
Easy does it/Live & Let Live/One day at a time. Thanks Bill.
john94549
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Post by john94549 »

I think there's a provision that addresses long-term care. You pay into the program, if you wish, and after five years of paying in you get a benefit of $50 - $60/day if you need such care.

My wife and I (both 64) have not purchased LTC insurance. In current dollars, our retirement assets would cover everything but skilled nursing. Should it come to that, the primary residence would be sold.

The main "gotcha" with LTC insurance (aside from insuror insolvency) is the propensity for rates to increase just as you can ill-afford to pay the increases. Are you aware of any LTC insuror which offers a product where it guarantees rates will never increase? I'd just hate to have paid LTC premiums for years and years and then lose coverage when I most need it because I couldn't afford the premiums any more.
Minot
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Post by Minot »

john94549 wrote:I think there's a provision that addresses long-term care. You pay into the program, if you wish, and after five years of paying in you get a benefit of $50 - $60/day if you need such care.
Don't count on it.
The Wall Street Journal, 9/23/11 wrote:The Obama administration said it may not enact a long-term-care insurance program included in last year's legislation that overhauled health care.
Minot
dhodson
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Post by dhodson »

If you can afford it, the single payment and limited pay options will eliminate cost increase problems. The issue of the insurance company going under is harder to deal with. One would hope that is a very unlikely event.
funnymoney
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Post by funnymoney »

Both of my parents had LTC, and altho both landed in nursing homes, neither got back what they had spent. Mother had GENWORTH, which just happens to be the worst run company I have seen in several years. They were totally awful to deal with from beginning to end, and by the time they finally paid out the measly sum they figured, they were so late they had to pay a little penalty. They are set up so that the data gets sent to NC and if anyone feels like entering it into the computer system, that would be nice. But the people you deal with are in CA, so they have no access to anything but the computer. They cannot look back at any of the actual paperwork or data.

I wrote a lengthy complaint (and some good suggestions for their business practices :lol: ) to the CEO. Guess who called back? Yep, the sales department.

It would be hard to find a company that cares less. And they are a subsidiary of GE, I think. So lucky them! Big profits, no taxes. :evil:

Hope this hasn't been too ambiguous!
Funnym0ney
yobria
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Post by yobria »

Genworth's stock price dropped from $35 to 78 cents during the recent downturn.

They may or may not be around in 30 years when you need to collect benefits. They'll certainly be around today to collect your premiums.

Nick
Independent
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Post by Independent »

I believe that Genworth is no longer a sub of GE.
G.E. Selling $2.8 Billion Stake in Insurer
General Electric is selling its remaining stake in Genworth Financial, a life and mortgage insurer, for about $2.8 billion as it leaves the insurance industry to focus on faster-growing markets.
February 28, 2006
IIRC, Genworth was created specifically so GE could get out of insurance businesses.

http://www.nytimes.com/2006/02/28/busin ... nancialinc
Independent
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Re: Long-Term Care

Post by Independent »

Dave C. wrote:
Is Omama-care going to seriously affect LTC? Are the projected health care changes expected in 2014 going to change the value of LTC?
Depends on your reading of the politics (which I won't get into). Google on "CLASS long term care". Here's one article http://www.thenewamerican.com/usnews/he ... -dismissed
Has LTC priced itself into a very narrow potential market? Do many of you Boglehead types own LTC policies?
The market has always been people who have enough money to afford the premiums but not enough to afford a long period of care. There are individuals who have too much to want LTCi and those who have too little to afford it. But I don't know if the middle is really very narrow.

We don't have policies. That's largely a protest over the lack of meaningful nonforfeiture options in the policies. When you buy one, you're making a bet on the future of the company you're buying from. I'd certainly look at single pay or limited pay, but the price premium may be excessive. I'd be sure that the company has no rights to reduce coverage instead of raising premiums.

I figured we had enough money to self insure early in retirement. We'd re-think the decision later if our assets seemed to be dropping. In our case, one of us then developed a serious medical problem and "thinking about it later" may not be an option.
chicagobear
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Post by chicagobear »

Alan S.
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Post by Alan S. »

If the CLASS Act was projecting a $75 benefit per day, that is around 25% of the actual costs of a nursing home in higher cost areas. Insuring 25% of an exposure is too low to be viable for the insured in the majority of cases.

Likewise, the analysis indicates that the revenue for the coverage would fall far short of the actual costs to taxpayers, and would be a huge budget buster.

Not doing much good at either end of the spectrum is good reason to mothball the proposal.
rocket
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LTCI

Post by rocket »

I have LTCI. I subscribe to the idea that what the govt gives me will not be nearly as good as taking care of myself. Case in point, Canada socialized medicine has created the situation that it takes 18 weeks to get an appointment with a GP, primary health care provider. With many LTC policies, the deal is premiums stay constant, but benefits go up around 4-5% per year. My premiums will seem very small compared to the benefit in 15 years from now.
Insurance works like this:
Some buy LTCI then drop it later. The ones that continue their insurance get the benefit from the people who dropped their policies. The people who drop are paying for my benefits.
I have more LTC insurance on my wife than I have because I think she will use it more than I. Genworth and Mutual of Omaha are MAYBE the best 2 LTC insurance policies.
yobria
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Re: LTCI

Post by yobria »

rocket wrote:I have LTCI. I subscribe to the idea that what the govt gives me will not be nearly as good as taking care of myself. Case in point, Canada socialized medicine has created the situation that it takes 18 weeks to get an appointment with a GP, primary health care provider.
Yeah and I hear busloads of Canadians cross the border to the US to obtain medications they can't afford there. Oh wait...

Nick
Bongleur
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Post by Bongleur »

The progression was AMEX to GE to GENWORTH.

I have had no real problems with Genworth paying the claims I submitted.

Takes time to start it up; they have a contracted nursing company who does a visit & a Plan of Care, then there might be some things at 80% reimbursement, and so many days of exclusion, etc.

Home care is a PIA because the aide needs to fill out a daily itemized log and that gets sent in with the invoices & your cancelled check showing you paid them.

Genworth has taken a pounding in their mortgage insurance business; but AFAIK the insurance money is segregated.
Seeking Iso-Elasticity. | Tax Loss Harvesting is an Asset Class. | A well-planned presentation creates a sense of urgency. If the prospect fails to act now, he will risk a loss of some sort.
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celia
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Post by celia »

I was talking to a relative whose father was in a nursing home his last few years. She made the comment once that the LTC insurance was a joke. His premiums were something like $3/month (since he took out the policy 40 years??? ago) with a benefit of something like $50/month. She wasn't complaining about the dollar amounts, since that is what inflation does. But she didn't have time to look into it until a few months after he was placed in a home.

After some investigation, I found out that to have the insurance company pay for the patient, you need to work with them when you are deciding where to place the patient. They probably have rules that spell out the qualifications/licensing of the staff and facility, doctors orders and if they can be delivered by the home. In other words, the insurance company has to decide if the home qualifies and the doctor says it is necessary. If you do a placement of a relative on your own, then be prepared to pay for it yourself.
Oneanddone
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Post by Oneanddone »

Alan S. wrote:If the CLASS Act was projecting a $75 benefit per day, that is around 25% of the actual costs of a nursing home in higher cost areas. Insuring 25% of an exposure is too low to be viable for the insured in the majority of cases.

Likewise, the analysis indicates that the revenue for the coverage would fall far short of the actual costs to taxpayers, and would be a huge budget buster.

Not doing much good at either end of the spectrum is good reason to mothball the proposal.
I want to attempt to avoid the politics of the CLASS Act, but it's difficult.

The CLASS Act as written has a few features:
1)No medical underwriting
2)Voluntary
3)Those with means subsidize those without
4)Actuarially sound

If anybody has even basic insurance knowledge, it is easy to understand that the program that has the first three characteristics can't have the fourth characteristic.

Why not? Who is most likely to sign up? Poor unhealthy people. Who is second most likely to sign up? Unhealthy people of means. Who won't sign up? Healthy people with money.

Because these facts are so obvious, it leads me to only two conclusions. 1)Nobody with insurance knowledge was involved with this or 2)(political statement) This plan was never intended to be actuarially sound and is really meant to be another entitlement.

As long as the plan needs to be actuarially sound, the CLASS Act won't ever exist because it's simply not possible.

Guaranteed issue (non employee sponsored) voluntary insurance can work, but it is designed solely for people who are unhealthy and it is done without subsidies.
Oneanddone
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Re: LTCI

Post by Oneanddone »

rocket wrote:I have LTCI. I subscribe to the idea that what the govt gives me will not be nearly as good as taking care of myself. Case in point, Canada socialized medicine has created the situation that it takes 18 weeks to get an appointment with a GP, primary health care provider. With many LTC policies, the deal is premiums stay constant, but benefits go up around 4-5% per year. My premiums will seem very small compared to the benefit in 15 years from now.
Insurance works like this:
Some buy LTCI then drop it later. The ones that continue their insurance get the benefit from the people who dropped their policies. The people who drop are paying for my benefits.
I have more LTC insurance on my wife than I have because I think she will use it more than I. Genworth and Mutual of Omaha are MAYBE the best 2 LTC insurance policies.
Rocket, you are making an excellent point, but at the same time are describing exactly what the problem is with LTCi.

Because the policies are designed for the benefit to go up while the premium stays the same, it isn't a product that gets dropped very often. The insurance companies screwed up this calculation and assumed many more people would drop policies than what happened. This, along with low interest rates, made it very hard for this to be a profitable product for the insurers.
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BruceM
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Re: LTCI

Post by BruceM »

Oneanddone wrote: Because the policies are designed for the benefit to go up while the premium stays the same, it isn't a product that gets dropped very often. The insurance companies screwed up this calculation and assumed many more people would drop policies than what happened. This, along with low interest rates, made it very hard for this to be a profitable product for the insurers.
Well, that's the insurance industry's explanation, and although it could be a contributing factor, its not, in my opinion, the primary reason.

These new products offered first in the later 1990s, were structured to be underpriced at the front end primarily for the benefit of short term sales and profitability, with future lapse rates expected to rise sharply in response to premium hikes when it became clear that insurers could no longer hide behind the untenable actuarial assumptions they made on this new product. What I find surprising is that these premium increases have started this early.

And to the OP's original question, other than the CLASS Act, the passed healthcare legislation really has to do with health care coverage and access, not long term care. And the CLASS Act, with its risk of adverse selection, has taken some severe criticism from the actuarial community as being unsustainable without significant future government cash infusions or significant premium increases, even for its modest benefit.

http://blogs.wsj.com/washwire/2011/09/2 ... -jeopardy/

BruceM
Oneanddone
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Post by Oneanddone »

These products were structured to be underpriced at the front end primarily for the benefit of short term sales and profitability, with future lapse rates expected to rise sharply in response to premium hikes when it became clear that insurers could no longer hide behind the untenable actuarial assumptions they made on this new product.
BruceM, don't let your anti-insurance bias allow you to state unfounded opinions as fact.

Insurance companies don't become profitable by raising rates. They raise rates to hopefully become less unprofitable. What happens to their book of business with every price increase? They lose customers. Which customers are they most likely to lose? Healthy younger customers. Which customers are most likely to stay? Those who are most likely to file claims.

MassMutual is a good example of this product and my comments towards it. They underestimated both lapse ratios and their interest assumptions. However, if what you are saying is true, why have they never raised their rates on existing clients? Instead, they have repriced the product several times for NEW insureds.
TN_INVEST
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Post by TN_INVEST »

My gut feeling is that i prefer the hybrid policies. At least with those, there are options to get your money back by surrendering, dying or getting sick.
Oneanddone
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Post by Oneanddone »

Bruce,

I need to respond again since you edited your original post.
These new products offered first in the later 1990s, were structured to be underpriced at the front end primarily for the benefit of short term sales and profitability, with future lapse rates expected to rise sharply in response to premium hikes when it became clear that insurers could no longer hide behind the untenable actuarial assumptions they made on this new product. What I find surprising is that these premium increases have started this early.
One of the problems with what you are saying is that the companies who waited until the late 1990's/early 2000's to sell these products have not had rate increases.

NYL and NML, for example, came into the market at (relatively) really high premiums and have simply waited for the rest of the industry to raise rates to the levels that they were charging.

The industry has admitted to screwing up lapse ratio projections. At the very least, if you are going to accuse them of doing this intentionally, shouldn't you have something to back up your point of view?
dhodson
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Post by dhodson »

What is the expected lapse percent for ltci and whole life?
Oneanddone
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Post by Oneanddone »

dhodson wrote:What is the expected lapse percent for ltci and whole life?
I don't know the answer. I just know that for whole life, they have enough experience to be accurate. With LTCi, they didn't have the experience and missed their estimations by a significant amount.
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speedbump101
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Re: LTCI

Post by speedbump101 »

rocket wrote: Case in point, Canada socialized medicine has created the situation that it takes 18 weeks to get an appointment with a GP, primary health care provider.
You are wrong, however there will be no debate from me (discussing this is contrary to forum rules).

The facts: I'm 63 and have lived in Canada all my life. Your assertion is incorrect based on a lifetime of personal experience.

SB...
"Man is not a rational animal, he is a rationalizing animal" -Robert A. Heinlein
Independent
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Post by Independent »

dhodson wrote:What is the expected lapse percent for ltci and whole life?
I assume you mean "is expected on newly priced business".

This article in the spring 2002 Contingencies magazine shows a base case assumption of 2% in years 6+, and a "stress" case of 1% in years 4+. Changing the lapse rates by that amount seems to pretty well wipe out expected profits.

http://www.contingencies.org/marapr02/workshop.pdf

Permanent life insurance lapse rates will vary more by product. IMO, the persistency of LTCi is related to the lack of nonforfeiture options - in most cases, if you stop paying premiums, you lose everything you've paid in the past. That is not an issue with permanent life where laws require nf options.

Edit: This is a newer (2009) and better source: http://publications.milliman.com/resear ... urance.pdf
See the table on page 6.

These are all reserve assumptions which should have some PADS. Given the magnitude of the numbers, I'd guess that pricing lapse rates could be 0.5% higher than the GAAP assumption.
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Post by Oneanddone »

john94549 wrote:I think there's a provision that addresses long-term care. You pay into the program, if you wish, and after five years of paying in you get a benefit of $50 - $60/day if you need such care.

My wife and I (both 64) have not purchased LTC insurance. In current dollars, our retirement assets would cover everything but skilled nursing. Should it come to that, the primary residence would be sold.

The main "gotcha" with LTC insurance (aside from insuror insolvency) is the propensity for rates to increase just as you can ill-afford to pay the increases. Are you aware of any LTC insuror which offers a product where it guarantees rates will never increase? I'd just hate to have paid LTC premiums for years and years and then lose coverage when I most need it because I couldn't afford the premiums any more.
John, LTCi does not pay for skilled nursing care. It is your health insurance that pays for skilled nursing care.

There are no companies that guarantee rates. I am not quite sure if tax qualified policies give the insurance companies the ability to guarantee rates.

There are certainly companies that are much less likely than others to raise rates. I think that it is highly unlikely for any of the mutual insurers who waited a long time to get into the LTCi business to ever raise rates on existing insureds.
Independent
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Post by Independent »

Oneanddone wrote:
John, LTCi does not pay for skilled nursing care. It is your health insurance that pays for skilled nursing care.

There are no companies that guarantee rates. I am not quite sure if tax qualified policies give the insurance companies the ability to guarantee rates.

There are certainly companies that are much less likely than others to raise rates. I think that it is highly unlikely for any of the mutual insurers who waited a long time to get into the LTCi business to ever raise rates on existing insureds.
In the lingo of LTC, "skilled nursing" is what most of us call "nursing homes". LTC insurance policies almost always cover nursing homes. OTOH, my major med health insurance doesn't cover extended stays in nursing homes.

I understand John to say that he thinks he can cover a long stay in an Assisted Living Facility, which might cost half of a nursing home, but moving to the more expensive nursing home would be the problem.
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Post by Oneanddone »

Has LTC priced itself into a very narrow potential market? Do many of you Boglehead types own LTC policies?


The market has always been people who have enough money to afford the premiums but not enough to afford a long period of care. There are individuals who have too much to want LTCi and those who have too little to afford it. But I don't know if the middle is really very narrow.
I believe that LTCi has priced itself into a very narrow market.

The market used to be "people who can afford the premiums".

The market is now "people who can afford the premiums and can't pay for care out of their own pocket."

Addressing the first part, "people who can afford the premiums", well obviously, that part has substantially narrowed as the price of LTCi has increased.

The second part, "and can't pay for care out of their own pocket" is a new wrinkle.

I used to have lots of people buy LTCi who could afford care out of their own pocket. Why? They looked at the price and decided they would rather pay a certain amount of pennies instead of an unknown amount of dollars. LTCi was an (obviously) underpriced product. With the price being substantially higher now, most people who don't NEED the coverage are choosing not to buy it. They are either going without coverage or some are putting the dollars into life insurance instead.
Oneanddone
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Post by Oneanddone »

Independent wrote:
Oneanddone wrote:
John, LTCi does not pay for skilled nursing care. It is your health insurance that pays for skilled nursing care.

There are no companies that guarantee rates. I am not quite sure if tax qualified policies give the insurance companies the ability to guarantee rates.

There are certainly companies that are much less likely than others to raise rates. I think that it is highly unlikely for any of the mutual insurers who waited a long time to get into the LTCi business to ever raise rates on existing insureds.
In the lingo of LTC, "skilled nursing" is what most of us call "nursing homes". LTC insurance policies almost always cover nursing homes. OTOH, my major med health insurance doesn't cover extended stays in nursing homes.

I understand John to say that he thinks he can cover a long stay in an Assisted Living Facility, which might cost half of a nursing home, but moving to the more expensive nursing home would be the problem.
To understand the product, we need to use accurate lingo. "Skilled nursing" should not be used synonymously with "nursing home". Skilled nursing could take place in any location. A Tax qualified LTCi policy only covers nursing homes because the person in the nursing home is typically "chronically ill". If the person doesn't meet the definition, LTCi is not going to pay for the nursing home.
TN_INVEST
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Post by TN_INVEST »

I've always looked at the LTC issue sorta like the disability issue (heck...even dental insurance).

If you don't have a disability insurance policy, you are less likely to show up on anybody's statistic list because you need to keep working to pay your bills. If you you have a disability ins policy, you might keep pressing your insurance company to declare you disabled so you can get benefits. In other words, there might be lots of folks walking the halls at work that ought to be declared disabled (and would be declared disabled) if they had a disability policy. Therefore, when the stats & studies are taken and reported, they might give a false sense of how low the probability is that a person would become disabled.

I think there are a lot of folks that would meet the standard definition of needed/receiving long-term care, but don't get reported because they don't have LTC insurance. Therefore, when folks say stuff like "the studies show, or the likelihood of needing care are _____, I think they might be discounting the "real" #s.

Example: I have a tooth that is bothering me, but I've been putting it off because I have to pay cash for the dental work.

Note: these are just my unscientific observations that are based on several occurrences where I've heard folks say the likelihood of putting in a claim for LTC is low.
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Post by bluemarlin08 »

TN_INVEST, you might be correct in your view. From a personal experience, I could qualify for disability, but because I could never qualify, I don't have coverage, so I must work even with the disability.
TN_INVEST
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Post by TN_INVEST »

bluemarlin08 wrote:TN_INVEST, you might be correct in your view. From a personal experience, I could qualify for disability, but because I could never qualify, I don't have coverage, so I must work even with the disability.
I don't know.

Interesting thing is that the whole subject is rather binary. Either it happens to you or it doesn't happen to you. It hardly matters what the odds are, however, a lot of us do look at the probabilities when trying to wrap our brains around the issue of whether to buy something.

I'll state it again. I don't know what the best thing to do, is. I just kinda like those hybrid policies because they seem to provide some more options than a traditional LTC policy.
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Post by Oneanddone »

TN_INVEST wrote:I've always looked at the LTC issue sorta like the disability issue (heck...even dental insurance).

If you don't have a disability insurance policy, you are less likely to show up on anybody's statistic list because you need to keep working to pay your bills. If you you have a disability ins policy, you might keep pressing your insurance company to declare you disabled so you can get benefits. In other words, there might be lots of folks walking the halls at work that ought to be declared disabled (and would be declared disabled) if they had a disability policy. Therefore, when the stats & studies are taken and reported, they might give a false sense of how low the probability is that a person would become disabled.

I think there are a lot of folks that would meet the standard definition of needed/receiving long-term care, but don't get reported because they don't have LTC insurance. Therefore, when folks say stuff like "the studies show, or the likelihood of needing care are _____, I think they might be discounting the "real" #s.

Example: I have a tooth that is bothering me, but I've been putting it off because I have to pay cash for the dental work.

Note: these are just my unscientific observations that are based on several occurrences where I've heard folks say the likelihood of putting in a claim for LTC is low.
It is an interesting observation, but I don't think that you are correct. One can't put off needing long term care simply because they don't have insurance. If you need help feeding yourself, bathing yourself, etc. insurance won't change any of this.

People often confuse the odds of needing long term care with the odds of going to a nursing home. They also have this same confusion in regards to the length of time that care is needed. Insurance will have no impact on whether care is needed. It can have a great impact on how that care is administered.

For instance, a 78 year old wife may try to take care of her ailing 83 year old husband on her own because insurance (or cash) isn't available.
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Post by Oneanddone »

bluemarlin08 wrote:TN_INVEST, you might be correct in your view. From a personal experience, I could qualify for disability, but because I could never qualify, I don't have coverage, so I must work even with the disability.
Bluemarlin, can you explain this because I'm having trouble following.

I am guessing that you are saying that you have had health problems, but since they've impacted your ability to work, but not your income, you would not be able to qualify for benefits. Is that what you are saying or am I completely missing it?
bluemarlin08
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Post by bluemarlin08 »

I couldn't qualify for LTD coverage. Developed some health issues that dramatically impact my ability to do some things. I still can work, just have to pick the days.
TN_INVEST
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Post by TN_INVEST »

Oneanddone wrote:
It is an interesting observation, but I don't think that you are correct. One can't put off needing long term care simply because they don't have insurance. If you need help feeding yourself, bathing yourself, etc. insurance won't change any of this.

People often confuse the odds of needing long term care with the odds of going to a nursing home. They also have this same confusion in regards to the length of time that care is needed. Insurance will have no impact on whether care is needed. It can have a great impact on how that care is administered.

For instance, a 78 year old wife may try to take care of her ailing 83 year old husband on her own because insurance (or cash) isn't available.
A person might not be able to put off needing care, but they can put off paying for care....especially if they don't have a LTC policy.

That can be a bit unfortunate for all those involved (grandpa spends all his energy waiting hand-n-foot on grandma, or the kids neglecting their own families so they can make sure somebody is there with dad). All I'm saying is that care given by a family member is not free care. It's quite often expensive because it's disruptive (sorta like investment opportunity costs). I also think the fact that so many folks don't show up on the stat sheet gives some folks a false sense of the odds they'll ever make claims against a LTC policy.

Like some say. Grandma is starting to get sick, so why not hire somebody to help grandpa take care of grandma? Just because grandpa is there with her, doesn't mean the old man doesn't want to go fishing, instead. Grandma is probably tired of looking at him all day long, too.
Oneanddone
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Post by Oneanddone »

I am in complete agreement that family care is not free care.

Even if there isn't a financial cost (and there often is), there is an emotional and physical cost.
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Post by flowerbuyer »

Oneanddone wrote:I am in complete agreement that family care is not free care.

Even if there isn't a financial cost (and there often is), there is an emotional and physical cost.
And if your loved one has Alzheimer's, as my mom does, the toll on family caregivers is often the health of the caregiver, in addition to financial burdens. Some have to leave their jobs because the one being cared for cannot ever be alone for safety reasons. Others have used their own retirement savings to provide care. When it comes to providing care for a parent or spouse, decisions are not always made based on what is financially practical.
bluemarlin08
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Post by bluemarlin08 »

I talked with a friend last night that I haven't spoke to in many years. He and his wife are 70, she is in end stages of MS. He spends all his time taking care of her. But it is wearing him out physically, mentally and financially.
Oneanddone
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Post by Oneanddone »

flowerbuyer wrote:
Oneanddone wrote:I am in complete agreement that family care is not free care.

Even if there isn't a financial cost (and there often is), there is an emotional and physical cost.
And if your loved one has Alzheimer's, as my mom does, the toll on family caregivers is often the health of the caregiver, in addition to financial burdens. Some have to leave their jobs because the one being cared for cannot ever be alone for safety reasons. Others have used their own retirement savings to provide care. When it comes to providing care for a parent or spouse, decisions are not always made based on what is financially practical.
That is the point that I try to make when ever I am talking to a client about long term care.

"Dad" is probably going to get the same identical level of care with or without insurance. The question is one of at what cost (financial, emotional, and physical) will providing this care extract from the family.
bluemarlin08
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Post by bluemarlin08 »

Friend of our family started going downhill rapidly, he had 4 kids that lived in the same town. They hired a caregiver, but left him alone without care several hours at times. Never was enough food, the kids wouldn't spend any additional money. His last few months could have been much better if the kids hadn't been watching the inheritance pile dwindle.
gkaplan
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Post by gkaplan »

Looks like the insurance guys are out in full force.
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Bongleur
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Post by Bongleur »

Another strategy is to give one of the kids money to add a mother-in-law apartment to their house and move in.

Except that if a severe health problem arises, there needs to be enough money left to hire outside hourly caregivers, or the family will have a great deal of strain.
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Topic Author
Dave C.
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Location: Mesa, AZ

LYCi

Post by Dave C. »

gkaplan wrote:Looks like the insurance guys are out in full force.

Hey, I was eating all this up before gkaplan's message. I even had my checkbook out! Hmmmm, I"m still thinking LTCi, but the decision is not a simple one, and clearly must be made on an individual basis using a lot of "gut feel".

And I'm the guy who started this thread!!
Easy does it/Live & Let Live/One day at a time. Thanks Bill.
yobria
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Post by yobria »

gkaplan wrote:Looks like the insurance guys are out in full force.
Yes, and no army of salesmen available to counter with the benefits of self insuring, I'm afraid.

The best investments tend to be the ones that don't get sold to you...

Nick
Honobob
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Post by Honobob »

yobria wrote:
gkaplan wrote:Looks like the insurance guys are out in full force.
Yes, and no army of salesmen available to counter with the benefits of self insuring, I'm afraid.

The best investments tend to be the ones that don't get sold to you...

Nick
Well you don't have to "sell" me on the benefits of self insuring just like I didn't need or use a salesman when I bought my LTCi, but I have yet to see how a self insurer "plan" pays the $226,000 benefit each and every year I need LTC 20 years from now, at an estimated cost of about $70,000 over 30 years figuring premiums will double every ten years.

Can ANYONE show how this can be accomplished through "self insuring" at similar cost?
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Topic Author
Dave C.
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LTCi

Post by Dave C. »

Honobob wrote:
yobria wrote:
gkaplan wrote:Looks like the insurance guys are out in full force.
Yes, and no army of salesmen available to counter with the benefits of self insuring, I'm afraid.

The best investments tend to be the ones that don't get sold to you...

Nick
Well you don't have to "sell" me on the benefits of self insuring just like I didn't need or use a salesman when I bought my LTCi, but I have yet to see how a self insurer "plan" pays the $226,000 benefit each and every year I need LTC 20 years from now. At an estimated cost of about $70,000 over 30 years figuring premiums will double every ten years.
















The term "self insured" is certainly common in this thread, but why not call it what it is.....no insurance, totally out of pocket. And by the way, those pockets had best be very, very deep should one of us face the need for some type of LTC.....without the benefit of the small "I" at the end of LTC. I'm getting closer and closer to calling my agent and pulling the trigger for LTCi.

Can ANYONE show how this can be accomplished through "self insuring"?
:roll: :roll:
Easy does it/Live & Let Live/One day at a time. Thanks Bill.
dhodson
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Post by dhodson »

the agents are correct when they say you cant self insure. Its a technical point however. You have to decide if the risk/reward is worth it. You cant purchase insurance for every event and some insurance "deals" are better than others meaning your odds are better or costs seem more reasonable. Rarely you see someone complain about term life insurance on this site bc the costs are fairly low even though of course the payout isnt likely. For this product, the costs are unknown unless using a single or limited pay product and the risks of needing some sort of care later in life are higher as well as the leader in this industry may be way off on some of their actuarial estimates although they have a chance of being correct as well. These additional risks make it a more touchy subject. Its going to take 30 years to figure this out and unfortunately by then most of us reading these posts will have made either the correct or incorrect decision.
TN_INVEST
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Re: LYCi

Post by TN_INVEST »

Dave C. wrote:
gkaplan wrote:Looks like the insurance guys are out in full force.

Hey, I was eating all this up before gkaplan's message. I even had my checkbook out! Hmmmm, I"m still thinking LTCi, but the decision is not a simple one, and clearly must be made on an individual basis using a lot of "gut feel".

And I'm the guy who started this thread!!
You can always hedge by getting a hybrid policy or a supplemental/partial coverage policy.

Folks would have to be blind to see that the healthcare field (and the need for healthcare) is growing. Educated folks with resources also have a tendency to gravitate towards using healthcare resources more so than folks that don't have college degrees and/or money.
TN_INVEST
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Re: LYCi

Post by TN_INVEST »

TN_INVEST wrote:
Dave C. wrote:
gkaplan wrote:Looks like the insurance guys are out in full force.

Hey, I was eating all this up before gkaplan's message. I even had my checkbook out! Hmmmm, I"m still thinking LTCi, but the decision is not a simple one, and clearly must be made on an individual basis using a lot of "gut feel".

And I'm the guy who started this thread!!
You can always hedge by getting a hybrid policy or a supplemental/partial coverage policy.

Folks would have to be blind to see that the healthcare field (and the need for healthcare) is growing. Educated folks with resources also have a tendency to gravitate towards using healthcare resources more so than folks that don't have college degrees and/or money.
dhodson wrote: Its going to take 30 years to figure this out and unfortunately by then most of us reading these posts will have made either the correct or incorrect decision.
I tend to agree. I also can't help but think there is a powerful trend of expanding healthcare services.
bluemarlin08
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Post by bluemarlin08 »

You better watch those insurance guys, they will walk away with all your money those scoundrels. They will hynotize you and convince you against your will to buy that insurance policy.
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