Long term care insurance

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pshonore
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Re: Long term care insurance

Post by pshonore » Wed Feb 21, 2018 2:01 pm

WoW2012 wrote:
Wed Feb 21, 2018 12:42 pm
DrGoogle2017 wrote:
Wed Feb 21, 2018 12:14 pm
WoW2012 wrote:
Wed Feb 21, 2018 12:04 pm
DrGoogle2017 wrote:
Wed Feb 21, 2018 11:59 am
WoW2012 wrote:
Wed Feb 21, 2018 11:58 am


Older policies have had a lot of rate increases.
Newer policies haven't had them due to new regulations.
I've had my policy for 9 years and I've not had any rate increases.
Not old, it was purchased in 2010. 3 rate increases already. I didn’t care when it was pretax money but after I retired it was after tax money.
9 states have not passed the new rules. Sounds like you live in one of those states.
How big were your increases?
I’m in California. I started with $88 per month, then it went up to $90 something, then last year it went up to $150 something. I’m under 60, so it can’t be because of age related increase. If I don’t pay for the increase, my benefits would be reduced. In the end, I looked at both of my aunts in their early 90s, still have all faculties in tact, I decided maybe I have longevity gene in me, that’s when I drop it. Plus I certainly could pay $500k(self insured).

Those weren't rate increases you had. Your premium went up because of the type of inflation protection you had in the policy. It's called a "Future Purchase Option" or a "Guaranteed Purchase Option". That type of inflation protect makes your premium go up every 2 or 3 years. It starts off cheap but then becomes increasingly expensive because the cost of the increases are based upon your attained age, not your issue age.
Don't think that how it works. I believe most LTC policies are issued with a fixed rate. If you have inflation protection the initial rate is higher. In most states, the company can only increase rates on fixed rate existing policies with permission of the State Insurance Dept. You can usually find out these details by going to the State Insurance Dept website in your state.

For example: http://www.catalog.state.ct.us/cid/port ... iling.aspx:

DrGoogle2017
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Re: Long term care insurance

Post by DrGoogle2017 » Wed Feb 21, 2018 2:18 pm

When I started my LTC policy, I had a built in inflation rate. The cost per day for nursing home was $150, I purchased $350 so I didn’t have to worry about inflation. But that was not enough.

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 5:00 pm

DrGoogle2017 wrote:
Wed Feb 21, 2018 2:18 pm
When I started my LTC policy, I had a built in inflation rate. The cost per day for nursing home was $150, I purchased $350 so I didn’t have to worry about inflation. But that was not enough.

The state of California publishes the rate increase history of every long-term care insurance company every year.

California passed a "Rate Stability Regulation" on 7/1/2002. Every individual LTC insurance policy purchased after 7/1/2002 is protected by this regulation. Most group policies (like CalPERS and FLTCIP) are not under this regulation.

For policies purchased in California, after 7/1/2002, the biggest rate increase any John Hancock policyholder has gotten is 15% (one-time). And they all had only one rate increase. No John Hancock policyholder has had more than one rate increase in California, if they purchased their policy after 7/1/2002.

That's why I said that your rates went up because of the inflation protection feature you chose. You said you had three rate increases. John Hancock has not had three rate increases on any policies sold in California after 7/1/2002.

JoeRetire
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Re: Long term care insurance

Post by JoeRetire » Wed Feb 21, 2018 5:13 pm

beardsworth wrote:
Tue Feb 20, 2018 2:04 pm
Whether for home insurance, long-term care, or any other risk, a decision not to purchase a policy, and to just keep a bunch of money on the sidelines if the need arrives, is not "insuring." No risk is being pooled with anyone else. A more accurate term would simply be "fund my own" or "pay out-of-pocket."
The definition of self-insure per https://www.investopedia.com/terms/s/self-insure.asp:
"Self-insure is a risk management technique in which a company or individual sets aside a pool of money to be used to remedy an unexpected loss. Theoretically, one can self-insure against any type of loss."

JoeRetire
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Re: Long term care insurance

Post by JoeRetire » Wed Feb 21, 2018 5:24 pm

westrichj312 wrote:
Wed Feb 21, 2018 9:35 am
Unfortunately statistics will tell you most people will never get their money's worth out of a LTC policy.
An odd statement to make about insurance.

Statistics will tell you most people will never get their money's worth out of a homeowner's insurance policy.

"I'll just become poor so other peoples' tax money can pay for my care" may be your plan. Apparently the OP chooses not to take that route. Neither do I.

pintail07
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Re: Long term care insurance

Post by pintail07 » Wed Feb 21, 2018 5:59 pm

westrichj312 wrote:
Tue Feb 20, 2018 9:27 am
LTC policies are one of the biggest sucker purchases out there. There are other legal ways to get around i. Find a good estate/asset protection attorney and protect yourself with a trust and you will get LTC free in almost any state.
You must be joking? So your plan is to go Medicaid for your care. No home care option, limited AL options, inferior Nursing Home care compared to all private pay. You are really just pulling our leg aren't you? That is the biggest sucker plan ever.

DrGoogle2017
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Re: Long term care insurance

Post by DrGoogle2017 » Wed Feb 21, 2018 6:16 pm

WoW2012 wrote:
Wed Feb 21, 2018 5:00 pm
DrGoogle2017 wrote:
Wed Feb 21, 2018 2:18 pm
When I started my LTC policy, I had a built in inflation rate. The cost per day for nursing home was $150, I purchased $350 so I didn’t have to worry about inflation. But that was not enough.

The state of California publishes the rate increase history of every long-term care insurance company every year.

California passed a "Rate Stability Regulation" on 7/1/2002. Every individual LTC insurance policy purchased after 7/1/2002 is protected by this regulation. Most group policies (like CalPERS and FLTCIP) are not under this regulation.

For policies purchased in California, after 7/1/2002, the biggest rate increase any John Hancock policyholder has gotten is 15% (one-time). And they all had only one rate increase. No John Hancock policyholder has had more than one rate increase in California, if they purchased their policy after 7/1/2002.

That's why I said that your rates went up because of the inflation protection feature you chose. You said you had three rate increases. John Hancock has not had three rate increases on any policies sold in California after 7/1/2002.
There is your answer to my rate increase.

skepticalobserver
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Re: Long term care insurance

Post by skepticalobserver » Wed Feb 21, 2018 6:17 pm

pintail07 wrote:
Wed Feb 21, 2018 5:59 pm
No home care option, limited AL options,
Under the Medicaid Waiver program limited home care may be available if a state participates in the program. Availability varies, however. For example, in DC and VA home care is readily available for Medicaid recipients; in MD there's a four year waiting list.

Medicaid does not pay for AL which is regulated, if at all, at the state level. Skilled nursing facilities are federally regulated.
Last edited by skepticalobserver on Wed Feb 21, 2018 6:20 pm, edited 1 time in total.

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 6:19 pm

DrGoogle2017 wrote:
Wed Feb 21, 2018 6:16 pm
WoW2012 wrote:
Wed Feb 21, 2018 5:00 pm
DrGoogle2017 wrote:
Wed Feb 21, 2018 2:18 pm
When I started my LTC policy, I had a built in inflation rate. The cost per day for nursing home was $150, I purchased $350 so I didn’t have to worry about inflation. But that was not enough.

The state of California publishes the rate increase history of every long-term care insurance company every year.

California passed a "Rate Stability Regulation" on 7/1/2002. Every individual LTC insurance policy purchased after 7/1/2002 is protected by this regulation. Most group policies (like CalPERS and FLTCIP) are not under this regulation.

For policies purchased in California, after 7/1/2002, the biggest rate increase any John Hancock policyholder has gotten is 15% (one-time). And they all had only one rate increase. No John Hancock policyholder has had more than one rate increase in California, if they purchased their policy after 7/1/2002.

That's why I said that your rates went up because of the inflation protection feature you chose. You said you had three rate increases. John Hancock has not had three rate increases on any policies sold in California after 7/1/2002.
There is your answer to my rate increase.

aha.... a group policy.
that explains it.

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celia
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Re: Long term care insurance

Post by celia » Wed Feb 21, 2018 6:30 pm

I would first see if your or your spouse's employer offers a plan that you can continue when you/she leaves the company. I signed up for almost the max coverage through my employer when I was about 50. The employer does withholding as long as you are still working. After you leave the company, you can continue paying the premiums through automatic bill-pay. They have never increased for me or those still working there (as far as I know). I don't expect the monthly benefit to pay my entire monthly bill (due to inflation) if/when I get to that point, but even if it pays part of it, that means I have less I have to pay. (This could be seen as "diversification".)

beardsworth
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Re: Long term care insurance

Post by beardsworth » Wed Feb 21, 2018 6:31 pm

JoeRetire wrote:
Wed Feb 21, 2018 5:13 pm
beardsworth wrote:
Tue Feb 20, 2018 2:04 pm
Whether for home insurance, long-term care, or any other risk, a decision not to purchase a policy, and to just keep a bunch of money on the sidelines if the need arrives, is not "insuring." No risk is being pooled with anyone else. A more accurate term would simply be "fund my own" or "pay out-of-pocket."
The definition of self-insure per https://www.investopedia.com/terms/s/self-insure.asp:
"Self-insure is a risk management technique in which a company or individual sets aside a pool of money to be used to remedy an unexpected loss. Theoretically, one can self-insure against any type of loss."
Said cheerfully, not "confrontationally":

You can call it what you want, and Investopedia can call it what they want, but I see no useful purpose in muddying the conceptual waters between true risk-pooled insurance vs. simply paying one's own way with a pile of cash set aside "just in case." And where payment of long-term care expenses is concerned, such a pile of cash will surely need to be vastly larger than the ongoing cost of insurance premiums pooled with others.

Nothing I've said here, or in my first post above, is intended as an argument for, or against, buying a LTC policy. My wife and I actually explored such policies but were told in advance by nitpicking insurance companies that, due to minor medical history issues which have no effect on our current health, we'd be rejected. So, even if we might have preferred to buy the policies, we'll nevertheless be forced to build that pile of cash. The point is that, Investopedia notwithstanding, the pile of cash is not true "insurance." It's just "a bunch of money that we could have used for other pleasures in life but felt we had to preserve toward a nursing home experience which may or may not ever arrive."

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 6:47 pm

beardsworth wrote:
Wed Feb 21, 2018 6:31 pm
My wife and I actually explored such policies but were told in advance by nitpicking insurance companies that, due to minor medical history issues which have no effect on our current health, we'd be rejected.
There are about 13 companies that sell long-term care insurance. They all have very different criteria for determining insurability. Most insurance agents know nothing about long-term care insurance underwriting.

Long-term care insurers typically don't care about prior health issues. They are mostly concerned about the stability of your current health issues. Cancer, for example, is something that most long-term care insurance companies don't care much about, especially if you've been recovered for over 2 years.

skepticalobserver
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Re: Long term care insurance

Post by skepticalobserver » Wed Feb 21, 2018 6:53 pm

WoW2012 wrote:
Wed Feb 21, 2018 6:47 pm
They all have very different criteria for determining insurability. Most insurance agents know nothing about long-term care insurance underwriting.
This is the Genworth LTC Underwriting Guide (for "Agents Only"--so this is just between us): http://www.resourcebrokerage.com/pdfs/l ... nworth.pdf

It's comprehensive and probative of the health issues other carriers are looking at.

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 6:57 pm

skepticalobserver wrote:
Wed Feb 21, 2018 6:53 pm
WoW2012 wrote:
Wed Feb 21, 2018 6:47 pm
They all have very different criteria for determining insurability. Most insurance agents know nothing about long-term care insurance underwriting.
This is the Genworth LTC Underwriting Guide (for "Agents Only"--so this is just between us): http://www.resourcebrokerage.com/pdfs/l ... nworth.pdf

It's comprehensive and probative of the health issues other carriers are looking at.

That underwriting guide was published in May of 2007. The LTCi claims data has increased by about 700% over the past 10 years. I'm not so sure a guide that's 11 years old is probative, are you?
Last edited by WoW2012 on Wed Feb 21, 2018 7:03 pm, edited 1 time in total.

westrichj312
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Re: Long term care insurance

Post by westrichj312 » Wed Feb 21, 2018 7:00 pm

LTC policy with death benefit? Your salesman loves you - LOL :oops:

skepticalobserver
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Re: Long term care insurance

Post by skepticalobserver » Wed Feb 21, 2018 7:02 pm

WoW2012 wrote:
Wed Feb 21, 2018 6:57 pm
Do you have anything more recent?
Genworth 2013, https://pinneyinsurance.com/underwritin ... -Guide.pdf

westrichj312
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Re: Long term care insurance

Post by westrichj312 » Wed Feb 21, 2018 7:06 pm

Most of the medicaid places I have seen are pretty nice and besides most of the residents don't even know their own names therefore could care less if they are in a beautiful private setting. I only have about 300K in retirement accounts. I could care less if they get that or the crummy SS check I am talking about preserving your saved Cashola!

skepticalobserver
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Re: Long term care insurance

Post by skepticalobserver » Wed Feb 21, 2018 7:13 pm

WoW2012 wrote:
Wed Feb 21, 2018 6:57 pm
Do you have anything more recent?
Genworth 2013, https://pinneyinsurance.com/underwritin ... -Guide.pdf

Also, do the math on whole life policies with LTC riders. From the products I've seen LTC payments do not come out as a lump sum. Instead, benefits are doled out in monthly sums over time (that is, over the actuarial lifetime of the insured at commencement of claim). One, the monthly payments are small relative to the cost of AL or nursing home care. Two, the carrier is betting you will use just enough benefit to cover the paid premium (getting your own money back). Another issue: will the cost of insurance (mortality debits?) eat into cash value/LTC benefits.

FBN2014
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Re: Long term care insurance

Post by FBN2014 » Wed Feb 21, 2018 7:15 pm

"October is one of the peculiarly dangerous months to speculate in stocks. The others are July, January, September, April, November, May March, June, December, August and February." - M. Twain

bayview
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Location: WNC

Re: Long term care insurance

Post by bayview » Wed Feb 21, 2018 7:32 pm

westrichj312 wrote:
Wed Feb 21, 2018 7:06 pm
Most of the medicaid places I have seen are pretty nice and besides most of the residents don't even know their own names therefore could care less if they are in a beautiful private setting. I only have about 300K in retirement accounts. I could care less if they get that or the crummy SS check I am talking about preserving your saved Cashola!
Wow, you are stubborn. :)

If you think that you will be a “drooler” when you go into LTC and won’t care, then you’re good.

It’s a lot more likely that you will be cognitively intact to “mild cognitive impairment” (think early Alzheimer’s), with medical/ physical issues that require skilled nursing care.

So there you’ll be, with your COPD, or your fractured hip that isn’t healing, or your Parkinson’s, or your pressure ulcers from immobility, and you will see everything, hear everything, smell everything, be served food you don’t like, share a room with someone who screams or moans all day and night, but hey, you excluded your savings for your kids.

Medicaid is there for a reason: to help those with no other resources. It might be the last resort for those who do have savings, but you probably would be happier postponing a Medicaid bed for a bit.

Our plan is to have 3-4 years’ worth of expenses at a “good” nursing home set aside in something safe, buying our way in to a good bed. If God forbid, we’re still alive and miserable after that time (I truly hope that someone will slip me a lethal dose of something at that point), then Medicaid can step in. I will have been a responsible taxpayer up to that point.

Note that if we don’t have to use it for LTC, our kids get it. It’s not wasted, as some might look at LTC insurance.

We don’t have a ton of money either. Our goal is to live off SS and my meager federal pension. The retirement savings are for disasters. But disasters happen, and we'll be as prepared as we can be.

I would not want to put my kids in the position of rejoicing in my mediocre care so that they will have a larger inheritance. Just me.
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 7:39 pm

skepticalobserver wrote:
Wed Feb 21, 2018 7:13 pm
WoW2012 wrote:
Wed Feb 21, 2018 6:57 pm
Do you have anything more recent?
Genworth 2013, https://pinneyinsurance.com/underwritin ... -Guide.pdf

Also, do the math on whole life policies with LTC riders. From the products I've seen LTC payments do not come out as a lump sum. Instead, benefits are doled out in monthly sums over time (that is, over the actuarial lifetime of the insured at commencement of claim). One, the monthly payments are small relative to the cost of AL or nursing home care. Two, the carrier is betting you will use just enough benefit to cover the paid premium (getting your own money back). Another issue: will the cost of insurance (mortality debits?) eat into cash value/LTC benefits.

Of the 24 "uninsurable conditions" in the 2013 Genworth guide you linked to, Genworth now insures three of those conditions, leaving only 21 uninsurable conditions.
Of those 21 "uninsurable conditons" four of those conditions are considered insurable with at least one other long-term care insurance company.

Obviously, someone who is diagnosed with alzheimer's, dementia, senility, lou gehrig's, multiple sclerosis, parkinson's.... won't be able to go out and buy long-term care insurance; just like you can't get hurricane insurance when there's a tropical storm warning.

Most health conditions that are "in the past" (which is how the poster described it) are likely insurable.

And, you're correct about life insurance policies with long-term care riders. When you do the math they are rarely the best value.

skepticalobserver
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Re: Long term care insurance

Post by skepticalobserver » Wed Feb 21, 2018 7:54 pm

As to the comments on "droolers":

I do some volunteer work at an AL facility. The residents are not cognitively impaired (there are facilities dedicated to “memory care”). Some might be “droolers” because they suffer from Parkinson’s or Huntington’s, but their minds are clear. AL residents certainly know their names, understand why they need AL and appreciate a decent environment.

Cost? $6,000 - $12,000 per month depending on level of care. Those with LTC insurance (Medicaid does not cover AL) thank their lucky stars.

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 8:15 pm

skepticalobserver wrote:
Wed Feb 21, 2018 7:54 pm
As to the comments on "droolers":

I do some volunteer work at an AL facility. The residents are not cognitively impaired (there are facilities dedicated to “memory care”). Some might be “droolers” because they suffer from Parkinson’s or Huntington’s, but their minds are clear. AL residents certainly know their names, understand why they need AL and appreciate a decent environment.

Cost? $6,000 - $12,000 per month depending on level of care. Those with LTC insurance (Medicaid does not cover AL) thank their lucky stars.
+1

Any long-term care policy that meets the federal guidelines pays benefits if the policyholder needs "standby assistance" or "physical assistance" to perform any two of the activities of daily living (e.g. bathing, dressing, eating, toileting, getting out of a bed or chair, and maintaining continence.)

Do you see all those pre-boards at the airport? Many of them could qualify for benefits under a long-term care policy that meets the federal guidelines.

My relative is receiving benefits from her LTCi policy. She needs help bathing three times a week and she needs standby assistance in the morning and the evening when she changes her clothes (to make sure she doesn't lose her balance and fall). She's living in a beautiful assisted-living facility. (The facility does NOT accept Medicaid residents.) She walks everyday (with her rollator). She has friends. She has activities. She sees her daughter and her grandchildren a few times each week. She goes to church with us on Sundays.

Her long-term care policy pays 100% of the cost of the assisted living facility. If she wanted to live in a house, the policy would cover the full cost of a live-in home health aide, but she prefers the social aspects of the assisted-living facility.

bayview
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Re: Long term care insurance

Post by bayview » Wed Feb 21, 2018 8:18 pm

skepticalobserver wrote:
Wed Feb 21, 2018 7:54 pm
As to the comments on "droolers":

I do some volunteer work at an AL facility. The residents are not cognitively impaired (there are facilities dedicated to “memory care”). Some might be “droolers” because they suffer from Parkinson’s or Huntington’s, but their minds are clear. AL residents certainly know their names, understand why they need AL and appreciate a decent environment.

Cost? $6,000 - $12,000 per month depending on level of care. Those with LTC insurance (Medicaid does not cover AL) thank their lucky stars.
Thank you for your comment. I did not mean to be disrespectful of these patients, and I hope it wasn’t taken that way. I was replying to a post that implied that many residents had no awareness of what was going on around them, and therefore wouldn’t care about the quality of their care.

My 92-year-old mother-in-law is already diagnosed with early dementia, and I fear that my 90-year-old mother will soon receive the same diagnosis. Both would be very aware (and VERY vocal, and rightfully so) if they found themselves placed in a poor setting.

Too many people think that in terms of LTC (including assisted living), you’re fine until you’re not. The reality is that you will probably be completely aware of your settings initially, and probably pretty unhappy to be there, or in any other facility, as is human nature. It’s wise to keep that in mind when looking at your retirement savings, including making the decision to go with LTC. I would probably not be eligible, so it’s off the table for me, and somewhat iffy for my husband.
The continuous execution of a sound strategy gives you the benefit of the strategy. That's what it's all about. --Rick Ferri

littlebird
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Re: Long term care insurance

Post by littlebird » Wed Feb 21, 2018 9:18 pm

westrichj312 wrote:
Wed Feb 21, 2018 9:58 am
Talk to an attorney that specializes in that area. There are trusts that protect assets from the look back, there are trusts for your children that exclude there married spouse so that in case they get divorced the spouse will not be entitled to any of your assets, there are divorce strategies to name just a few perfectly legal ways to protect your assets from the lookback. About 6 weeks ago Barron's had something about this in the back page or too talking about how wealthy people always know how to get free LTC by gaining the system. It was written by some lawyer, I have it saved and will look for it this afternoon to post.
If I were wealthy, I'd prefer to spend my money keeping myself well cared for, with a modicom of privacy, in a very good assisted living home for as long as possible, and then when absolutely necessary going into a very good nursing home that operates at a standard well above the Medicaid reimbursal amount. Why wealthy people would want to impoverish themselves for the purpose of putting themselves in a room shared with a stranger with strange bathroom and TV watching habits and all the other horrors attendant on Medicaid Nursing Homes is beyond my understanding.

I speak as someone who is not wealthy, but who is managing to pay for a very comfortable situation for her spouse in an alternative to a nursing home, which does not take Medicaid. And I did this after looking at the most highly rated Nursing Homes in my area that accepted Medicaid, as well as self-pay patients. There is no way I would have subjected my beloved spouse to those conditions. I seriously doubt that any wealthy people with loving spouses or children are there.

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Wed Feb 21, 2018 10:01 pm

littlebird wrote:
Wed Feb 21, 2018 9:18 pm
westrichj312 wrote:
Wed Feb 21, 2018 9:58 am
Talk to an attorney that specializes in that area. There are trusts that protect assets from the look back, there are trusts for your children that exclude there married spouse so that in case they get divorced the spouse will not be entitled to any of your assets, there are divorce strategies to name just a few perfectly legal ways to protect your assets from the lookback. About 6 weeks ago Barron's had something about this in the back page or too talking about how wealthy people always know how to get free LTC by gaining the system. It was written by some lawyer, I have it saved and will look for it this afternoon to post.
If I were wealthy, I'd prefer to spend my money keeping myself well cared for, with a modicom of privacy, in a very good assisted living home for as long as possible, and then when absolutely necessary going into a very good nursing home that operates at a standard well above the Medicaid reimbursal amount. Why wealthy people would want to impoverish themselves for the purpose of putting themselves in a room shared with a stranger with strange bathroom and TV watching habits and all the other horrors attendant on Medicaid Nursing Homes is beyond my understanding.

I speak as someone who is not wealthy, but who is managing to pay for a very comfortable situation for her spouse in an alternative to a nursing home, which does not take Medicaid. And I did this after looking at the most highly rated Nursing Homes in my area that accepted Medicaid, as well as self-pay patients. There is no way I would have subjected my beloved spouse to those conditions. I seriously doubt that any wealthy people with loving spouses or children are there.
Kudos to you, littlebird.
Your spouse is very fortunate to have married you.

Hubris
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Re: Long term care insurance

Post by Hubris » Wed Feb 21, 2018 11:54 pm

losangchodren wrote:
Mon Feb 19, 2018 4:56 pm
I have just become a "Boglehead" and am interested in getting some information on best long term care insurance that would be available in the state of Pennsylvania. I greatly appreciate any advice. My father's old policy is a dream come true and I know those types of policies don't exist any more, but am interested in securing a plan. Thank you! :happy
OP, you don’t seem to have chimed in recently, but no worries. I encourage you to use the search function to see other/older threads as there are some other good discussion threads.

westrichj312
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Re: Long term care insurance

Post by westrichj312 » Thu Feb 22, 2018 9:15 am

The short article in barrons was in the mailbag section of 7/3/2017 edition, you can find it in your local library. I guess its a choice as I said earlier I have worked my whole life to enjoy myself and leave all I can to my children not a fancy nursing home.

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Thu Feb 22, 2018 9:21 am

westrichj312 wrote:
Thu Feb 22, 2018 9:15 am
The short article in barrons was in the mailbag section of 7/3/2017 edition, you can find it in your local library. I guess its a choice as I said earlier I have worked my whole life to enjoy myself and leave all I can to my children not a fancy nursing home.
That's exactly why people own long term care insurance.

FBN2014
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Re: Long term care insurance

Post by FBN2014 » Thu Feb 22, 2018 9:54 am

westrichj312 wrote:
Thu Feb 22, 2018 9:15 am
The short article in barrons was in the mailbag section of 7/3/2017 edition, you can find it in your local library. I guess its a choice as I said earlier I have worked my whole life to enjoy myself and leave all I can to my children not a fancy nursing home.
Here is the article, page 31

https://psv4.userapi.com/c812323/u50977 ... I2YTTrGtm8
"October is one of the peculiarly dangerous months to speculate in stocks. The others are July, January, September, April, November, May March, June, December, August and February." - M. Twain

JoeRetire
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Re: Long term care insurance

Post by JoeRetire » Thu Feb 22, 2018 10:21 am

westrichj312 wrote:
Thu Feb 22, 2018 9:15 am
The short article in barrons was in the mailbag section of 7/3/2017 edition, you can find it in your local library. I guess its a choice as I said earlier I have worked my whole life to enjoy myself and leave all I can to my children not a fancy nursing home.
Everyone is entitled to follow their own plan.

Your plan is to become poor and live in a less-than-fancy nursing home funded by taxpayers when the time comes. And you assume that you won't know the difference. And you are doing this in order to leave more to your children. Current laws allow this. Have you discussed this with your children?

I told my parents that I didn't want them to leave anything to us if it impacted their life negatively. It is their hard earned money to spend however they choose. They chose to purchase Long Term Care Insurance. My wife and I have done the same.

My Mom passed away a few weeks ago at home, with her family around her. She was lucky, and went the way she wanted to. It was very hard on my Dad, but she never had to live away from home. I'm hoping when my Dad's time comes, he goes whatever way he wants, too.

Good luck with your plan. I sincerely hope it works out the way you choose. It's not what I'd advise for most folks, and certainly not my plan. But it is your plan, and you are entitled to your own.

pshonore
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Re: Long term care insurance

Post by pshonore » Thu Feb 22, 2018 10:30 am

Going the Medicaid route is fine if that's your choice. However, if you have a spouse, that may impoverish them as well. It all depends on the Medicaid rules in your state. An LTC partnership policy policy can lessen that.

JoeRetire
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Re: Long term care insurance

Post by JoeRetire » Thu Feb 22, 2018 10:36 am

Here's some general LTCi advice from Edelman Financial. They revised their recommendations a few years ago.
Remember, everyone's specific situation is different. But this article gives you a few things to consider, and the thinking behind those considerations:

https://www.edelmanfinancial.com/educat ... -insurance

Also note that you can use your HSA to pay for LTCi premiums.

pshonore
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Re: Long term care insurance

Post by pshonore » Thu Feb 22, 2018 11:00 am

JoeRetire wrote:
Thu Feb 22, 2018 10:36 am
Here's some general LTCi advice from Edelman Financial. They revised their recommendations a few years ago.
Remember, everyone's specific situation is different. But this article gives you a few things to consider, and the thinking behind those considerations:

https://www.edelmanfinancial.com/educat ... -insurance

Also note that you can use your HSA to pay for LTCi premiums.
This statement from the article stuck out: LTC costs are not tax-deductible, and they are not covered by health insurance or Medicare.
LTC costs certainly are tax deductible (as long as you itemize). Not sure I'd trust that article. I'd also debate the statement that partnership policies are more expensive. The insurance company is paying the same amount regardless.

Jon H
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Re: Long term care insurance

Post by Jon H » Thu Feb 22, 2018 11:11 am

FBN2014 wrote:
Tue Feb 20, 2018 11:18 am
westrichj312 wrote:
Tue Feb 20, 2018 9:27 am
LTC policies are one of the biggest sucker purchases out there. There are other legal ways to get around i. Find a good estate/asset protection attorney and protect yourself with a trust and you will get LTC free in almost any state.
There is a 5 year look back to transfer assets for Medicaid eligibility. Is that what you are referring to?
I agree with Westrichj at least in the case of disability. Be aware that "free" doesn't exactly cover all financial needs for care services but it does provide for the assessed level of care (not 24/7 at this point, but it might eventually). We had to demonstrate impoverishment with a 5 year look back. This is a non-trivial task for people with assets. Hence the need for qualified and experienced legal representation.
Consider gain and loss, but never be greedy and everything will be alright (fortune cookie)

Jon H
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Re: Long term care insurance

Post by Jon H » Thu Feb 22, 2018 11:13 am

pintail07 wrote:
Wed Feb 21, 2018 5:59 pm
westrichj312 wrote:
Tue Feb 20, 2018 9:27 am
LTC policies are one of the biggest sucker purchases out there. There are other legal ways to get around i. Find a good estate/asset protection attorney and protect yourself with a trust and you will get LTC free in almost any state.
You must be joking? So your plan is to go Medicaid for your care. No home care option, limited AL options, inferior Nursing Home care compared to all private pay. You are really just pulling our leg aren't you? That is the biggest sucker plan ever.
Home care can be arranged.
Consider gain and loss, but never be greedy and everything will be alright (fortune cookie)

WoW2012
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Re: Long term care insurance

Post by WoW2012 » Thu Feb 22, 2018 11:21 am

Jon H wrote:
Thu Feb 22, 2018 11:13 am
pintail07 wrote:
Wed Feb 21, 2018 5:59 pm
westrichj312 wrote:
Tue Feb 20, 2018 9:27 am
LTC policies are one of the biggest sucker purchases out there. There are other legal ways to get around i. Find a good estate/asset protection attorney and protect yourself with a trust and you will get LTC free in almost any state.
You must be joking? So your plan is to go Medicaid for your care. No home care option, limited AL options, inferior Nursing Home care compared to all private pay. You are really just pulling our leg aren't you? That is the biggest sucker plan ever.
Home care can be arranged.


Anyone who thinks Medicaid long-term care choices will stay the same over the next 20+ years is in la-la land.
The choices will worsen.
It doesn't matter what your plan might be today, you can't guarantee Medicaid will have the same rules when you need it.

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munemaker
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Re: Long term care insurance

Post by munemaker » Thu Feb 22, 2018 11:37 am

pshonore wrote:
Thu Feb 22, 2018 10:30 am
Going the Medicaid route is fine if that's your choice. However, if you have a spouse, that may impoverish them as well. It all depends on the Medicaid rules in your state. An LTC partnership policy policy can lessen that.
No expert here, but the Medicaid homes I have seen are not very nice. If you pay out of pocket, you can stay in a nice, comfortable place. Why anyone would want to stay in a home that Medicaid pays for is beyond me. Especially people on this forum who are generally pretty affluent.

Jon H
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Re: Long term care insurance

Post by Jon H » Thu Feb 22, 2018 12:51 pm

WoW2012 wrote:
Thu Feb 22, 2018 11:21 am
Jon H wrote:
Thu Feb 22, 2018 11:13 am
pintail07 wrote:
Wed Feb 21, 2018 5:59 pm
westrichj312 wrote:
Tue Feb 20, 2018 9:27 am
LTC policies are one of the biggest sucker purchases out there. There are other legal ways to get around i. Find a good estate/asset protection attorney and protect yourself with a trust and you will get LTC free in almost any state.
You must be joking? So your plan is to go Medicaid for your care. No home care option, limited AL options, inferior Nursing Home care compared to all private pay. You are really just pulling our leg aren't you? That is the biggest sucker plan ever.
Home care can be arranged.


Anyone who thinks Medicaid long-term care choices will stay the same over the next 20+ years is in la-la land.
The choices will worsen.
It doesn't matter what your plan might be today, you can't guarantee Medicaid will have the same rules when you need it.
Sorry, my bad. Should have clarified "In-home care can be arranged."

In-home care isn't the solution for everybody, but it has become a bigger piece of the elder and disability care spectrum and will continue to grow with the aging population.
Consider gain and loss, but never be greedy and everything will be alright (fortune cookie)

WoW2012
Posts: 312
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Re: Long term care insurance

Post by WoW2012 » Thu Feb 22, 2018 12:53 pm

Jon H wrote:
Thu Feb 22, 2018 12:51 pm
WoW2012 wrote:
Thu Feb 22, 2018 11:21 am

Anyone who thinks Medicaid long-term care choices will stay the same over the next 20+ years is in la-la land.
The choices will worsen.
It doesn't matter what your plan might be today, you can't guarantee Medicaid will have the same rules when you need it.
Sorry, my bad. Should have clarified "In-home care can be arranged."

In-home care isn't the solution for everybody, but it has become a bigger piece of the elder and disability care spectrum and will continue to grow with the aging population.

Most in-home caregivers do NOT accept Medicaid.

Jon H
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Re: Long term care insurance

Post by Jon H » Thu Feb 22, 2018 12:58 pm

WoW2012 wrote:
Thu Feb 22, 2018 12:53 pm
Jon H wrote:
Thu Feb 22, 2018 12:51 pm
WoW2012 wrote:
Thu Feb 22, 2018 11:21 am

Anyone who thinks Medicaid long-term care choices will stay the same over the next 20+ years is in la-la land.
The choices will worsen.
It doesn't matter what your plan might be today, you can't guarantee Medicaid will have the same rules when you need it.
Sorry, my bad. Should have clarified "In-home care can be arranged."

In-home care isn't the solution for everybody, but it has become a bigger piece of the elder and disability care spectrum and will continue to grow with the aging population.

Most in-home caregivers do NOT accept Medicaid.
Again, it can be arranged. At this moment, I don't remember the details. I'll find out what we did exactly and post it.

Finding good and consistent caregivers has been a challenge and is a unending struggle.

(maybe we should start a new thread on in home care services so the conversation can continue about LTC)
Consider gain and loss, but never be greedy and everything will be alright (fortune cookie)

westrichj312
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Re: Long term care insurance

Post by westrichj312 » Thu Feb 22, 2018 2:06 pm

Some of you act like the medicaid facilities are pure garbage and thats just not true they have rules and regulations they follow just like the others. Also about 90% of the elderly are in these type's of nursing homes. How many people do you think can afford 100K per year for their care in this country.

carruthers209
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Re: Long term care insurance

Post by carruthers209 » Thu Feb 22, 2018 2:07 pm

www.nytimes.com/2018/02/22/business/nur ... v=top-news

The New York Times published this article which highlights how desperate many skilled nursing facilities and actually hospitals have become and are removing their Medicaid patients. Even if your family member is not on Medicaid and paying full fare they might be removed. When I visited some skilled nursing facilities that was a question I asked. I was told that if the patient becomes a danger to themselves or others (think Alzheimer's), or if the patient ends up needing care that the facility is not licensed to deliver, the patient will have to be moved. Now, I was also told that if the patient comes in at an early enough stage, they can usually be accommodated.

My dad needed 24/7 caregivers for his dementia. We were able to keep him at home. We paid about $12,000 a month plus all the extra expenses of an "employee" which means social security match, overtime, disability, unemployment and add in worker's compensation. Had we used an agency it would have been $18,000 a month. And yes, it was income tax deductible. I think there was a 10% floor and above that we were able to deduct these costs. We paid $120,000 for a year of in-home 24/7 caregiving.

Long term care insurance has been such a blessing for our nuclear family. My husband has Parkinson's and was working for AT&T. John Hancock offered long term care insurance as a group policy. We jumped on it. No medical exam was required-this was about 15 years ago. Originally it was a $200,000 lifetime benefit. We have opted for every inflation adjustment offered. It is now a $500,000 life time option. I cannot tell you what a relief it is to know that when the time comes, I can activate this policy and hire the caregivers for our home and when we can no longer take care of him at home, we can move him to a really nice, really lovely skilled nursing facility. I will pay the difference between the daily rate coverage in our policy and what it actually costs. Thank you Littlebird for illustrating how to really honor and love our family members by making what will be the end-of-their-journey the best that you can. We will not get do-overs and regrets will last the rest of our lifetimes.

FBN2014
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Re: Long term care insurance

Post by FBN2014 » Thu Feb 22, 2018 2:39 pm

JoeRetire wrote:
Thu Feb 22, 2018 10:36 am
Here's some general LTCi advice from Edelman Financial. They revised their recommendations a few years ago.
Remember, everyone's specific situation is different. But this article gives you a few things to consider, and the thinking behind those considerations:

https://www.edelmanfinancial.com/educat ... -insurance

Also note that you can use your HSA to pay for LTCi premiums.
In the same article Edelman makes this statement: "And we believe advances in exponential technologies — including medical innovations in science, neuroscience, physiology and psychology — will eliminate the need for long-term care by 2030."

Not sure what crystal ball he is looking into but this statement on its face is ridiculous. Edelman doesn't want you to buy LTCi so you can keep it in your portfolio for him to manage. His AUM fee is close to 2%. But he is a great marketer.
"October is one of the peculiarly dangerous months to speculate in stocks. The others are July, January, September, April, November, May March, June, December, August and February." - M. Twain

WoW2012
Posts: 312
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Re: Long term care insurance

Post by WoW2012 » Thu Feb 22, 2018 2:50 pm

FBN2014 wrote:
Thu Feb 22, 2018 2:39 pm
JoeRetire wrote:
Thu Feb 22, 2018 10:36 am
Here's some general LTCi advice from Edelman Financial. They revised their recommendations a few years ago.
Remember, everyone's specific situation is different. But this article gives you a few things to consider, and the thinking behind those considerations:

https://www.edelmanfinancial.com/educat ... -insurance

Also note that you can use your HSA to pay for LTCi premiums.
In the same article Edelman makes this statement: "And we believe advances in exponential technologies — including medical innovations in science, neuroscience, physiology and psychology — will eliminate the need for long-term care by 2030."

Not sure what crystal ball he is looking into but this statement on its face is ridiculous. Edelman doesn't want you to buy LTCi so you can keep it in your portfolio for him to manage. His AUM fee is close to 2%. But he is a great marketer.

OMG. I missed that the first time I breezed through the article.
Can Mr. Edelman spell C-O-G-N-I-T-I-V-E D-I-S-S-O-N-A-N-C-E ????????

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munemaker
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Re: Long term care insurance

Post by munemaker » Thu Feb 22, 2018 3:15 pm

westrichj312 wrote:
Thu Feb 22, 2018 2:06 pm
How many people do you think can afford 100K per year for their care in this country.
Most of the ones on this forum.

littlebird
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Re: Long term care insurance

Post by littlebird » Thu Feb 22, 2018 3:24 pm

pshonore wrote:
Thu Feb 22, 2018 10:30 am
Going the Medicaid route is fine if that's your choice. However, if you have a spouse, that may impoverish them as well. It all depends on the Medicaid rules in your state. An LTC partnership policy policy can lessen that.
The poster you are addressing believes he can "game the system" like all the "wealthy people" do, so I'm sure he has a plan to avoid that dire consequence. :wink:

visualguy
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Re: Long term care insurance

Post by visualguy » Thu Feb 22, 2018 3:45 pm

munemaker wrote:
Thu Feb 22, 2018 3:15 pm
westrichj312 wrote:
Thu Feb 22, 2018 2:06 pm
How many people do you think can afford 100K per year for their care in this country.
Most of the ones on this forum.
Right, but it is interesting to note how much of an exception people on this forum are.

85% of Americans have less than $10K saved for retirement, and the median savings for families whose wage earners are between the ages of 56 and 61 is $17K. Most people are in an abysmal financial situation. Reading these statistics is shocking, actually.

The fact that most don't have meaningful retirement savings, and most would need to rely on Medicaid doesn't mean that it's ok to end up in their shoes, or that it isn't so bad to be in that situation. The fact that so many are in a horrible situation doesn't make it any better, or any less desirable to avoid ending up there.

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munemaker
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Re: Long term care insurance

Post by munemaker » Thu Feb 22, 2018 7:28 pm

visualguy wrote:
Thu Feb 22, 2018 3:45 pm
...the median savings for families whose wage earners are between the ages of 56 and 61 is $17K. Most people are in an abysmal financial situation.
Yet the most frequent age for claiming social security is age 62: 42% of men, 48% of women. So go figure.

Diogenes
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Re: Long term care insurance

Post by Diogenes » Fri Feb 23, 2018 11:33 am

Still scratching my head about these LTCI policies. It was suggested that one of the best available now are group policies, such as what is available to Federal employees or former workers. Makes sense as a measuring stick. Most private plans are likely not as good.
Just took a look at that website (https://www.ltcfeds.com) to see how it would shake out, and the costs/benefits look like this:

Example (60-year-old): $200/day max benefit, 90-day waiting period, inflation protection ACI - 5%, lifetime max $219K
Yearly premium $3294.

Assuming a claim at age 80, the person would have paid in $66K. With the 90-day waiting period, claiming the max per day, the first year the policy would pay $54K, the second and full year $72K, in today's dollars. Per Forbes, the average stay is 2.2 years for a man. That means the benefit used on average would be maybe $140K, if you need it at all. Deducting the premium paid of $66K means that on average you would be ahead less than $74K. If you are lucky not to need it, you are out 100 percent of the $66K. I know, I know - it's insurance.

What's the benefit to buying peace of mind this way versus setting aside $200K now? I don't see it. If you don't have the money, you likely won't be able to swing the premium reliably for 20 years either, even IF it never increases (which it will).

I know there are a couple of folks posting here who sell this kind of insurance and would argue differently, but the current state of LTC seems heavily slanted toward self-insure. Only talking about whats for sale now. Naturally, there will be few anecdotal cases out there from someone who got a stellar plan and paid little for it years ago. But that's not the state of the market now. I suspect many others ultimately canceled such policies anyway due to premium hikes.

Missing something?

(updated to select a 3-year max payout)
Last edited by Diogenes on Fri Feb 23, 2018 1:20 pm, edited 1 time in total.

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