Long term care insurance policy

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DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 1:16 pm

GeoffD wrote:
Mon Jan 14, 2019 1:12 pm
neilpilot wrote:
Mon Jan 14, 2019 12:44 pm
When you say "Most men who land in nursing homes die before their Medicare coverage runs out." I have 2 questions:
[1] when does someone's Medicare coverage "run out"?
[2] What does Medicare coverage have to do with your nursing home expenses?
[1] Medicare pays 100 days of nursing home coverage. You're normally required to be hospitalized for 3 days to be eligible.
[2] Medicare pays the first 100 days in a nursing home after hospitalization. For males, your odds of being in a nursing home for more than 6 months are really low.

I'm kind of amazed that anyone financial planning long term care wouldn't know all of this. There's a huge gender bias with long term care. An LTC policy is a much better bet for a woman than a man. You simply don't see many men in assisted living, memory care, and nursing homes. They tend to die off fairly quickly.
Exactly, people should read the Medicare book. I read my husband from cover to cover.

ncbill
Posts: 563
Joined: Sun Jul 06, 2008 4:03 pm
Location: Western NC

Re: Long term care insurance policy

Post by ncbill » Mon Jan 14, 2019 1:19 pm

GeoffD wrote:
Mon Jan 14, 2019 1:12 pm
neilpilot wrote:
Mon Jan 14, 2019 12:44 pm
When you say "Most men who land in nursing homes die before their Medicare coverage runs out." I have 2 questions:
[1] when does someone's Medicare coverage "run out"?
[2] What does Medicare coverage have to do with your nursing home expenses?
[1] Medicare pays 100 days of nursing home coverage. You're normally required to be hospitalized for 3 days to be eligible.
[2] Medicare pays the first 100 days in a nursing home after hospitalization. For males, your odds of being in a nursing home for more than 6 months are really low.

I'm kind of amazed that anyone financial planning long term care wouldn't know all of this. There's a huge gender bias with long term care. An LTC policy is a much better bet for a woman than a man. You simply don't see many men in assisted living, memory care, and nursing homes. They tend to die off fairly quickly.
For rehabilitation purposes... if you're not making progress in your rehab you'll be booted off Medicare's dime, with very limited rights of appeal.

I just went through this for the relative mentioned in my other post, who IIRC got all of 14 days paid for by Medicare...after that the custodial side of the nursing home cost ~$7,500/month for a semi-private room (before I moved them to a private room in an assisted living facility @ half that price)

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 1:25 pm

ncbill wrote:
Mon Jan 14, 2019 1:14 pm
Forget nursing homes...you'll most likely to both get your LTC (& die) at home or an assisted living facility.

And both are a lot more pleasant environment than any nursing home.

I just finished taking care of a close relative who died last week following a terminal cancer diagnosis last fall.

Following a hospitalization, they loved the Medicare rehab hall of a cross-town nursing home...but hated it once they moved over to a semi-private room on the custodial side, even after enrolling in Hospice.

So I moved them to a private room in an assisted living 5 minutes from me.

Which proved a much more "home-y" environment, at half the price even given the level of care needed (bed-bound, so bathing/dressing, could still feed themselves)

I'll probably buy LTCi insurance for the assistance for which it pays, rather than place all the caregiving burden on my spouse or children, who usually become the default caregivers.

Yes, you say you'll simply pay out of pocket...but when push comes to shove the temptation is to save the money & do the care themselves instead, often with significantly negative results (e.g. injuries, loss of job/career consequences)
I’ve given my kids clear directive to manage my money only, use the money to get help. No physically care for me. My mom died in a hospice care in less than 3 months.

Another reason not to buy LTCi if you want to live at home, you may not be able to get LTCi to pay even if you lose 2 functions as they state, I read many cases on this, plus WOW has confirmed that you should ask nursing home facility to file for claims, that means the option to die at home is not likely.

Actually, I do know of a person related to our families, had both dementia and Parkinson’s, but not Lewd disease, his daughter told us that, she’s in the medical related professsion. They paid for private care at home less than $5000 per month, this was 2012 time frame, less than 5 years. Her mom didn’t have the health to take care of her dad, just managed the money.

Also most of the cost of LTCi is in real estate, especially if you live in HCOL.
Last edited by DrGoogle2017 on Mon Jan 14, 2019 1:29 pm, edited 6 times in total.

GeoffD
Posts: 89
Joined: Tue Mar 20, 2018 1:31 pm

Re: Long term care insurance policy

Post by GeoffD » Mon Jan 14, 2019 1:26 pm

ncbill wrote:
Mon Jan 14, 2019 1:19 pm

For rehabilitation purposes... if you're not making progress in your rehab you'll be booted off Medicare's dime, with very limited rights of appeal.

I just went through this for the relative mentioned in my other post, who IIRC got all of 14 days paid for by Medicare...after that the custodial side of the nursing home cost ~$7,500/month for a semi-private room (before I moved them to a private room in an assisted living facility @ half that price)
So someone massively screwed up the clinical documentation. If you code it properly, Medicare doesn't boot people off.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 1:26 pm

GeoffD wrote:
Mon Jan 14, 2019 1:12 pm
neilpilot wrote:
Mon Jan 14, 2019 12:44 pm
When you say "Most men who land in nursing homes die before their Medicare coverage runs out." I have 2 questions:
[1] when does someone's Medicare coverage "run out"?
[2] What does Medicare coverage have to do with your nursing home expenses?
[1] Medicare pays 100 days of nursing home coverage. You're normally required to be hospitalized for 3 days to be eligible.
[2] Medicare pays the first 100 days in a nursing home after hospitalization. For males, your odds of being in a nursing home for more than 6 months are really low.

I'm kind of amazed that anyone financial planning long term care wouldn't know all of this. There's a huge gender bias with long term care. An LTC policy is a much better bet for a woman than a man. You simply don't see many men in assisted living, memory care, and nursing homes. They tend to die off fairly quickly.

Since 80% of people receiving long-term care receive that care at home, you're looking in the wrong place.
Most men receive their care at home.
It's provided by their wife or daughter.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 1:28 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 1:13 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:59 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 12:55 pm
WoW2012 wrote:
Mon Jan 14, 2019 10:32 am
DrGoogle2017 wrote:
Mon Jan 14, 2019 2:27 am


That’s not how I see it. It means we don’t really need LTCi. In fact the super rich will be better of with buying life insurance. You’re guaranteed to be dead, however you’re not guaranteed to be needing a LTC.

I don't own medical insurance because the average doctor visit is $200.
I own medical insurance for the catastrophic medical expense.
I don't own long-term care insurance because of the average cost of care.
I own it to protect against the catastrophic long-term care loss.
I’m not surprised by your comment. You sell LTCi. Enough from me on this thread.
I do sell LTCi, but that does not mean my logic is flawed.
It means you comments will be biased because you tend to profit from it.

Then it should be very easy to refute my logic.

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 1:32 pm

WoW2012 wrote:
Mon Jan 14, 2019 1:28 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 1:13 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:59 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 12:55 pm
WoW2012 wrote:
Mon Jan 14, 2019 10:32 am



I don't own medical insurance because the average doctor visit is $200.
I own medical insurance for the catastrophic medical expense.
I don't own long-term care insurance because of the average cost of care.
I own it to protect against the catastrophic long-term care loss.
I’m not surprised by your comment. You sell LTCi. Enough from me on this thread.
I do sell LTCi, but that does not mean my logic is flawed.
It means you comments will be biased because you tend to profit from it.

Then it should be very easy to refute my logic.
It’s hard for people to know ahead, especially when you claim these new policies are different now. We don’t have statistics about them, most people have to wait another 20 years in order to know for real about these plans. That’s what you sell, the new and improved LTCi.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 1:34 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 1:25 pm
ncbill wrote:
Mon Jan 14, 2019 1:14 pm
Forget nursing homes...you'll most likely to both get your LTC (& die) at home or an assisted living facility.

And both are a lot more pleasant environment than any nursing home.

I just finished taking care of a close relative who died last week following a terminal cancer diagnosis last fall.

Following a hospitalization, they loved the Medicare rehab hall of a cross-town nursing home...but hated it once they moved over to a semi-private room on the custodial side, even after enrolling in Hospice.

So I moved them to a private room in an assisted living 5 minutes from me.

Which proved a much more "home-y" environment, at half the price even given the level of care needed (bed-bound, so bathing/dressing, could still feed themselves)

I'll probably buy LTCi insurance for the assistance for which it pays, rather than place all the caregiving burden on my spouse or children, who usually become the default caregivers.

Yes, you say you'll simply pay out of pocket...but when push comes to shove the temptation is to save the money & do the care themselves instead, often with significantly negative results (e.g. injuries, loss of job/career consequences)


Another reason not to buy LTCi if you want to live at home, you may not be able to get LTCi to pay even if you lose 2 functions as they state, I read many cases on this, plus WOW has confirmed that you should ask nursing home facility to file for claims, that means the option to die at home is not likely.

I did NOT say that.
We had a home care agency file my MIL's claim for us.
It was approved in less than 3 weeks.
All we had to do was give the policy to the owner of the agency and sign two HIPAA forms.
Two out of every three long-term care insurance claims start and/or end at home.

neilpilot
Posts: 2721
Joined: Fri Dec 04, 2015 1:46 pm
Location: Memphis area

Re: Long term care insurance policy

Post by neilpilot » Mon Jan 14, 2019 1:52 pm

GeoffD wrote:
Mon Jan 14, 2019 1:12 pm
neilpilot wrote:
Mon Jan 14, 2019 12:44 pm
When you say "Most men who land in nursing homes die before their Medicare coverage runs out." I have 2 questions:
[1] when does someone's Medicare coverage "run out"?
[2] What does Medicare coverage have to do with your nursing home expenses?
[1] Medicare pays 100 days of nursing home coverage. You're normally required to be hospitalized for 3 days to be eligible.
[2] Medicare pays the first 100 days in a nursing home after hospitalization. For males, your odds of being in a nursing home for more than 6 months are really low.

I'm kind of amazed that anyone financial planning long term care wouldn't know all of this. There's a huge gender bias with long term care. An LTC policy is a much better bet for a woman than a man. You simply don't see many men in assisted living, memory care, and nursing homes. They tend to die off fairly quickly.
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D

GeoffD
Posts: 89
Joined: Tue Mar 20, 2018 1:31 pm

Re: Long term care insurance policy

Post by GeoffD » Mon Jan 14, 2019 3:11 pm

neilpilot wrote:
Mon Jan 14, 2019 1:52 pm
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D
My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

[OT comments removed by admin LadyGeek]

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 3:25 pm

GeoffD wrote:
Mon Jan 14, 2019 3:11 pm
neilpilot wrote:
Mon Jan 14, 2019 1:52 pm
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D
My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

[OT comments removed by admin LadyGeek]

80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 3:27 pm

WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm
GeoffD wrote:
Mon Jan 14, 2019 3:11 pm
neilpilot wrote:
Mon Jan 14, 2019 1:52 pm
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D
My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

[OT comments removed by admin LadyGeek]

80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 3:31 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm
GeoffD wrote:
Mon Jan 14, 2019 3:11 pm
neilpilot wrote:
Mon Jan 14, 2019 1:52 pm
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D
My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

[OT comments removed by admin LadyGeek]

80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow

User avatar
willthrill81
Posts: 13192
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Long term care insurance policy

Post by willthrill81 » Mon Jan 14, 2019 3:42 pm

WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm
GeoffD wrote:
Mon Jan 14, 2019 3:11 pm
neilpilot wrote:
Mon Jan 14, 2019 1:52 pm
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D
My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

[OT comments removed by admin LadyGeek]

80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 3:48 pm

WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm
GeoffD wrote:
Mon Jan 14, 2019 3:11 pm
neilpilot wrote:
Mon Jan 14, 2019 1:52 pm
Well I'm familiar with the 100 day Medicare limit. I made a poor assumption that this discussion was about "assisted living" and "long term nursing home" situations that went beyond the initial 100 day stay. My bad.

While the ratio of men to women in "assisted living" is about 1:7, the ratio in "nursing homes" maybe more like 1:2, at least when I look at this 2014 data.
https://www.kff.org/other/state-indicat ... 2asc%22%7D
My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

[OT comments removed by admin LadyGeek]

80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
It just says 80% receive care at home, but where does it say the wives and daughters provide the care. I didn’t see it. They may supervise the care, but not providing care. Don’t forget a lot of women are much smaller than men in general.

User avatar
ThereAreNoGurus
Posts: 324
Joined: Fri Jan 24, 2014 11:41 pm

Re: Long term care insurance policy

Post by ThereAreNoGurus » Mon Jan 14, 2019 3:48 pm

adamthesmythe wrote:
Mon Jan 14, 2019 12:58 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:49 pm
GeoffD wrote:
Mon Jan 14, 2019 12:35 pm
WoW2012 wrote:
Mon Jan 14, 2019 10:32 am

I don't own medical insurance because the average doctor visit is $200.
I own medical insurance for the catastrophic medical expense.
I don't own long-term care insurance because of the average cost of care.
I own it to protect against the catastrophic long-term care loss.
If I have a catastrophic medical expense, it can easily rack up hundreds of thousands of dollars. So you're saying you sell long term care insurance that doesn't have a yearly and lifetime cap?

My mom is in memory care to the tune of $9K per month, which reminds me, I have to write a $9,022 check today. If she's there for 20 years, is your long term care policy going to pay the whole thing?

My mother is private pay in a gold-plated CCRC memory care building. If she declines to the point where she needs skilled nursing, they wheel her across the driveway to the skilled nursing facility part of the complex. If she runs out of money, they will convert her to Medicaid. It will require a few financial/legal gyrations because her income between pensions & annuities is too high to qualify for Medicaid but that can be done if the time comes. Skilled nursing selection is awful if you have no money. You're double occupancy in some disaster of a facility that takes Medicaid patients. There are lots of very nice places that will take you private pay if you have the resources to go a few years. They're willing to take the bet that you won't outlive your assets to convert to Medicaid and if you do, it won't be for very long.

Having been in and out of assisted living places and, more recently, memory care facilities for quite a few years, I'm very aware that there are almost no men in those places. The data backs that observation pretty well. Most men who land in nursing homes die before their Medicare coverage runs out. Male, I think long term care insurance is a poor bet. The cash from sale of my house and my projected income would easily fund me for many years even if I otherwise run out of money. I've been writing the checks so I'm familiar with the math.

There are 4 companies that sell LTCi policies with no lifetime cap.
There are several companies that allow couples to share 15+ years of benefits.
There are several companies, in 45 states, that sell Long-Term Care Partnership policies which can protect your assets from Medicaid even if the policy runs out of benefits.
WoW2012 has made these statements multiple times before. I, for one, would appreciate an EXAMPLE of what one could get for a policy and what it would cost. This needs substantially more detail than "20 basis points."

I am in the situation where I SUSPECT a policy to deal with my personal situation is either unavailable or unreasonably expensive. I am unwilling to subject myself to extended discussions with an agent unless I feel that it is likely they will be productive. Just as when buying cars and new houses, insurance can have a "basic" plan that appears to be attractive but may look very different when options (riders) are attached.

By the way, there is no reason why specific companies cannot be mentioned. Many times people have recommended (or recommended against) suppliers for products as diverse as 9 mm weapons and car insurance.
I too would appreciate an example(s). This request has been made before, on other threads, and to my knowledge no examples have been forthcoming.
Trade the news and you will lose.

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 3:50 pm

willthrill81 wrote:
Mon Jan 14, 2019 3:42 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm
GeoffD wrote:
Mon Jan 14, 2019 3:11 pm


My point is really the length of stay in nursing homes for men. It's very common that a male will die before the 100 day Medicare limit is used up. Men have a median length of stay of 3 months. Women are more like 8 months.

In my view, LTC policies aren't a great bet for affluent men. They make a lot more sense for women.

I also think that your zip code has a lot to do with this. I'm in the bluest of blue states. The town council on elderly affairs has a senior center a mile from my house. The town funds geriatric social workers and community geriatric nursing through state grant money. There are a plethora of services aimed at the elderly aging in place. In an awful lot of red states, if Medicare isn't paying for it, it's not a service.

80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
Life over is to sell fear. If WOW has said, the wives would be with the cabana boys on a cruise ship having the time of her life, nobody would buy LTC. 😁

User avatar
willthrill81
Posts: 13192
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Long term care insurance policy

Post by willthrill81 » Mon Jan 14, 2019 3:52 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 3:50 pm
willthrill81 wrote:
Mon Jan 14, 2019 3:42 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm



80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
Life over is to sell fear. If WOW has said, the wives would be with the cabana boys on a cruise ship having the time of her life nobody would buy any LTC.
There does seem to be a lot of lauding over the worst-case scenarios, but if we did that for all potential risks that could be insured, we would literally load up on every kind of insurance we could get our hands on. But that's clearly not a wise move. Risk management 101 (yes, I took that course in college) is to insure against financially detrimental risks and self-insure the rest.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

User avatar
willthrill81
Posts: 13192
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Long term care insurance policy

Post by willthrill81 » Mon Jan 14, 2019 3:54 pm

ThereAreNoGurus wrote:
Mon Jan 14, 2019 3:48 pm
adamthesmythe wrote:
Mon Jan 14, 2019 12:58 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:49 pm
GeoffD wrote:
Mon Jan 14, 2019 12:35 pm
WoW2012 wrote:
Mon Jan 14, 2019 10:32 am

I don't own medical insurance because the average doctor visit is $200.
I own medical insurance for the catastrophic medical expense.
I don't own long-term care insurance because of the average cost of care.
I own it to protect against the catastrophic long-term care loss.
If I have a catastrophic medical expense, it can easily rack up hundreds of thousands of dollars. So you're saying you sell long term care insurance that doesn't have a yearly and lifetime cap?

My mom is in memory care to the tune of $9K per month, which reminds me, I have to write a $9,022 check today. If she's there for 20 years, is your long term care policy going to pay the whole thing?

My mother is private pay in a gold-plated CCRC memory care building. If she declines to the point where she needs skilled nursing, they wheel her across the driveway to the skilled nursing facility part of the complex. If she runs out of money, they will convert her to Medicaid. It will require a few financial/legal gyrations because her income between pensions & annuities is too high to qualify for Medicaid but that can be done if the time comes. Skilled nursing selection is awful if you have no money. You're double occupancy in some disaster of a facility that takes Medicaid patients. There are lots of very nice places that will take you private pay if you have the resources to go a few years. They're willing to take the bet that you won't outlive your assets to convert to Medicaid and if you do, it won't be for very long.

Having been in and out of assisted living places and, more recently, memory care facilities for quite a few years, I'm very aware that there are almost no men in those places. The data backs that observation pretty well. Most men who land in nursing homes die before their Medicare coverage runs out. Male, I think long term care insurance is a poor bet. The cash from sale of my house and my projected income would easily fund me for many years even if I otherwise run out of money. I've been writing the checks so I'm familiar with the math.

There are 4 companies that sell LTCi policies with no lifetime cap.
There are several companies that allow couples to share 15+ years of benefits.
There are several companies, in 45 states, that sell Long-Term Care Partnership policies which can protect your assets from Medicaid even if the policy runs out of benefits.
WoW2012 has made these statements multiple times before. I, for one, would appreciate an EXAMPLE of what one could get for a policy and what it would cost. This needs substantially more detail than "20 basis points."

I am in the situation where I SUSPECT a policy to deal with my personal situation is either unavailable or unreasonably expensive. I am unwilling to subject myself to extended discussions with an agent unless I feel that it is likely they will be productive. Just as when buying cars and new houses, insurance can have a "basic" plan that appears to be attractive but may look very different when options (riders) are attached.

By the way, there is no reason why specific companies cannot be mentioned. Many times people have recommended (or recommended against) suppliers for products as diverse as 9 mm weapons and car insurance.
I too would appreciate an example(s). This request has been made before, on other threads, and to my knowledge no examples have been forthcoming.
That '20 basis points for someone with $10 million net worth' works out to $20k annually.
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 3:56 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 3:50 pm
willthrill81 wrote:
Mon Jan 14, 2019 3:42 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:25 pm



80% of the people who need long-term care receive their care at home.
Most men receive their care at home courtesy of an exhausted wife or daughter.
Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
Life over is to sell fear. If WOW has said, the wives would be with the cabana boys on a cruise ship having the time of her life, I’m sure he couldn’t convince nobody anybody to buy LTC.
Maybe it's because I've been a caregiver. I was healthy, in my mid-30's, and it took everything I could to transfer a 5'2, 110lb, 80-year old half-paralyzed man. Being a caregiver for a relative is one of the most stressful things you'll ever experience in life. The situation with my MIL is completely different. All her care is provided by the aides in the ALF, fully paid for by her LTCi policy. We can ENJOY spending time with her, rather than being burdened with the physical care.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 3:57 pm

ThereAreNoGurus wrote:
Mon Jan 14, 2019 3:48 pm
adamthesmythe wrote:
Mon Jan 14, 2019 12:58 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:49 pm
GeoffD wrote:
Mon Jan 14, 2019 12:35 pm
WoW2012 wrote:
Mon Jan 14, 2019 10:32 am

I don't own medical insurance because the average doctor visit is $200.
I own medical insurance for the catastrophic medical expense.
I don't own long-term care insurance because of the average cost of care.
I own it to protect against the catastrophic long-term care loss.
If I have a catastrophic medical expense, it can easily rack up hundreds of thousands of dollars. So you're saying you sell long term care insurance that doesn't have a yearly and lifetime cap?

My mom is in memory care to the tune of $9K per month, which reminds me, I have to write a $9,022 check today. If she's there for 20 years, is your long term care policy going to pay the whole thing?

My mother is private pay in a gold-plated CCRC memory care building. If she declines to the point where she needs skilled nursing, they wheel her across the driveway to the skilled nursing facility part of the complex. If she runs out of money, they will convert her to Medicaid. It will require a few financial/legal gyrations because her income between pensions & annuities is too high to qualify for Medicaid but that can be done if the time comes. Skilled nursing selection is awful if you have no money. You're double occupancy in some disaster of a facility that takes Medicaid patients. There are lots of very nice places that will take you private pay if you have the resources to go a few years. They're willing to take the bet that you won't outlive your assets to convert to Medicaid and if you do, it won't be for very long.

Having been in and out of assisted living places and, more recently, memory care facilities for quite a few years, I'm very aware that there are almost no men in those places. The data backs that observation pretty well. Most men who land in nursing homes die before their Medicare coverage runs out. Male, I think long term care insurance is a poor bet. The cash from sale of my house and my projected income would easily fund me for many years even if I otherwise run out of money. I've been writing the checks so I'm familiar with the math.

There are 4 companies that sell LTCi policies with no lifetime cap.
There are several companies that allow couples to share 15+ years of benefits.
There are several companies, in 45 states, that sell Long-Term Care Partnership policies which can protect your assets from Medicaid even if the policy runs out of benefits.
WoW2012 has made these statements multiple times before. I, for one, would appreciate an EXAMPLE of what one could get for a policy and what it would cost. This needs substantially more detail than "20 basis points."

I am in the situation where I SUSPECT a policy to deal with my personal situation is either unavailable or unreasonably expensive. I am unwilling to subject myself to extended discussions with an agent unless I feel that it is likely they will be productive. Just as when buying cars and new houses, insurance can have a "basic" plan that appears to be attractive but may look very different when options (riders) are attached.

By the way, there is no reason why specific companies cannot be mentioned. Many times people have recommended (or recommended against) suppliers for products as diverse as 9 mm weapons and car insurance.
I too would appreciate an example(s). This request has been made before, on other threads, and to my knowledge no examples have been forthcoming.
An example of what?

neilpilot
Posts: 2721
Joined: Fri Dec 04, 2015 1:46 pm
Location: Memphis area

Re: Long term care insurance policy

Post by neilpilot » Mon Jan 14, 2019 4:00 pm

Well the posts are no too long to copy....but so far as care at home is concerned, much of this is of course covered by my LTC policy. I assume it is for most others.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 4:00 pm

willthrill81 wrote:
Mon Jan 14, 2019 3:54 pm
ThereAreNoGurus wrote:
Mon Jan 14, 2019 3:48 pm
adamthesmythe wrote:
Mon Jan 14, 2019 12:58 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:49 pm
GeoffD wrote:
Mon Jan 14, 2019 12:35 pm


If I have a catastrophic medical expense, it can easily rack up hundreds of thousands of dollars. So you're saying you sell long term care insurance that doesn't have a yearly and lifetime cap?

My mom is in memory care to the tune of $9K per month, which reminds me, I have to write a $9,022 check today. If she's there for 20 years, is your long term care policy going to pay the whole thing?

My mother is private pay in a gold-plated CCRC memory care building. If she declines to the point where she needs skilled nursing, they wheel her across the driveway to the skilled nursing facility part of the complex. If she runs out of money, they will convert her to Medicaid. It will require a few financial/legal gyrations because her income between pensions & annuities is too high to qualify for Medicaid but that can be done if the time comes. Skilled nursing selection is awful if you have no money. You're double occupancy in some disaster of a facility that takes Medicaid patients. There are lots of very nice places that will take you private pay if you have the resources to go a few years. They're willing to take the bet that you won't outlive your assets to convert to Medicaid and if you do, it won't be for very long.

Having been in and out of assisted living places and, more recently, memory care facilities for quite a few years, I'm very aware that there are almost no men in those places. The data backs that observation pretty well. Most men who land in nursing homes die before their Medicare coverage runs out. Male, I think long term care insurance is a poor bet. The cash from sale of my house and my projected income would easily fund me for many years even if I otherwise run out of money. I've been writing the checks so I'm familiar with the math.

There are 4 companies that sell LTCi policies with no lifetime cap.
There are several companies that allow couples to share 15+ years of benefits.
There are several companies, in 45 states, that sell Long-Term Care Partnership policies which can protect your assets from Medicaid even if the policy runs out of benefits.
WoW2012 has made these statements multiple times before. I, for one, would appreciate an EXAMPLE of what one could get for a policy and what it would cost. This needs substantially more detail than "20 basis points."

I am in the situation where I SUSPECT a policy to deal with my personal situation is either unavailable or unreasonably expensive. I am unwilling to subject myself to extended discussions with an agent unless I feel that it is likely they will be productive. Just as when buying cars and new houses, insurance can have a "basic" plan that appears to be attractive but may look very different when options (riders) are attached.

By the way, there is no reason why specific companies cannot be mentioned. Many times people have recommended (or recommended against) suppliers for products as diverse as 9 mm weapons and car insurance.
I too would appreciate an example(s). This request has been made before, on other threads, and to my knowledge no examples have been forthcoming.
That '20 basis points for someone with $10 million net worth' works out to $20k annually.
...oh puleez....

The average LTCi premium is about $2K/yr per person.

User avatar
willthrill81
Posts: 13192
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Long term care insurance policy

Post by willthrill81 » Mon Jan 14, 2019 4:02 pm

WoW2012 wrote:
Mon Jan 14, 2019 4:00 pm
willthrill81 wrote:
Mon Jan 14, 2019 3:54 pm
ThereAreNoGurus wrote:
Mon Jan 14, 2019 3:48 pm
adamthesmythe wrote:
Mon Jan 14, 2019 12:58 pm
WoW2012 wrote:
Mon Jan 14, 2019 12:49 pm



There are 4 companies that sell LTCi policies with no lifetime cap.
There are several companies that allow couples to share 15+ years of benefits.
There are several companies, in 45 states, that sell Long-Term Care Partnership policies which can protect your assets from Medicaid even if the policy runs out of benefits.
WoW2012 has made these statements multiple times before. I, for one, would appreciate an EXAMPLE of what one could get for a policy and what it would cost. This needs substantially more detail than "20 basis points."

I am in the situation where I SUSPECT a policy to deal with my personal situation is either unavailable or unreasonably expensive. I am unwilling to subject myself to extended discussions with an agent unless I feel that it is likely they will be productive. Just as when buying cars and new houses, insurance can have a "basic" plan that appears to be attractive but may look very different when options (riders) are attached.

By the way, there is no reason why specific companies cannot be mentioned. Many times people have recommended (or recommended against) suppliers for products as diverse as 9 mm weapons and car insurance.
I too would appreciate an example(s). This request has been made before, on other threads, and to my knowledge no examples have been forthcoming.
That '20 basis points for someone with $10 million net worth' works out to $20k annually.
...oh puleez....

The average LTCi premium is about $2K/yr per person.
I was using your numbers. You're changing the mileposts now by saying "average."
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

ncbill
Posts: 563
Joined: Sun Jul 06, 2008 4:03 pm
Location: Western NC

Re: Long term care insurance policy

Post by ncbill » Mon Jan 14, 2019 4:03 pm

GeoffD wrote:
Mon Jan 14, 2019 1:26 pm
ncbill wrote:
Mon Jan 14, 2019 1:19 pm

For rehabilitation purposes... if you're not making progress in your rehab you'll be booted off Medicare's dime, with very limited rights of appeal.

I just went through this for the relative mentioned in my other post, who IIRC got all of 14 days paid for by Medicare...after that the custodial side of the nursing home cost ~$7,500/month for a semi-private room (before I moved them to a private room in an assisted living facility @ half that price)
So someone massively screwed up the clinical documentation. If you code it properly, Medicare doesn't boot people off.
Are you saying the health care provider should lie?

I just went through this...and it was made very clear to me through the appeals process that unless the patient is able to show progress rehab benefits end.

People with dementia or terminal illnesses aren't likely to qualify under that criteria (can't comply or are too debilitated) to get many "free" Medicare days in skilled nursing.
Last edited by ncbill on Mon Jan 14, 2019 4:03 pm, edited 1 time in total.

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 4:03 pm

WoW2012 wrote:
Mon Jan 14, 2019 3:56 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:50 pm
willthrill81 wrote:
Mon Jan 14, 2019 3:42 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:27 pm


Do you have data for this claim. I know it’s not true for my relatives. The wives are tiny, there’s no way they can do any physical help. The people they hired were males.

according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
Life over is to sell fear. If WOW has said, the wives would be with the cabana boys on a cruise ship having the time of her life, I’m sure he couldn’t convince nobody anybody to buy LTC.
Maybe it's because I've been a caregiver. I was healthy, in my mid-30's, and it took everything I could to transfer a 5'2, 110lb, 80-year old half-paralyzed man. Being a caregiver for a relative is one of the most stressful things you'll ever experience in life. The situation with my MIL is completely different. All her care is provided by the aides in the ALF, fully paid for by her LTCi policy. We can ENJOY spending time with her, rather than being burdened with the physical care.
My dad was half paralyzed, needed to be changed, but that only happened his last 2-3 years. Only one case that I currently know is my daughter’s best friend from high school, his dad was a neurologist, who was diagnosed with Alzheimer’s for nearly 5-6 years, he has been in a home for 2-3 years. He is so far the worst case. I do know another lady in my bridge club who’s been diagnosed with Alzheimer’s, but she’s still moving, still playing bridge, she just can’t drive. She lives across the street from her daughter, but she doesn’t need 100% care yet. Pretty old as in her 80s at least.

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 4:07 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 4:03 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:56 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:50 pm
willthrill81 wrote:
Mon Jan 14, 2019 3:42 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:31 pm



according to a report by the Congressional Budget Office, 80% of the people who need long-term care receive their care at home, 13% in nursing homes, 5% in assisted living facilities, and 2% in "other" (e.g. Adult Day Care, etc...)

Exhibit 12 on page 20

https://www.cbo.gov/sites/default/files ... 63-ltc.pdf


Sincerely,
Wow
The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
Life over is to sell fear. If WOW has said, the wives would be with the cabana boys on a cruise ship having the time of her life, I’m sure he couldn’t convince nobody anybody to buy LTC.
Maybe it's because I've been a caregiver. I was healthy, in my mid-30's, and it took everything I could to transfer a 5'2, 110lb, 80-year old half-paralyzed man. Being a caregiver for a relative is one of the most stressful things you'll ever experience in life. The situation with my MIL is completely different. All her care is provided by the aides in the ALF, fully paid for by her LTCi policy. We can ENJOY spending time with her, rather than being burdened with the physical care.
My dad was half paralyzed, needed to be changed, but that only happened his last 2-3 years. Only one case that I currently know is my daughter’s best friend from high school, his dad was a neurologist, who was diagnosed with Alzheimer’s for nearly 5-6 years, he has been in a home for 2-3 years. He is so far the worst case. I do know another lady in my bridge club who’s been diagnosed with Alzheimer’s, but she’s still moving, still playing bridge, she just can’t drive. She lives across the street from her daughter, but she doesn’t need 100% care yet. Pretty old as in her 80s at least.

Don't worry. I'm sure it won't happen to you or your spouse.

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 4:09 pm

WoW2012 wrote:
Mon Jan 14, 2019 4:07 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 4:03 pm
WoW2012 wrote:
Mon Jan 14, 2019 3:56 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 3:50 pm
willthrill81 wrote:
Mon Jan 14, 2019 3:42 pm


The question then becomes whether you need LTC as defined by the government to be provided for you full-time by hired help or by a family member. When I mentioned this latter possibility, you shot it down, saying that you wouldn't want your wife's life to be over. But I know my wife well enough to know that she's not going to be a happy-go-lucky globe trotter if I were stuck at home receiving LTC, and I don't believe that I would or could do that if the roles were reversed either. And the odds are fairly high that by the time we would need LTC, those days would be behind us anyway. But regardless, we should have plenty of funds to pay for whatever LTC we need out of pocket.
Life over is to sell fear. If WOW has said, the wives would be with the cabana boys on a cruise ship having the time of her life, I’m sure he couldn’t convince nobody anybody to buy LTC.
Maybe it's because I've been a caregiver. I was healthy, in my mid-30's, and it took everything I could to transfer a 5'2, 110lb, 80-year old half-paralyzed man. Being a caregiver for a relative is one of the most stressful things you'll ever experience in life. The situation with my MIL is completely different. All her care is provided by the aides in the ALF, fully paid for by her LTCi policy. We can ENJOY spending time with her, rather than being burdened with the physical care.
My dad was half paralyzed, needed to be changed, but that only happened his last 2-3 years. Only one case that I currently know is my daughter’s best friend from high school, his dad was a neurologist, who was diagnosed with Alzheimer’s for nearly 5-6 years, he has been in a home for 2-3 years. He is so far the worst case. I do know another lady in my bridge club who’s been diagnosed with Alzheimer’s, but she’s still moving, still playing bridge, she just can’t drive. She lives across the street from her daughter, but she doesn’t need 100% care yet. Pretty old as in her 80s at least.

Don't worry. I'm sure it won't happen to you or your spouse.
There no need for snarky comment. This is typical if you can’t sell them, you make snarky comment. But on my husband’s side nobody needed LTCi yet, they died quickly at old age. For me, since I live in California, I’m sure they will pass something soon, maybe LTCi is a right eventually, like most things here.

But this article has 75 must know statistics from Christine Benz about LTCi.
https://www.forbes.com/sites/lawrenceli ... insurance/
Last edited by DrGoogle2017 on Mon Jan 14, 2019 4:18 pm, edited 2 times in total.

Silk McCue
Posts: 3063
Joined: Thu Feb 25, 2016 7:11 pm

Re: Long term care insurance policy

Post by Silk McCue » Mon Jan 14, 2019 4:16 pm

WoW2012 wrote:
Mon Jan 14, 2019 4:07 pm

Don't worry. I'm sure it won't happen to you or your spouse.
At this point I actually think it is a waste of your time to continue to reply to the folks that you have already replied to multiple times. Some people only seem to want to argue or accuse you of ulterior motives. I appreciate your knowledge and diligence in responding but some folks (not all) are only looking to argue/challenge because their life experience is different from the universe of situations that exist and that I personally saw as the owner of a private duty home care company.

Cheers

WoW2012
Posts: 584
Joined: Sun Dec 23, 2012 11:28 am

Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 4:19 pm

Silk McCue wrote:
Mon Jan 14, 2019 4:16 pm
WoW2012 wrote:
Mon Jan 14, 2019 4:07 pm

Don't worry. I'm sure it won't happen to you or your spouse.
At this point I actually think it is a waste of your time to continue to reply to the folks that you have already replied to multiple times. Some people only seem to want to argue or accuse you of ulterior motives. I appreciate your knowledge and diligence in responding but some folks (not all) are only looking to argue/challenge because their life experience is different from the universe of situations that exist and that I personally saw as the owner of a private duty home care company.

Cheers

Never a dull moment!
Thanks, silk.

Silk McCue
Posts: 3063
Joined: Thu Feb 25, 2016 7:11 pm

Re: Long term care insurance policy

Post by Silk McCue » Mon Jan 14, 2019 4:20 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 4:09 pm
There no need for snarky comment. This is typical if you can’t sell them, you make snarky comment. But on my husband’s side nobody needed LTCi yet, they died quickly at old age. For me, since I live in California, I’m sure they will pass something soon, maybe LTCi is a right eventually, like most things here.

But this article has 75 must know statistics from Christine Benz about LTCi.
https://www.forbes.com/sites/lawrenceli ... insurance/
You continue to disparage Wow2012 and it is unseemly. Please stop.

Cheers

DrGoogle2017
Posts: 2528
Joined: Mon Aug 14, 2017 12:31 pm

Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 4:23 pm

Silk McCue wrote:
Mon Jan 14, 2019 4:20 pm
DrGoogle2017 wrote:
Mon Jan 14, 2019 4:09 pm
There no need for snarky comment. This is typical if you can’t sell them, you make snarky comment. But on my husband’s side nobody needed LTCi yet, they died quickly at old age. For me, since I live in California, I’m sure they will pass something soon, maybe LTCi is a right eventually, like most things here.

But this article has 75 must know statistics from Christine Benz about LTCi.
https://www.forbes.com/sites/lawrenceli ... insurance/
You continue to disparage Wow2012 and it is unseemly. Please stop.

Cheers
I don’t think I did made disparage comment. He made snarky comment toward me. I wish you told him to stop. I’m not sure you have the right to tell people to stop if they don’t agree with you.

The market for LTCi has crumbled for a reason. See link below,
https://www.forbes.com/sites/howardglec ... -crumbles/

Northern Flicker
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Re: Long term care insurance policy

Post by Northern Flicker » Mon Jan 14, 2019 4:29 pm

I have no doubt that many do, but it doesn't make mathematical sense to pay someone else to insure a risk (apart from perhaps owning a business and paying for LTCi with pre-tax instead of post-tax money, but that's not an option available to most people) that you can easily self-insure, and a person who's a decamillionaire can easily self-insure LTC. If it were mathematically advantageous for you to do so, the insurance companies would all go bankrupt. They must, by definition, charge more in premiums than they pay in benefits.
It is not the purpose of insurance to increase the expected value of your future net worth. In fact, even if an insurance company’s actuarial models are 100% accurate, the admin cost and profit for the insurance company pretty much guarantees that buying insurance of any kind lowers the expected value of future net worth in some measure.

But if self-insuring against a risk that lasts until end of life, buying insurance will increase expected future net worth of the insured and decrease expected net value of beneficiaries of the insured’s estate. Self-insuring means setting aside the assets until you die and no longer need to cover the risk. Residual value flows to heirs not to the self-insurer.

But people actually buy insurance to reduce the variance of their future net worth. This could be in the form of tail risk one cannot afford to take at all, or less extreme variances that one may be able to afford to cover, but not without risking a reduction in standard of living.

There has been lots of discussion of sequence of return risk for a retiree, but an equivalent risk is sequence of expenses. Unpredictably high expenses early in retirement is equivalent to a lower return and lower expenses. Reducing variance of expenses improves the probability of success for anyone whose net worth does not greatly exceed the level needed to meet expected expenses.

Also, LTCi premiums are HSA-eligible expenses up to a certain annual limit (I think around $4200/yr for a married couple).
Risk is not a guarantor of return.

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munemaker
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Re: Long term care insurance policy

Post by munemaker » Mon Jan 14, 2019 4:40 pm

Silk McCue wrote:
Fri Jan 11, 2019 1:37 pm
Payouts are clearly defined as to amount paid per period for care and total amount to be paid; , thresholds met are clearly defined and tied to ADL's and elimination period before any payments are made, strength of the insurer can reasonably be determined.
OK, the real problem is the PREMIUMS are not clearly defined. Relatives of mine were subject to huge premium increases in their later years with no corresponding increase in benefits. What happens is people in this situation either drop the coverage entirely, or take a steep reduction in benefits to maintain their current premiums. That's the dirty secret of long term care insurance.

The policyholder thinks they have this covered (i.e. budgeted for LTCI premium) and then the insurer yanks the rug out from under them (with a big fat rate increase) when they are in a position where they can't react (because their income is more or less fixed at that point in their life).

This is why I am going the self-insurance route.

Northern Flicker
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Re: Long term care insurance policy

Post by Northern Flicker » Mon Jan 14, 2019 4:43 pm

2 previous posts wrote: Forget nursing homes...you'll most likely to both get your LTC (& die) at home or an assisted living facility.
...
Another reason not to buy LTCi if you want to live at home, you may not be able to get LTCi to pay even if you lose 2 functions as they state
Some policies I’m seeing seem to cover licensed providers offering LTC in one’s home, but require a rider with additional premium to reimbures an unlicensed family member providing the care. Professional in-home care is expensive and wanting it if needed could be a reason to buy LTC insurance, not a reason to avoid it.

Skilled nursing facilities (what primarily used to be offered in nursing homes) may be needed by people with more extreme nursing care needs. You may be less likely to need skilled nursing care but that is the most expensive for which to self-insure.
Risk is not a guarantor of return.

DrGoogle2017
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Re: Long term care insurance policy

Post by DrGoogle2017 » Mon Jan 14, 2019 4:44 pm

They plan on a lot of people droppping the insurance coverage so they can pocket the premium. I’ve contributed 7 years, 5 years pretax so I didn’t see the pain, 2 years after tax, then I decided enough is enough. There are cases that you read people were denied benefits even with reduced functions.
But for some people they are in too deep, as in they already paid 10-20 years.
Last edited by DrGoogle2017 on Mon Jan 14, 2019 4:47 pm, edited 1 time in total.

WoW2012
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Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 4:45 pm

munemaker wrote:
Mon Jan 14, 2019 4:40 pm
Silk McCue wrote:
Fri Jan 11, 2019 1:37 pm
Payouts are clearly defined as to amount paid per period for care and total amount to be paid; , thresholds met are clearly defined and tied to ADL's and elimination period before any payments are made, strength of the insurer can reasonably be determined.
OK, the real problem is the PREMIUMS are not clearly defined. Relatives of mine were subject to huge premium increases in their later years with no corresponding increase in benefits. What happens is people in this situation either drop the coverage entirely, or take a steep reduction in benefits to maintain their current premiums. That's the dirty secret of long term care insurance.

The policyholder thinks they have this covered (i.e. budgeted for LTCI premium) and then the insurer yanks the rug out from under them (with a big fat rate increase) when they are in a position where they can't react (because their income is more or less fixed at that point in their life).

This is why I am going the self-insurance route.
That's why 41 states have passed the Rate Stability Regulation. Long-term care insurance policies purchased today have pricing regulations very different from policies purchased 15+ years ago.

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Re: Long term care insurance policy

Post by WoW2012 » Mon Jan 14, 2019 4:47 pm

DrGoogle2017 wrote:
Mon Jan 14, 2019 4:44 pm
They plan on a lot of people droppping the insurance coverage so they can pocket the premium. I’ve contributed 7 years, 5 years pretax so I didn’t see the pain, 2 years after tax, then I decided enough is enough. There are cases that you read people were denied benefits even with reduced functions.
Less than 4% of policyholders drop their LTC insurance after a large rate increase. Even those who "drop it" still receive a small, paid-up policy from the insurer.

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willthrill81
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Re: Long term care insurance policy

Post by willthrill81 » Mon Jan 14, 2019 4:47 pm

jalbert wrote:
Mon Jan 14, 2019 4:29 pm
I have no doubt that many do, but it doesn't make mathematical sense to pay someone else to insure a risk (apart from perhaps owning a business and paying for LTCi with pre-tax instead of post-tax money, but that's not an option available to most people) that you can easily self-insure, and a person who's a decamillionaire can easily self-insure LTC. If it were mathematically advantageous for you to do so, the insurance companies would all go bankrupt. They must, by definition, charge more in premiums than they pay in benefits.
It is not the purpose of insurance to increase the expected value of your future net worth. In fact, even if an insurance company’s actuarial models are 100% accurate, the admin cost and profit for the insurance company pretty much guarantees that buying insurance of any kind lowers the expected value of future net worth in some measure.

But if self-insuring against a risk that lasts until end of life, buying insurance will increase expected future net worth of the insured and decrease expected net value of beneficiaries of the insured’s estate. Self-insuring means setting aside the assets until you die and no longer need to cover the risk. Residual value flows to heirs not to the self-insurer.

But people actually buy insurance to reduce the variance of their future net worth. This could be in the form of tail risk one cannot afford to take at all, or less extreme variances that one may be able to afford to cover, but not without risking a reduction in standard of living.

There has been lots of discussion of sequence of return risk for a retiree, but an equivalent risk is sequence of expenses. Unpredictably high expenses early in retirement is equivalent to a lower return and lower expenses. Reducing variance of expenses improves the probability of success for anyone whose net worth does not greatly exceed the level needed to meet expected expenses.

Also, LTCi premiums are HSA-eligible expenses up to a certain annual limit (I think around $4200/yr for a married couple).
I'm not disparaging all insurance, not even LTC insurance. It has a place, but it's not for everyone, not by a long shot, and certainly not by a lot, perhaps even most, Bogleheads. I've stated several times explicitly that insurance should be used to insure against those risks that would be financially detrimental to you if they manifested themselves. For a decamillionaire (WoW's example), LTC would not be a financially detrimental event.

I don't insure my TV, my cellphone, my clothes, my air conditioner, my furnace, or my refrigerator. Yes, that results in uneven expenditures over time, but I can handle those uneven expenses (and 'save' for them monthly) on my own without the need for an insurance company. Similarly, with enough assets, the data strongly suggest that LTC can be self-insured as well. What level of assets is needed is dependent on many factors, but it's certainly less than $10 million.
Last edited by willthrill81 on Mon Jan 14, 2019 4:51 pm, edited 2 times in total.
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Northern Flicker
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Re: Long term care insurance policy

Post by Northern Flicker » Mon Jan 14, 2019 4:48 pm

OK, the real problem is the PREMIUMS are not clearly defined. Relatives of mine were subject to huge premium increases in their later years with no corresponding increase in benefits.
Originally, insurance companies underpriced the actuarial risk with LTC policies and had to increase premiums to cover the liabilities. The newer generation of regulations and products are purported to have addressed this, but hard to know how it will play out.
Risk is not a guarantor of return.

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Re: Long term care insurance policy

Post by LadyGeek » Mon Jan 14, 2019 4:53 pm

This thread has run its course and is locked (derailed, contentious, no progress in the discussion). I also removed some political comments (off-topic).
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