Author Topic: Long term care insurance  (Read 16978 times)

rocketman48097

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Long term care insurance
« on: September 24, 2013, 01:42:28 PM »
So someone I work with, a very highly compensated individual working at age 60, just informed me that he was "applying" for long term care insurance for he and his wife.

"Why?" 
"Because it's a good deal, $200 for the both of us through AARP."

If it's a good deal for you, why would they offer it?  It's probably a good deal for them (insurance company)

"Because for ONLY $200 per month, I buy piece of mind, and that's worth it."

You're only 60, what if you never need it, or need it at age 90?

"That may be true but it's worth having a piece of mind.

He makes over 300k with bonus and has stock options/grants, etc.  Does anyone wonder why he's still slaving away at age 60??? 

avonlea

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Re: Long term care insurance
« Reply #1 on: September 24, 2013, 02:36:50 PM »
That's my understanding of longterm care insurance, too, Frankie's Girl.  I thought we'd look into it when we are a little older as well.

Carrie

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Re: Long term care insurance
« Reply #2 on: September 24, 2013, 02:48:01 PM »
Nursing home care can deplete a nest egg very quickly.  We plan to get it around age 60.

Hunny156

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Re: Long term care insurance
« Reply #3 on: September 25, 2013, 09:57:20 AM »
Yes, LTC is something I will consider as I get older, as dementia runs in my family.  I would love to see what the policy coverage is for $200/mo, that sounds mad cheap to me!  I tried to get my Mom into a LTC policy once Dad passed away, but the cost was well over $1K/mo, and she had visions of us locking her up and throwing away the key, so she balked.

Fast forward not many years later, and my Mom lives in assisted living.  She was living in one of the most expensive areas of NY, so I priced her care at $20K/mo in some places!  Family issues and cheaper costs enabled us to move her to TX instead, where I originally had her in a very nice assisted living facility for "only" $4,500/mo.  As she continued to decline in health, I moved her to a much smaller facility with better care and a cheaper price of $3K/mo.  This doesn't include medical, prescriptions, activities, etc.  She's been under hospice care for years, she's been in crisis care twice already (this is when they are pretty sure you are going to pass away w/in days), she has seizures every other month along w/a few strokes sprinkled in for good measure, and she still carries on.  Tough little cookie.  ;)

Her care is approaching the $200K mark at this point.  Good thing my parents were frugal savers, but I'm sure they didn't want their hard-earned cash to go to this service.  Had they planned appropriately w/a LTC Policy and/or estate planning, the financial picture would be very different.

The way I see it, it's my parents money and it should be spent to take care of their needs first.  If there's anything left, great, but I'm not counting on that.

Oh, and my mom is only 74, so she could live like this for many more years.  Early-onset, at least 12 years that we know of.

footenote

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Re: Long term care insurance
« Reply #4 on: September 25, 2013, 10:12:48 AM »
I researched LTC this year and came away deciding to self-insure.

I drilled into companies offering LTC coverage in my state (our state provided a comprehensive list). About 50% of the companies listed were no longer writing LTC policies.

I worked in the insurance / annuities industry for three years and I know that's a huge red flag.

If I thought LTC was working for insurers, I would get coverage. But if it's financial problematic for the insurer, hand-down, it's going to be problematic for you, the insured.

Spudd

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Re: Long term care insurance
« Reply #5 on: September 25, 2013, 10:52:55 AM »
The examples in this thread of $48k/year, 54k/year (4500/mo), and 36k/year (3k/mo) make me think that most people should self-insure. Once you're in LTC, you don't have any other expenses on top of the LTC costs (no car, meals, etc). These prices are pretty much in-line with the average person's annual spending budget - so why worry? The only time I could see it making sense would be if these annual costs would represent a large increase to your budget, and the monthly cost for the insurance doesn't increase your budget beyond this level.

Here in Canada, I am fully planning to self-insure. Assisted living runs around the same prices quoted here, which I think I should be able to afford just fine if I've sold my house and moved into assisted living. And if I get to the point of needing a nursing home, prices are regulated by the government and max out at around $2500/mo.

Forcus

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Re: Long term care insurance
« Reply #6 on: September 25, 2013, 10:58:06 AM »
Dang, 50k / yr or more for assisted living? When my time comes, just take me out in the woods and leave me. Much cheaper.

jfer_rose

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Re: Long term care insurance
« Reply #7 on: September 25, 2013, 12:40:37 PM »
The examples in this thread of $48k/year, 54k/year (4500/mo), and 36k/year (3k/mo) make me think that most people should self-insure.  These prices are pretty much in-line with the average person's annual spending budget - so why worry?

These prices may be in line with an average person's budget, but from what I've seen here they are much higher than an average mustachian's budget. Plus, some of these prices don't include medical care.

The possibility of needing long term care is the scariest part of early retirement to me, especially as a single person who may not have kids or a spouse to rely on. I'm still here and I'm still hoping to retire early, but these worries will keep me more conservative than I would be otherwise.

brewer12345

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Re: Long term care insurance
« Reply #8 on: September 25, 2013, 01:44:30 PM »
I have spent most of my career dealing with the companies that offer this product.  As it is currently structured, I would not buy it.  YMMV.

Spudd

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Re: Long term care insurance
« Reply #9 on: September 25, 2013, 01:45:00 PM »
That's true, Frankie's Girl, I hadn't thought about it that way.

footenote

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Re: Long term care insurance
« Reply #10 on: September 25, 2013, 02:22:09 PM »
I have spent most of my career dealing with the companies that offer this product.  As it is currently structured, I would not buy it.  YMMV.
+1
The concept is good. Just be very, very careful. Before you sign up: Read every word of the policy. Insist that every contingency (like rate hikes) is explained to you. Work through all the worst-case scenarios.

Hunny156

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Re: Long term care insurance
« Reply #11 on: September 25, 2013, 03:32:35 PM »
The examples in this thread of $48k/year, 54k/year (4500/mo), and 36k/year (3k/mo) make me think that most people should self-insure.  These prices are pretty much in-line with the average person's annual spending budget - so why worry?

These prices may be in line with an average person's budget, but from what I've seen here they are much higher than an average mustachian's budget. Plus, some of these prices don't include medical care.

The possibility of needing long term care is the scariest part of early retirement to me, especially as a single person who may not have kids or a spouse to rely on. I'm still here and I'm still hoping to retire early, but these worries will keep me more conservative than I would be otherwise.

If you are happy with your life while still being conservative, then that should be a fair compromise. 

As for kids or a spouse, many people (myself included) will tell you that it may not make a difference.  Mom was shocked when Dad died 12 weeks after being diagnosed w/cancer.  She admitted that it was her plan to die first, so reality did a good job of rattling her.  I'm guessing she also assumed she had her two kids to take care of her, and I assure you, that's not the case either. 

Since I've had the occasion to spend almost 5 years visiting assisted living communities, I can guarantee you that plenty of family members drop people off, never to return again.  Sad reality, but we all need to depend on ourselves, regardless of if we have family or not.

Hunny156

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Re: Long term care insurance
« Reply #12 on: September 25, 2013, 03:39:08 PM »
Just had another question:  If LTC and self-insuring are not the best options for you, how do you feel about Medicaid Planning?  (FAR in advance, b/c that 5 year look-back period sneaks up on you.)

I do know several people who were able to put their SO into a nursing home and have Medicaid pick up the cost by signing legal documents which essentially state that they choose not to be financially responsible for their spouse.

Argyle

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Re: Long term care insurance
« Reply #13 on: September 26, 2013, 12:37:02 AM »
Having lived to the point where most of my older relatives are past 80, there's no way I would not get long-term care insurance.  An elderly relative has moderate dementia, to the point where it would be unsafe for her to live independently, though she is definitely still enjoying life.  And she is frail enough to need help bathing, can't cook, etc.  She is in quite a nice nursing home -- not like the desperate one I saw another old friend in.  Her care is phenomenally expensive, and she's been there three years.

Of course companies offer insurance and it remains a "good deal for them" -- most insurance (life, health, auto, LTC) in the U.S. is for-profit, but that doesn't mean it's not useful to the buyer.  Frankly, the fact that so many companies offering LTC insurance have ceased to offer it shows how valuable it is.  They didn't reckon on the enormous amounts of money they were going to have to pay out.  It turned out not to be "a good deal for them" because so many people needed the insurance and the long-term care costs were so great. 

LTC insurance is cheaper if you get it earlier.  I believe the experts recommend around age 55.  You may well say, "But then it could be 30 years before I need it!"  But the thing is that the longer you wait, the greater the chances that something will happen where you become uninsurable.  Any serious illness may make you uninsurable for LTC.  The applications ask if you've used a cane in the past five years, if you've ever had a heart attack, etc. etc. 

Another consideration for those thinking about self-insuring is whether you want to leave anything to children or a spouse.  Long-term nursing home costs can eat up every penny, and indeed have to before you can qualify for any kind of government support.  This is why people sometimes get divorced when they face these circumstances -- so as not to bankrupt the well partner.  If you have LTC insurance, you stand a chance of leaving your mustachian savings to your partner. 

I don't work for the insurance industry or anything related.  I just have seen a number of elderly relatives, both with and without the insurance.  There's no way I'm going without it.

footenote

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Re: Long term care insurance
« Reply #14 on: September 26, 2013, 06:19:14 AM »
This has been discussed in other threads, so I'll just mention it briefly here. Consider genetic testing through 23andme.com to learn more about your chances of diseases like dementia, Parkinson's and Alzheimer's.

There are legitimate privacy concerns. For me, my results (and my husband's results) helped me make a more informed decision about LTC vs self-insuring. YMMV.

Hunny156

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Re: Long term care insurance
« Reply #15 on: September 26, 2013, 09:12:50 AM »
This has been discussed in other threads, so I'll just mention it briefly here. Consider genetic testing through 23andme.com to learn more about your chances of diseases like dementia, Parkinson's and Alzheimer's.

There are legitimate privacy concerns. For me, my results (and my husband's results) helped me make a more informed decision about LTC vs self-insuring. YMMV.

+1!  Thanks for the link, I'll be doing that soon!

willn

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Re: Long term care insurance
« Reply #16 on: September 27, 2013, 10:27:49 AM »
I guess it just depends if you can self insure. The average length of care seems to be in the 1-4 year range, and may cost 50K / year or more depending on level of care.

Typical scenario is grandpa goes in, dies after 3 years, and uses up 150K of the nest egg, meanwhile grandma still has some housing and health costs so what was a 250K nest egg disappears pretty quick, and now she has to go in but can't afford it.

For you youngsters, inflation in 30 or 50 years or whenever you might need it is going to make those numbers look very different.


Systematic

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Re: Long term care insurance
« Reply #17 on: September 27, 2013, 12:24:57 PM »
I'm a full time carer for a parent. If she didn't live with me she would live in a home.

In this country the government pays for private homes.  It's means tested. Very few people,  far less than 10 per cent of those who are eligible take it up.

I get a very small payment from the government, it pays for the groceries and electricity. Which is dam good.

Personally the insurance doesn't sound expensive. I just want to point out there are many different ways to be assisted. Read the detail to see if you can pay for someone to assist you wherever you choose to live.

The most common comment from people who haven't been in this situation is why don't you tell her to go into a home.

From people who have had parents in this situation it's I wish I could have done that.

It would be a shame if the only way to access funding was through a home

Systematic

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Re: Long term care insurance
« Reply #18 on: September 27, 2013, 12:39:04 PM »
I signed off too quickly. Dealing with insurance companies can be an absolute nightmare. Get an advisor/ lawyer to go through the policy with you.  Imagine dealing with them when you are elderly.

Note brewer12345 comment.

And never ever let somebody go through the health system, especially a&e on their own no matter how good the health system is. It is incredible how many people, including elderly face this alone.

Rust

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Re: Long term care insurance
« Reply #19 on: September 27, 2013, 12:54:57 PM »

johnintaiwan

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Re: Long term care insurance
« Reply #20 on: July 24, 2014, 08:15:34 AM »
Not trying to be funny, this is a real question:

Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.


enigmaT120

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Re: Long term care insurance
« Reply #21 on: July 24, 2014, 09:50:32 AM »
The trouble with that option is that, by the time you would wish to use it, you won't remember.


Fred Tracy

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Re: Long term care insurance
« Reply #22 on: July 24, 2014, 11:30:46 AM »
Not trying to be funny, this is a real question:

Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.

Amen to this. As far as I can tell, I will not be purchasing any kind of LTC insurance.

kite

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Re: Long term care insurance
« Reply #23 on: July 24, 2014, 02:23:58 PM »
Does anyone wonder why he's still slaving away at age 60???

I wont practically call it slaving yourself but the man's got a point. So long that diseases like dementia go untreated by science, the possibility of ending up in a nursing home is 50-50. Thus, making long-term care insurance a necessity. He is, however, not buying the other 50 in the 50-50 equation but merely preparing for the 50 that is bound to happen soon...if it will even happen.

He probably enjoys the job, wouldn't call it slaving.  From what I've seen,  300K jobs are pleasant.    But I thought the likelihood of disability was well over 60%.  In my extended family and the people I knew, things like stroke, ALS, broken hip necessitated long term care, either in a facility or at home.  The stroke patient lived 10 years with paralysis on one side.  The degree of home care was extensive.    The most tragic stories I know of are where one person's illness bankrupted the family.   For all the good in the ACA, it doesn't cover LTC. 

La Bibliotecaria Feroz

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Re: Long term care insurance
« Reply #24 on: July 24, 2014, 08:26:56 PM »
Not trying to be funny, this is a real question:

Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.

More or less my father's plan, I think. He still smokes (he's 60). When I was a kid I remember him saying at the dinner table that if he was ever diagnosed with lung cancer, he would just go to the beach and swim out into the ocean and never come back. Since I was, like, ten, that scared the shit out of me.

But on the other end of the coin, his best friend spent two years fighting terminal brain cancer hard--and now his wife is facing bankruptcy at age 60. (They had insurance, of course, but the copays were through the roof.) I don't want to say he was wrong to fight, but that sure isn't how I would want to leave MY surviving family!

Lyssa

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Re: Long term care insurance
« Reply #25 on: July 25, 2014, 12:55:35 AM »
Not trying to be funny, this is a real question:

Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.

Same here. I have seen dementia run its course three times now and, considering the age of my aunts and uncles, there are a few more times to come. I am not going to tolerate this and I am not going to let my loved ones go through this. If I would choose a 9mm or a trip to Switzerland I cannot tell yet. But no, I don't think there is an obligation to live as long as possible. Especially if "living" is reduced to "existing". And no, I am not going to get LTC insurance.

nordlead

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Re: Long term care insurance
« Reply #26 on: July 25, 2014, 12:50:39 PM »
Dang, 50k / yr or more for assisted living? When my time comes, just take me out in the woods and leave me. Much cheaper.

Someone just did that in the next county over to their 83 year old mom.

Most people weren't happy with the results, so you'll probably have to take yourself.

dycker1978

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Re: Long term care insurance
« Reply #27 on: July 25, 2014, 01:41:37 PM »
I am 36 and used to own my own business.  When I was looking into injury insurance(incase I was hurt when we were starting and needed it before saving had grown) they tried to sell me this.  They said it was cheaper, and I would not use disabilty unless I ended up in a place where I would need the long term care anyways.

Besides that, it was cheaper and had an immidate effect in the case it was needed, where disability had a 12 week waiting period...  I had the 12 weeks worth saved thank you...

Nords

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Re: Long term care insurance
« Reply #28 on: July 30, 2014, 10:35:48 AM »
Not trying to be funny, this is a real question:
Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.
My spouse says she's purchased one of those 9mm plans for me.

Proficient shooters will tell you that while shooting yourself is easy, killing yourself is less guaranteed.  If you don't get it right on the very first try then there's a substantial risk of ending up alive yet much worse off than you started. 

As for the option of Percocet & Bailey's Irish Cream, again the issue is predicting when your cognition is slipping below your minimum standard.  It's more of a very uneven staircase than a glide slope.  Alzheimer's (and many other forms of dementia) tend to make you more of what your personality already is, and you may also become apathetic about your declining cognition.  The person you're going to become might not give a crap about the life-ending policy of the person you are today.  In other words, my father is the happiest he's ever been and he doesn't have a care in the world.  If he was capable of killing himself, he would choose not to.

socaso

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Re: Long term care insurance
« Reply #29 on: July 30, 2014, 11:22:01 AM »
A tip from my dad: he and my mom got LTC when they were 50 and they are paying much less that other people their age. I believe he told me they pay around $40 a month for the two of them. Now that they are in their mid-60's they are hearing from friends who are paying several hundred a month for the same insurance. We have a relative in our family who spent the last decade of her life in a nursing home. Personally I plan to spring for the LTC when I'm older.

kite

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Re: Long term care insurance
« Reply #30 on: July 30, 2014, 05:35:24 PM »
A tip from my dad: he and my mom got LTC when they were 50 and they are paying much less that other people their age. I believe he told me they pay around $40 a month for the two of them. Now that they are in their mid-60's they are hearing from friends who are paying several hundred a month for the same insurance. We have a relative in our family who spent the last decade of her life in a nursing home. Personally I plan to spring for the LTC when I'm older.

Priced this for two of us at ages 45 & 50.  Already it's a few hundred a month or now.  Your folks may have locked into a really sweet deal that just can't be replicated.  Benefit amounts vary.   What we learned through the deal is that there's a net worth for which this makes sense.  Below that, you better off with saving the money you'd spend on premiums and count on Medicaid.   Above a certain level of assets,  you need to estimate the cost of care and if you could self insure.   For couples,  if paying LTC expenses for an  illness or injury to one would leave the other destitute, it's important to get the insurance.   I think the likelihood of disability and related expenses get glossed over in FIRE discussions,  owing to the relative youth and health of those who dominate the blogs. 

Hunny156

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Re: Long term care insurance
« Reply #31 on: July 31, 2014, 10:14:33 AM »
Alzheimer's (and many other forms of dementia) tend to make you more of what your personality already is, and you may also become apathetic about your declining cognition.  The person you're going to become might not give a crap about the life-ending policy of the person you are today.  In other words, my father is the happiest he's ever been and he doesn't have a care in the world.  If he was capable of killing himself, he would choose not to.

1,000 times this.  Mom was a negative person, w/psychological issues that were not effectively treated b/c you don't air your dirty laundry.  Going to see her is tough, on several points.  First, I have no idea where she is mentally, although my guess is that she thinks she's a teenager living at home w/her parents.  This puts me in a very bad place, b/c when she does engage, she'll talk about someone and say something like, you know who, what's her name?  Faking your way through that is not easy, and the end result is that I piss her off.

The other point is trying not aggravate their "enhanced" personality.  She hates green and I once wore a brown & green dress, which she focused on the entire visit, hurtling insults and rude comments the whole way.  I try really hard not to let these comments affect me, but it's just not that easy to separate the past relationship w/the current situation.

Given my experiences these past 5 years, I'm inclined to the idea of ending it earlier than necessary, just so I don't fall into that rabbit hole where I'm too far gone to do anything about it.  Moving someplace where assisted suicide is legal will most certainly be an option for me.

The Resilent Dame

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Re: Long term care insurance
« Reply #32 on: July 31, 2014, 05:27:32 PM »

Given my experiences these past 5 years, I'm inclined to the idea of ending it earlier than necessary, just so I don't fall into that rabbit hole where I'm too far gone to do anything about it.  Moving someplace where assisted suicide is legal will most certainly be an option for me.

Yes, owning business for the care of the elderly, I have NEVER seen a person with dementia suicidal. Their former selves would have had this "policy" but by the time it gets beyond simple forgetfulness, there can be a great lack of self-awareness. Don't count on this as your "out."

I have also seen LTC insurance really pay off in those circumstances. It depends if you want any money left when you die and/or are okay with letting your next egg get to $0 and be okay with living in a Medicaid nursing home.
« Last Edit: August 01, 2014, 12:20:07 PM by swick »

EricL

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Re: Long term care insurance
« Reply #33 on: August 01, 2014, 07:13:50 AM »
Not trying to be funny, this is a real question:
Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.
My spouse says she's purchased one of those 9mm plans for me.

Proficient shooters will tell you that while shooting yourself is easy, killing yourself is less guaranteed.  If you don't get it right on the very first try then there's a substantial risk of ending up alive yet much worse off than you started. 

As for the option of Percocet & Bailey's Irish Cream, again the issue is predicting when your cognition is slipping below your minimum standard.  It's more of a very uneven staircase than a glide slope.  Alzheimer's (and many other forms of dementia) tend to make you more of what your personality already is, and you may also become apathetic about your declining cognition.  The person you're going to become might not give a crap about the life-ending policy of the person you are today.  In other words, my father is the happiest he's ever been and he doesn't have a care in the world.  If he was capable of killing himself, he would choose not to.

What a depressing place to go!  But it's still better than long term care.  I prefer to stay active enough so there's a real prospect of doing a face plant in the middle of it.  If a serious decline seemed imminent start up a business to ramp up the stress and take up sky diving, long distance sail boarding, or such.  But I suppose there's always a chance that won't work so maybe a LTC policy is prudent.

Pegasus

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Re: Long term care insurance
« Reply #34 on: August 01, 2014, 02:52:22 PM »
When these policies were first introduced they were a great deal -- the insurance companies took a bath on them.  Not sure what all is out there but what I can get through work has a 100k cap on benefits and payments work out to about the equivalent of earning a 7% return for the 100k I might not use.  So am self insuring but if any of you find a decent policy out there, would love to investigate it.

Pegasus

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Re: Long term care insurance
« Reply #35 on: August 01, 2014, 02:54:20 PM »
When these policies were first introduced they were a great deal -- the insurance companies took a bath on them.  Not sure what all is out there but what I can get through work has a 100k cap on benefits and payments work out to about the equivalent of earning a 7% return for the 100k I might not use.  So am self insuring but if any of you find a decent policy out there, would love to investigate it.

Lyssa

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Re: Long term care insurance
« Reply #36 on: August 02, 2014, 12:49:04 PM »
Yes, owning business for the care of the elderly, I have NEVER seen a person with dementia suicidal. Their former selves would have had this "policy" but by the time it gets beyond simple forgetfulness, there can be a great lack of self-awareness. Don't count on this as your "out."

That's only correct if you are not aware that you can't wait for your former self falling apart.

There have been cases of both assissted and un-assisted suizides of people with dementia that went public (and probably many more that didn't). All had in common that the people in question had quite a few more months to come that would have been worth living. They decided to cut those precious good months short in order to avoid being too far down the rabbit hole later.

Unfortunately I don't see any way around such loss. I would not want to have the will of the "former selfs" imposed on dementia patients who are quite content thinking they are a teenagers. However, when a feeding tube would become necessary in order to keep a dementia patient alive, the properly documented wishes of the "former self" should take over again.

BlueHouse

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Re: Long term care insurance
« Reply #37 on: August 02, 2014, 02:50:34 PM »
Not trying to be funny, this is a real question:
Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.
My spouse says she's purchased one of those 9mm plans for me.

Proficient shooters will tell you that while shooting yourself is easy, killing yourself is less guaranteed.  If you don't get it right on the very first try then there's a substantial risk of ending up alive yet much worse off than you started. 

As for the option of Percocet & Bailey's Irish Cream, again the issue is predicting when your cognition is slipping below your minimum standard.  It's more of a very uneven staircase than a glide slope.  Alzheimer's (and many other forms of dementia) tend to make you more of what your personality already is, and you may also become apathetic about your declining cognition.  The person you're going to become might not give a crap about the life-ending policy of the person you are today.  In other words, my father is the happiest he's ever been and he doesn't have a care in the world.  If he was capable of killing himself, he would choose not to.

What a depressing place to go!  But it's still better than long term care.  I prefer to stay active enough so there's a real prospect of doing a face plant in the middle of it.  If a serious decline seemed imminent start up a business to ramp up the stress and take up sky diving, long distance sail boarding, or such.  But I suppose there's always a chance that won't work so maybe a LTC policy is prudent.
I've been looking forward to going back to Africa, but for my final trip, I'm planning to bring a "meat necklace".  I'll do everything you're not allowed to do on safari and I'll leave the vehicle by myself and run as fast as I want to.  If that doesn't work, I'll start wearing the meat necklace.  As long as it's a lion that gets me, it will be fast.  If it's hyenas, then I'll toss them the necklace so I can run towards the lions.  I'm partially serious with this.  Can't think of a better way to go, but I don't want anyone else getting in danger's way trying to find me and I sure don't want any animals killed just because they do what wild animals do.  (Policy is to kill the animal if it bites or eats a human). 

Scandium

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Re: Long term care insurance
« Reply #38 on: August 04, 2014, 12:13:22 PM »
Morbid question;
What is the life expectancy once people go into nursing homes, especially ones with high level of care (and presumably prices?). When making the choice to self-insure vs LTC insurance this seem to be important information so I know how long I would expect to have to pay for this, i.e how much money I'd need.

My life expectancy may be 95, but if I need LTC at 80 I can't imagine I'd need the nest egg for as long as I had originally planned?

Nords

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Re: Long term care insurance
« Reply #39 on: August 04, 2014, 05:07:22 PM »
Morbid question;
What is the life expectancy once people go into nursing homes, especially ones with high level of care (and presumably prices?). When making the choice to self-insure vs LTC insurance this seem to be important information so I know how long I would expect to have to pay for this, i.e how much money I'd need.
My life expectancy may be 95, but if I need LTC at 80 I can't imagine I'd need the nest egg for as long as I had originally planned?
You're asking a question which tries to apply group health/longevity statistics to your individual situation.  That doesn't work very well.  If you're trying to do it for a situation involving dementia then it really doesn't work at all.  The statistic also tend to lump together all the care situations-- whether it's a broken hip, congestive heart failure, or Alzheimer's.  And when you're asking a financial question then you don't want the statistic that tells you "50% of the patients survive this long".  You want the one that says "95% of the patients survive this long".

Insurance companies will discuss stays of a few months (because Medicare covers six weeks of rehab at a skilled nursing facility) to a few years.  You may find that most long-term care policies are sold for terms of up to three years (after a 90-day exclusion period) and with a total payout cap.  I think most of today's policy buyers focus on that same time period because insurance actuaries find that it covers most of their bell curve for large groups of elders, so that's what they sell.  If you try to buy a policy that's outside of the catalog (five years?  Ten?) then you may encounter medical exams, genetic testing, underwriting, and higher premiums.  However many of the "typical" long-term care policies in the 1990s and early 2000s were horribly mispriced.  Today's policies may be hybrids of life insurance and long-term care, or they may have only a payout cap instead of a time period.

Once you're in a care facility (insurance or private pay) then the facility will not evict you if you have to go on Medicaid.  They may evict you for a legitimate reason like hostile behavior  or physical assault or an extended hospitalization, but not if you spend down your assets.  If you're worried about staying in a care facility for a decade then maybe it's better to have income from an annuity (longevity insurance) instead of "just" a long-term care insurance policy and a pile of assets.

I think once you start pricing policies you'll find yourself gravitating toward a period of about three years with a 90-day exclusion and a payout cap, perhaps with the cap indexed to inflation.

iris lily

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Re: Long term care insurance
« Reply #40 on: August 04, 2014, 07:34:03 PM »
RE: how long a period LTC policies cover:

My mother had a LTC policy that she likely bought in the 1980's. It paid out for 5 years and covered maybe 2/3 (3/4?) of her nursing home expenses. She had Alzhimer's.

She lived in the nursing home for about 6+ years. Another year and all of her assets would have been gone. This policy was really great for her situation.

« Last Edit: August 04, 2014, 10:02:32 PM by iris lily »

Nords

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Re: Long term care insurance
« Reply #41 on: August 04, 2014, 08:14:25 PM »
Morbid question;
What is the life expectancy once people go into nursing homes, especially ones with high level of care (and presumably prices?).

...
My mother had a LTC policy that she likely bought in the 1980's. It paid out for 5 years and covered maybe 2/3 (3/4?) of her nursing home expenses. She had Alzhimer's.

She lived in the nursing home for about 6+ years. Another year and all of her assets would have been gone. This policy was really great for her situation.
Iris Lily, would you mind fixing your quote tags so that you're the person talking about your mother's LTC?  Because right now, the way you've edited Scandium's and my quotes makes it look like I'm talking about your mother's policy. 

fartface

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Re: Long term care insurance
« Reply #42 on: August 05, 2014, 05:01:36 PM »
Not trying to be funny, this is a real question:

Does anyone else plan on using a round of 9mm as their LTC insurance? I have seen some of my family members live a very long time in not great situations and I don't plan on sticking around for that.

Ok, after reading many of the depressing comments above yours...that really gave me a chuckle.

My dad (who can't swim) once said to me..."If I ever get that bad, just toss me off your boat!"

Hunny156

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Re: Long term care insurance
« Reply #43 on: August 07, 2014, 12:11:49 PM »
Morbid question;
What is the life expectancy once people go into nursing homes, especially ones with high level of care (and presumably prices?). When making the choice to self-insure vs LTC insurance this seem to be important information so I know how long I would expect to have to pay for this, i.e how much money I'd need.

My life expectancy may be 95, but if I need LTC at 80 I can't imagine I'd need the nest egg for as long as I had originally planned?

I've read so many different stats, all of which would indicate that my mother would have passed away long ago. 
 * Spouses usually die within 7 years of their spouses death.  Dad will be gone 13 years in November.
 * Avg stay in assisted living/nursing home is 40 months.  Mom's going strong at 52 months.
 * Avg cycle of Alzheimer's is 7-10 years.  From what we know, 13 years.  We strongly suspect Dad was   covering for her long before he passed away, so it's possible that she was early early onset.

Even hospice has given up w/setting timetables for my Mom.  She's been in crisis care three times, the last time her extremities were mottling, and she just rebounded when no one expected it.

I would say that her first 12-18 months in assisted living produced a very drastic decline.  Since then, she's been slowly declining, but its hardly noticeable.  She even began to gain weight, and we had to go through several hoops to keep her hospice care.  I realize that she is an anomaly in many ways, and my parents didn't plan for anything at all - in her case, it wouldn't have mattered much.

Oh, and a little side note, assisted living and nursing homes are two different animals, especially in the eyes of Medicaid.  Nursing home care is covered once you spend down all your assets.  Assisted living is cash and LTC policy only.

CaliToCayman

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Re: Long term care insurance
« Reply #44 on: August 07, 2014, 12:17:09 PM »
So someone I work with, a very highly compensated individual working at age 60, just informed me that he was "applying" for long term care insurance for he and his wife.

"Why?" 
"Because it's a good deal, $200 for the both of us through AARP."

If it's a good deal for you, why would they offer it?  It's probably a good deal for them (insurance company)

"Because for ONLY $200 per month, I buy piece of mind, and that's worth it."

You're only 60, what if you never need it, or need it at age 90?

"That may be true but it's worth having a piece of mind.

He makes over 300k with bonus and has stock options/grants, etc.  Does anyone wonder why he's still slaving away at age 60???

Obviously it depends on what they consider "care" and how much you would have to fight with them to qualify, but I will say this - my grandfather was worth around $800k prior to his needing assistance. By the time he passed away (about 5-6 years of care needed, I believe) he ended up with only about half of that.

castoriehandley93

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Re: Long term care insurance
« Reply #45 on: September 08, 2014, 11:35:57 PM »
Quote
Does anyone wonder why he's still slaving away at age 60???

I won't practically call it slaving. It such as strong word to use, tbh, but the man's got a point. So long that diseases like dementia go untreated by science, the possibility of ending up in a nursing home is 50-50. Thus, making long-term care insurance a necessity. He is, however, not buying the other 50 in the 50-50 equation but merely preparing for the 50 that is bound to happen soon...if it will even happen.

I know that the prospect of buying a long-term care insurance is a scary thought when the statistic and news about it are not really optimistic...and positive. But if you look closely, there are cases, and numerous ones, where everything ended rather pretty well. So I say we watch how things turn up and hope for the best.

MrsPete

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Re: Long term care insurance
« Reply #46 on: September 19, 2014, 07:05:37 PM »
We were investigating long-term care insurance but it didn't seem to be a worthwhile investment.  If we bought it now, we'd have to pay for so many years, and that money -- invested -- could easily end up being more money than the insurance would pay out. 

Our plan may not be fool-proof, but this is it:

My husband is older than I am and is in worse health.  Likely he's going to be the one who'll have it easy:  He'll have me to take care of him. 

My family has live-forever genes; I could easily see 100.  I have two children to whom I am very close, but I never want to take their money to care for me.  We are planning to build a house that will work well for us as we age:  One-level, no-barrier shower with a seat and hand-held shower, wide hallways, etc., etc., etc.  We're also planning to include a space that would function well for one of our adult children (or grandchildren or a paid caregiver) to live-in.  Looking at my relatives, I see that with a little bit of help -- and not professional help -- a lot of elderly people can stay in their own homes quite well.  My grandmother, for example, was FINE making her own breakfast, washing her own dishes, and bathing herself . . . but she could not carry laundry baskets, could not vacuum or mop, could not pick up her own medications or drive herself to the doctor.  But with a little bit of help with driving and cleaning, she was able to stay in her own home -- where she wanted to be -- until age 99. 

Also, community resources exist to help elderly people.  For example, Meals on Wheels was wonderful for my grandmother.  They bring a meal to elderly people's door five days a week.  She liked the food, and -- just as importantly -- she had a visitor every day.  The food was also plentiful; as my grandmother's appetite dwindled, she often stretched that lunch into lunch and dinner.  And free transportation is available to the elderly who can't drive -- I think you have to have a doctor's documentation for that. 

Roadrunner53

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Re: Long term care insurance
« Reply #47 on: January 15, 2019, 12:44:33 PM »
This subject matter is old but still valid.

I bought LTC many years ago thru my employer for me and spouse. It was cheap at the time and I was making excellent money and found it affordable. I swear when they gave the presentation that they said the cost would never go up. That sounds strange but I have had the policies for about 20 years and it has never gone up till last year. This year it went up again and went up 23.70%. The letter says they were granted permission thru the State to increase costs. They offered choices like not paying any more premiums and there is a small amount we can draw on if we go to a nursing home. It is so small it wouldn't even cover one full month of care! My Mom was in a nursing home here in CT in 2013 and the cost per month was $12,000 a month. She was in for rehab and was covered by Medicare under the 100 day rehab portion Medicare allows. They only allow 100 days and if you need more it is on your dime. My Mom was there 45 days and took a turn for the worst and passed away. During the 45 days they were in constant contact with Medicare and we had meetings to determine if her rehab was working or not.

So my policies cover $210 a day in a facility. By now I am assuming that particular nursing home costs $500 a day now ($15,000 a year). My LTC policy would cover $210 a day and the rest would have to be covered by me or the spouse.  Insurance would pay $76,650 a year. I think the SS check goes to the nursing home too. So that would take off around $20,000 off of the $105,850 leaving about $85,850 a year out of our pocket. UGH!  The insurance covers 5 years.

Our policies are still low I assume even though we had two hikes in two years. The two policies cost a total of $1,151.00 a year ($593.56 & $557.72). I read somewhere that they might be able to increase the costs for 4 years in a row. So if that is true I will expect two more years of double digit increases.

I know most couples have to spend down to qualify for the sick spouse to be covered by Medicaid and I wonder if I have to spend almost $86,000 a year it might be smarter to just spend down and let Medicaid take over sooner. What do you all think?

Cost of 1 year in nursing home Connecticut (Litchfield County) Approximately:
$500 a day x 365 days=         $182,500
----------------------------------------------------------------------------------------
Long Term Care Insurance:
$210 a day x 365 days=             $ 76,650

Social Security:
$1,666 a month SS or 1 yr=  $ 20,000
----------------------------------------------
                                                $ 96,650

*Out of our pocket per year:
                                              $182,500

                                            - $ 96,650

                                          * $ 85,850



Laura33

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Re: Long term care insurance
« Reply #48 on: January 15, 2019, 01:26:32 PM »
You know, we can debate whether LTC insurance is a good choice in a particular situation, but to claim that getting such a policy merits the Antimustachian Wall of Shame and Comedy?  Really? 

In the US, Medicare doesn't cover LTC -- only Medicaid does, and then only after you've spent down all your assets.  Which means that if you're married and your spouse needs a nursing home, you get to spend down almost all of your combined savings before Medicaid will pay a cent -- leaving you with practically nothing to live on for the rest of your life.  And the selection of Medicaid facilities is, well, not where I want to spend my final days/years. 

I have seen a large enough variety of human experience not to take my eternal youth and health for granted, including:

-- A family friend permanently disabled by a freak medical condition
-- A family member diagnosed with an incurable, debilitating medical condition in his early 50s
-- A family member living in a nursing home with Alzheimers for well over a decade
-- A family member scraping by for years on a very small pension and gifts who was limited to Medicaid nursing homes -- and who ultimately died in one when no one responded to her call for asthma medicine in the middle of the night.

In short, I have seen enough to understand that there is a realistic chance either DH or I may need LTC, and to know that we do not want to have to choose between our spouse's financial health and a reasonable place to spend the last few years.  That kind of choice comes with money -- around here, $6-10K/mo.  LTC may or may not be the best way to give us that choice.  But sure as hell is not mock-worthy.

Roadrunner53

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Re: Long term care insurance
« Reply #49 on: January 15, 2019, 02:05:07 PM »
Here is a list of costs for nursing homes in each state.

https://www.payingforseniorcare.com/longtermcare/paying-for-nursing-homes.html