Author Topic: LTC insurance for Mom - prepping for call tomorrow with Agent  (Read 6822 times)

FrugalFisherman10

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LTC insurance for Mom - prepping for call tomorrow with Agent
« on: August 22, 2018, 07:06:58 PM »
Hello,
I'm looking over some materials an insurance agent has provided to my mom's financial advisor for us all to review tomorrow on a call together. The materials are for long term care insurance for her.
Yes my mom has a financial advisor. Yes he probably takes bad fees. But we're passed all that at this point and I think his general 'looking after' of matters like this one (Long term care insurance) is valuable.

From what I understand, her basic situation is this:
She's 65
She's got a small pension from a previous employer that pays out something like $140 a month
She lives off her SS check which is like $1600 a month. This will go up by maybe $200 I think when she starts receiving my deceased father's SS check instead of her own.
She's single
She owns her house outright (it's a 3br/2ba and it's worth probably $115k)
She has around $200k+ invested with the Financial Advisor
She theoretically could still work at this point, but
- she's been through some bad injuries and thus doesn't have alot of 'stamina' for the day I guess, she does workout nearly every day though for exercise
- she's over her past profession
- and lives in a small town without many employment options

In terms of LTC, what are some things I should look for /I grill the insurance agent on? What should make sure she gets? what riders are important?
Is there some sort of gauge/guideline out there for how much insurance you should get as a % of some other metric (like the 2-4% LT Disability rule of thumb I've heard of)?

Another Reader

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #1 on: August 22, 2018, 08:44:17 PM »
Your mom's best bet is to plan to spend down the $200k and then go on Medicaid, for which you will have to sell the house after she passes to pay the Medicare lien.  She can't afford a good policy at her age, and this insurance salesman/"adviser" is going to sell her something that provides him a commission and not a lot of benefits for her.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #2 on: August 23, 2018, 08:47:53 AM »
Yeah the policies we are looking at are basically $75k, and provide a max benefit of about $240k, or $40k for 6 years.


Not sure how I feel about that math. Especially ones that have her pay the full premium up front.

Thanks for responding.

I think it would be a weird position to be in to have someone close to you go into long term care and hope they pass away before they use up all the money and get stranded. Although at that point the natural thing to do would be for my sister and I to step in and pay for her care.

Anyone else have comments or know more about this stuff?

merula

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #3 on: August 23, 2018, 09:03:31 AM »
The core rule of insurance is that you don't insure what you can afford to replace, unless you have knowledge about the risk that the insurer lacks. My expertise is in a different part of insurance, but that's applicable anywhere.

You and your mom don't have any insider information on when your mom might need long term care. The insurer probably knows this better, because they have the data on when people like your mom (age, health status, etc.) typically need care.

What are the details of this policy? You pay $75k once and then, if at any point in your mom's life she needs long-term care, they pay $40k a year for 6 years? Or is it something more like term life insurance; pay $75k now and you have coverage for the next 10 years or whatever? Those details will help you evaluate what you're paying for what you're getting.

With any insurance product, it's important to evaluate the financial health of the insurance company. If they go bankrupt, they owe you nothing. Now, typically, state regulators require reserves to ensure that they can cover their financial obligations to policyholders, but that's messy and it's better if they don't go bankrupt at all. Do this by searching "[Carrier name] AM Best Rating".

Cranky

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #4 on: August 23, 2018, 09:59:35 AM »
My mom had a long term care policy which she bought, mmmm..., maybe in the 80's? It was ancient, to the point where it covered "rest homes". The company had been bought and re-bought, so it took some effort to track them down.

It took some arguing to get them to pay up at all, but my brother-in-law was persistent. It certainly didn't cover the entire cost, but with my mom's pension, it was enough.

I think LTC coverage is important if you are trying to protect a surviving spouse, but there are certainly other routes to take if the circumstances are different.

When we were shopping for assisted living/memory care places, we found that a lot of places only accepted private pay patients, but when the money ran out they took Medicaid.

Everything I've read says the LTC insurance is not, at this point, a good buy. It's expensive for what they pay out.

By the time my mom passed, she had *not* run out of money, and she was not rich. The LTC policy was helpful, but without it she would simply have spent down the money she did have. We weren't trying to protect assets.

Catbert

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #5 on: August 23, 2018, 11:47:04 AM »
Frankly, in her case (modest income and assets) I would either not get LTC insurance or opt for a short term (e.g. 2 years rather than 6).  Her ~300K in assets would pay for several years of care (depending on area).  I think the average stay in a nursing home is 2-3 years.  Once she's in a good facility she can generally stay even after Medicaid kicks in.

 

lizzzi

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #6 on: August 23, 2018, 04:13:59 PM »
Just use her money to pay for her care until it runs out, and then go on Medicaid.  Long term care insurance is expensive--takes resources that could better be used to pay privately for what care might be needed--and I have seen patient after patient struggle to get benefits approved. If she isn't trying to save the net worth for the kids, I wouldn't get into LTC insurance. The only case I ever had where the LTC insurance paid without a huge battle was when one of my cancer patients took a big downturn and was given two weeks to live. The LTC insurance people were wonderful...gave the family all kinds of help. Well, sure...for two weeks. The company could afford to be magnanimous. Patients also don't understand that these policies kick in when they start to need personal care. When what they really need is an aide to do light homemaking, laundry, shopping and errands, they think their LTC insurance will pay. In the cases I saw, it wouldn't. So I used to tell the patients to let the aides help wash their hair...whether they needed that "personal care"  or not, lol--so their LTC insurance would pay for their aide. Those experiences were all when I was a public employee. (county public health nurse.) Later, when I retired from public employment and worked for a private agency, I used to have to do the paperwork for patients who were trying to access the LTC insurance they had paid premiums on for years. The whole point of the paperwork--yards and yards of it--my visits could last over two hours--was to try to Not give any care. To nitpick and nitpick until something--anything--turned up that would enable the insurance company not to pay.

This is all anecdotal, of course. I hope somebody out there has seen good experiences come out of Long Term Care insurance. I never have. Tread extremely carefully and be majorly skeptical.

frugaliknowit

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #7 on: August 24, 2018, 09:15:48 AM »
Your mom is not high asset, nor high income, nor does she have to worry about a spouse being buried in bills due to her care.  I don't see her as a prime candidate for LTC insurance.  The only thing LTC insurance MIGHT (I emphasize might) accomplish is to protect heirs SOMEWHAT.

SimpleCycle

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #8 on: August 24, 2018, 10:20:09 AM »
What is your mom's primary concern that is being addressed with LTC insurance?

My mom's stats are similar (although more pension, more property, less invested) and we did pay an eldercare lawyer to talk us through what her options were.  His recommendation was that she pay for care out of her own assets first and then she may need Medicaid to pay for more care, although given her particular mix of income and assets, it was unlikely she'll even end up on Medicaid.

With no community-dwelling spouse to worry about and relatively little in the way of assets, insurance is a bad deal here in my opinion.

We also recently went through Medicaid spend-down with my wife's grandmother.  Grandma had about $2k/month in pension, $1k/month in SS, and $1k/month in LTC insurance benefits, plus a primary residence.  She qualified for spend-down, but Medicaid never actually paid anything because she passed away well before her (very limited) assets were spent.  In the end there was only a $2500 gap between her income/LTC insurance ($4k) and the cost of her nursing home ($6500) that had to be covered out of assets, and she was in a nursing home for about 10 months before she passed away.

Bucs4Ever

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #9 on: August 24, 2018, 12:10:07 PM »
Yeah the policies we are looking at are basically $75k, and provide a max benefit of about $240k, or $40k for 6 years.


Not sure how I feel about that math. Especially ones that have her pay the full premium up front.




That's not long-term care insurance they are trying to get your mother to buy.

That's a life insurance policy with a rider to pay for long-term care.

The last thing your mother needs to do is put $75K into a life insurance policy.

Your mother does not have enough income to justify buying a policy.

When she needs care, she should just use her savings until it runs out.

If you want to protect some of her net worth for your and your sibling(s), then you and your sibling(s) should buy a "Long Term Care Partnership" policy and you pay the premium for your mom.

If she owns a long-term care partnership policy, and it runs out of benefits, her assets can be protected from Medicaid while she's alive and even after she passes away.

For every dollar the policy pays in benefits she can protect a dollar from Medicaid.

Not every state offers these programs. Here's a book on the subject:

https://t.co/m6FWrHoff7



Bucs4Ever

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #10 on: August 24, 2018, 12:12:07 PM »
Just use her money to pay for her care until it runs out, and then go on Medicaid.  Long term care insurance is expensive--takes resources that could better be used to pay privately for what care might be needed--and I have seen patient after patient struggle to get benefits approved. If she isn't trying to save the net worth for the kids, I wouldn't get into LTC insurance. The only case I ever had where the LTC insurance paid without a huge battle was when one of my cancer patients took a big downturn and was given two weeks to live. The LTC insurance people were wonderful...gave the family all kinds of help. Well, sure...for two weeks. The company could afford to be magnanimous. Patients also don't understand that these policies kick in when they start to need personal care. When what they really need is an aide to do light homemaking, laundry, shopping and errands, they think their LTC insurance will pay. In the cases I saw, it wouldn't. So I used to tell the patients to let the aides help wash their hair...whether they needed that "personal care"  or not, lol--so their LTC insurance would pay for their aide. Those experiences were all when I was a public employee. (county public health nurse.) Later, when I retired from public employment and worked for a private agency, I used to have to do the paperwork for patients who were trying to access the LTC insurance they had paid premiums on for years. The whole point of the paperwork--yards and yards of it--my visits could last over two hours--was to try to Not give any care. To nitpick and nitpick until something--anything--turned up that would enable the insurance company not to pay.

This is all anecdotal, of course. I hope somebody out there has seen good experiences come out of Long Term Care insurance. I never have. Tread extremely carefully and be majorly skeptical.


My mother-in-law's long-term care insurance claim was approved in only 3 weeks. All she had to do is sign two HIPAA forms and the home care agency filed the claim. We didn't have to do anything.

Bucs4Ever

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #11 on: August 24, 2018, 12:13:23 PM »
Your mom's best bet is to plan to spend down the $200k and then go on Medicaid, for which you will have to sell the house after she passes to pay the Medicare lien.  She can't afford a good policy at her age, and this insurance salesman/"adviser" is going to sell her something that provides him a commission and not a lot of benefits for her.

Her income is definitely too low for her to be able to afford a decent long-term care policy. If the kids want to pay the premium they should get a Long-Term Care Partnership policy which would be able to protect all of her assets from Medicaid.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #12 on: August 24, 2018, 12:56:18 PM »
To the people that said she shouldn't do it/doesn't really have enough income or enough assets...what's the root of what you're saying? Just asking because I'm trying to think through it. Are you arguing that:
1) she could be getting a better return on her money elsewhere, or something like that? (because if so, I likely agree, but I feel like we're kindof passed that. The financial advisor yesterday said the portfolio returns around 5-6% (which I question), and regardless I don't really want to try and turn over the leaf of "what is she invested in" and "she should be ramping up the risk here//dialing it down here..etc."
2) It's not worth it because at her income level people just don't get to enjoy some things like nice long term care options..she's low income so probably used to that. If that's the case, to some extent I could agree. Like I don't think poor people should have pools. It's a luxury, end of story. But at the same time, I don't want her to have really bad options of cockroach infested crapholes for long term care because we made some bad decision 20 years ago (i.e. now). This would 'leverage' her $75k up to a benefit of $3,300 a month or $240k total. It's just in this case, it seems so hard to know what that tipping point will be and what prices will be if/when she ever needs this
3) something else?

I agree we're not trying to protect assets. I have no plans to inherit anything here and I'm pretty sure my mom doesn't intend to pass anything on. Guess that would be a 'nice to have' but that's the extent of our thoughts on it, nothing more.

Yes this is one of the life insurance policies with a long term rider.
I agree it seems a bit odd. That's what I brought up on the call yesterday with the agent and the financial advisor..."why would we be buying something with a life insurance component when my mom (wisely) dropped her term life insurance years ago?" (when she determined it wasn't necessary to try and leave her non-dependent kids anything)

To the person that brought up medicaid..I brought that up to the financial advisor and he said he had personally checked out some of the  medicaid places for his father and that they were not very nice. My mom doesn't require "very" nice, but I mean, I would have a hard time putting her somewhere that wasn't clean, quiet and private.



Cranky

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #13 on: August 24, 2018, 02:14:25 PM »
Your mom isn't impoverished. She has a modest income, and assets. So she lives off that income, which she should be able to do with a paid for house.

Should she need long term care, she doesn't go into some crummy place, she goes into a nice place where she pays a bunch of money every month, but you make sure that AFTER she spends down her money, the very same place will accept Medicaid.

You would sell the house, and pay for her care with HER assets, until they are gone. Then Medicaid pays.

The places that are incredibly nice and never accept Medicaid are more than $40k/year anyway - long term care is extremely expensive.

Seriously, I have been through this with my mom and my in-laws. LTC insurance is for people who need to shelter assets for a spouse, or who have major family money.

SimpleCycle

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #14 on: August 24, 2018, 03:01:19 PM »
So if we take my wife's grandma's example, often by the time you need LTC, the insurance benefit you purchased is only a fraction of what the nursing home actually costs.  So she bought a policy with a benefit of $1k/month in the 80s, and needed nursing home care in 2013.  Her nursing home cost $6500/month, so while it helped, she paid premiums for over 25 years for a policy that covered 15% of her costs.  She still had to make up the rest out of income, assets, and Medicaid.

I don't fully understand the details of the insurance product you are being offered.  Is there a cash benefit upon death if she doesn't use the LTC portion?  Does she pay the $75k now or over a period of years?  The answers change the math slightly, but the story is still the same.

In your mom's case, let's assume she needs LTC in 2035 and nursing home costs grow at 4% a year (which is a fairly conservative estimate) from the $6800/month U.S. average.  Let's also assume her assets do in fact grow at 5% a year.  Also assume she spends none of her assets on other things, even though it is unlikely that she won't need assets for anything else.

Her assets today without insurance are $200k, and with the insurance purchase drop to $125k.
In 2035 a nursing home costs $13,245/month.  She still has $1600/month in income and insurance would give her $3300 in benefits, so the net cost of a nursing home after her income is used up is $11,645 without insurance and $8,345 with insurance.
In 2035 her assets are $467,902 without insurance and $292,429 with insurance.
Without insurance, she can pay for 40 months of a nursing home with her assets and income. ($467,902/$11,645)
With insurance, she can pay for 35 months of nursing home care before her assets are fully depleted ($292,429/$8,345).  She then has another 37 months of a $3,300 benefit, but she'd need Medicaid anyway because her income plus benefit doesn't pay for the full cost of the nursing home.

My back of the envelope math is a little rough around the edges, but it tells the basic story.  This scenario assumes your mom has a 100% chance of needing nursing home care, which is not the case.  The math is even more in favor of no insurance if she ends up not needing a nursing home, or she only needs a short nursing home stay.  The average length of stay in a nursing home is 2 years, 3 months.

Basically, these insurance salesmen prey on your fear of the unknown and the extreme costliness of healthcare to convince you that you need insurance, when actually, LTC is one of the things that most people can self insure for.  You have Medicaid as a backstop if things go dramatically off the rails (all assets get spent, or a very long length of stay) but most people can just spend down their own assets to pay for care.

Having been through this with a family member, I can say that the money she paid for LTC insurance would have been much better spent paying for things she needed as she got older.  Medicare doesn't cover hearing aids and she was so stressed out about covering the cost on her fixed income, while still having to pay the LTC insurance premium.  In the end, the LTC insurance benefit was negligible in her care decisions.
« Last Edit: August 24, 2018, 03:25:05 PM by SimpleCycle »

SimpleCycle

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #15 on: August 24, 2018, 03:12:54 PM »
Also, disparaging nursing home that accept Medicaid is a common sales tactic.  In reality, a huge amount of LTC used by the poor and middle class is paid for by Medicaid, which means most nursing homes accept Medicaid.  41 of the 42 nursing homes within 25 miles of my mom's home accept Medicaid.

Frankies Girl

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #16 on: August 24, 2018, 03:16:02 PM »
DL/DR: don't buy the LTC, period. She has assets to use to live modestly and she can sell the house after $ assets are depleted to get decent care on medicaid.


Quote
To the person that brought up medicaid..I brought that up to the financial advisor and he said he had personally checked out some of the  medicaid places for his father and that they were not very nice. My mom doesn't require "very" nice, but I mean, I would have a hard time putting her somewhere that wasn't clean, quiet and private.


Asking a sales rep for advice on not purchasing their product is equivalent to asking the wolf to watch the herd of sheep. He has a vested interest in selling his products. Nothing he says is going to be in your mother's best interests; it is primarily a business transaction meant to give him a handsome bonus and his company a nice chunk of money they hope to make more money off of while doing as little as possible for the client itself.

I honestly would be pushing to get that 1% back from the "adviser" and back into her pocket, and her into low cost index funds that fit her needs better than dealing with this garbage.

Another Reader

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #17 on: August 24, 2018, 03:25:54 PM »
It's less expensive and more flexible to get her into a good place using her income and assets and then transition to Medicaid at the same place if the money runs out.  Unless you are in a HCOL area, her assets should cover at least three to four years of care, which is longer than most people need.  A lot of the money she will pay to the insurance company is fees and commissions.  There is no free lunch.

She has $300k in net assets and an income that will soon be $1,940 a month.  She does not need long term care insurance.  She can self-insure and then rely on Medicaid IF she runs out of money.  The FA is likely robbing her blind.  A low cost balanced fund and some laddered CD's and treasuries would be what I would buy in her shoes.   
« Last Edit: August 24, 2018, 03:29:03 PM by Another Reader »

socaso

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #18 on: August 24, 2018, 03:26:00 PM »


To the person that brought up medicaid..I brought that up to the financial advisor and he said he had personally checked out some of the  medicaid places for his father and that they were not very nice. My mom doesn't require "very" nice, but I mean, I would have a hard time putting her somewhere that wasn't clean, quiet and private.

Please don't take someone else's word for this, go check them out. We are going through this right now with my MIL, who did not purchase long term care insurance when she had a chance and now she has Alzheimer's. The biggest problems we ran into were finding a place that took Medicaid in the first place and finding a place that had space. My MIL's assets are quite similar to your mother's with the exception being she did not own a home. We ended up putting her in a place with an assisted living area and a nursing home with the idea being that she could transition more easily into the nursing home since she was already a resident. Well, the transition happened and now she has a roommate, which is very difficult because the roommate is a bad sleeper and wakes her up all night. We are still spending down her assets at this point and have been advised that most people have a gap in coverage of about 2 months in between spending down to a level where you qualify for Medicaid and actually getting on Medicaid. So we are setting money aside for that.

It really sounds to me like this financial adviser is going to get some kind of kickback for selling you this product. Both my parents have LTC insurance and they just pay a monthly fee. Get quotes from some other companies just to see how they structure their LTC.

MayDay

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #19 on: August 24, 2018, 03:35:15 PM »
My grandma had similar assets. Paid off house worth 100k, maybe 200k in the bank, and a pension.

She went in the nursing home as private pay, and spent down her 200k. The house was sold, and they just had to start touching that money when she died. If she had used all the house money, they would have kept her as a patient in the same facility with Medicaid paying.

Generally (obviously get it in writing) if you start as private pay they'll keep you once Medicaid kicks in. That is because most patients die either before their assets run out, or fairly soon after.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #20 on: August 25, 2018, 07:51:02 AM »
I don't fully understand the details of the insurance product you are being offered.  Is there a cash benefit upon death if she doesn't use the LTC portion? 
Yes

Does she pay the $75k now or over a period of years? 
She can pay it all now, or split up over 10 years

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #21 on: August 25, 2018, 08:10:35 AM »
The policy is called Lincoln Financial Moneyguard II. I've attached a screenshot of the premiums paid and how the payouts would look. The attachment would be for a policy that is twice as large (double the premiums, double the potential coverage).

As I research this more and read all the replies I'm realizing the policy we're looking at really isn't "traditional LTC insurance" as one person above mentioned, and that's a huge deal/would likely affect alot of your responses. Please check out the attachment.

There is definitely a 'fear' associated with seeing the statistics quoted for cost of care. I will say that I genuinely don't believe the FA is using this as fear mongering or being intentionally malicious, but he (or the insurance agent) benefits from it nonetheless. Here's why I don't think he's being intentionally deceptive:
- he is trying to sell her the same thing that he has purchased for his mother and plans to purchase for himself
- he has expressed how his father didn't have any LTC insurance and it hasn't been the best
- he mentioned I should check for LTC group rates through my employer, which shows me he's not too concerned with her getting this exact policy (and his potential kickback)
- honestly he makes plenty of money and I just don't think he's that concerned in screwing my mom over. They've had a long relationship and I think he sees her account as small potatoes. He was her financial advisor through my dad's passing (at age 56) and I think he feels at least some amount of empathy/sympathy/personal ownership towards my mom and I. If he's pushing something like this it's only because he genuinely thinks she needs it, whether misinformed or not.
- he has expressed genuine concern himself over having my mom 'write this big of a check' out of her assets. It sounds like he's not that sure himself about how much coverage she should try to get, but he does think she needs some sort of 'backstop' (backstop being the insurance).

but yes it's scary to hear the stats that are out there: things like "normal cost is $6800/month, normal cost for Alzheimers is $10k+/month"
...can't say she won't get alzheimers. Nobody in her family had it, but her father died young (58) so we wouldn't have known. And she does have some "microangiophatic densities" and some brain atrophy or something like that, which showed up on a scan recently. This has her "hesitantly aware/concerned" that some sort of brain issue may be in her future?? but really who knows, she may just be getting older. We don't want to really expect either circumstance. I think it's good that she is aware of it and knows she's not invincible, but we don't want to just assume "oh that's it. she's going to have dementia now!"

Yes I know it's silly to ask the wolf to guard the sheep, but sometimes you get somewhere just being honest with salespeople and calling stuff out. I didn't expect a great answer from him on the things that will jeopardize the sale for them.

Thanks everyone for the replies. I will take these things to my mom and help her evaluate. I also think I'm going to look more into the investments she has and the fees he's charging her.
« Last Edit: August 25, 2018, 08:45:06 AM by FrugalFisherman10 »

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #22 on: August 25, 2018, 08:45:50 AM »
I also added an attachment for the policy we've been discussing so far in this thread (around $75k of 'premiums'..although can they really be called that? it's kinda like the insurance company is just holding your money and planning to return a leveraged amount of it to you if you need coverage (at a decreasing IRR/return), and return all of it to you when you die if you don't need coverage)

Catbert

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #23 on: August 25, 2018, 11:16:56 AM »
But even at 10K a month her income and assets would last 39 months:

10K - 2K= 8K a month coming from assets.

115k+200 = 315K current assets

315K/8K = 39.375 months or a bit over 3 years

You (or your mother) seem determined to get LTC insurance although all the comments have advised against it.  If that's the case look at traditional LTC policies to compare.  Since there is no spouse or dependents to consider look at the cost of a policy that doesn't kick in for a year or two.  That should be significantly cheaper.

Look back at SimpleCycle's math.  Please.   

merula

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #24 on: August 25, 2018, 08:41:37 PM »
OP, what is your mom's goal? To pay for LTC or to leave something for heirs? Those are two vastly different goals, and pretty much mutually exclusive.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #25 on: August 26, 2018, 01:12:26 PM »
OP, what is your mom's goal? To pay for LTC or to leave something for heirs? Those are two vastly different goals, and pretty much mutually exclusive.
Goal: To pay for long term care without running out of money.

I think she is/was having a hard time remembering what her goal is herself.
-----
Logic tree so far as I see it:

Should she get a traditional LTC policy?
Consensus here says "no". It is too expensive in her situation, and isnt suited to the goal of paying for long term care (it is more suited towards protecting assets).

 (Although I still have the "to do" of looking at some quotes for traditional LTC myself)

Should she get one of these life insurance type policies?
Still not sure. She doesn't need life insurance because that is just to leave some money to heirs..(seems similar to the goal of traditional LTC). But the option of getting the money she paid into it back if it isn't needed is nice?


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merula

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #26 on: August 27, 2018, 08:33:25 AM »
Goal: To pay for long term care without running out of money.

There's never any guarantee that she won't run out of money, with or without LTC insurance or significant assets. (A family member of mine had assets much more significant than your mom's and recently ran out of money because she's been in a really nice memory care facility for 10+ years.)

If she runs out of money in long-term care, Medicaid will take over after a few month gap.


Should she get one of these life insurance type policies?
Still not sure. She doesn't need life insurance because that is just to leave some money to heirs..(seems similar to the goal of traditional LTC). But the option of getting the money she paid into it back if it isn't needed is nice?

So... best case scenario, the heirs get the money that was paid in? You could bypass the whole insurance concept and end up in the same boat. Best case scenario is that your mom lives decades longer and dies peacefully in her sleep at home. If you buy the insurance, the heirs get something. If you don't buy the insurance... the heirs still get those assets.

cchrissyy

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #27 on: August 30, 2018, 12:52:26 PM »
Quote
around $75k of 'premiums'..although can they really be called that? it's kinda like the insurance company is just holding your money and planning to return a leveraged amount of it to you if you need coverage (at a decreasing IRR/return), and return all of it to you when you die if you don't need coverage)


it sounds like you're looking at this as a way to take $75k and turn it into some larger number.  Like, you might get $x back or it might be $y but in no case would it be less than $75k.  but of course that's not true. The insurance company exists to make money and they have calculated the cost and the benefits in such a way that THEY profit on the deal. Not you.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #28 on: September 05, 2018, 01:51:53 PM »
Quote
around $75k of 'premiums'..although can they really be called that? it's kinda like the insurance company is just holding your money and planning to return a leveraged amount of it to you if you need coverage (at a decreasing IRR/return), and return all of it to you when you die if you don't need coverage)


it sounds like you're looking at this as a way to take $75k and turn it into some larger number.  Like, you might get $x back or it might be $y but in no case would it be less than $75k.  but of course that's not true. The insurance company exists to make money and they have calculated the cost and the benefits in such a way that THEY profit on the deal. Not you.
They can make money on my moms money in the meantime, and still return all of it to her. Kinda like a ponzy scheme, but with them earning a real return in the marketplace, while my mom settles for just merely getting her money back at the worst.

So no, it's not impossible that they do this.

Regardless, we've figured out she's probably not insurable. We asked for a quote from an insurance company recommended by my coworker and a recommended by Dave ramsey, and they said they couldn't get a quote together because of her medical history.
They also validated what most of you are saying here..that neither a traditional LTC policy nor a life insurance policy with a LTC benefit rider/accelerator would make sense for my mom.

I will admit I'm a bit concerned about proceeding forward with no insurance for this type of thing, especially when one of the conditions she's recently been told she has somehow relates to alzheimers.
That is why I'm now more interested in making sure she's keeping any of the money she is earning on her investments. You can follow that thread over here:
https://r.tapatalk.com/shareLink?url=https%3A%2F%2Fforum%2Emrmoneymustache%2Ecom%2Findex%2Ephp%3Ftopic%3D96170%2E0&share_tid=96170&share_fid=111053&share_type=t


MayDay

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #29 on: September 05, 2018, 07:30:25 PM »
What exactly is your concern?

That you won't get an inheritance? You probably won't if she gets Alzheimer's.

That she'll end up in a crappy home? She won't if she enters self pay in a nice home that accepts Medicaid from formerly self pay patients.

I don't get what you are worried about.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #30 on: September 05, 2018, 08:04:12 PM »
What exactly is your concern?

That you won't get an inheritance? You probably won't if she gets Alzheimer's.

That she'll end up in a crappy home? She won't if she enters self pay in a nice home that accepts Medicaid from formerly self pay patients.

I don't get what you are worried about.
No not concerned that I won't get an inheritance.

Concerned about her running out of money and i gess about that whole concept of entering self pay place with/without alzheimers and then transferring to medicaid.

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MayDay

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #31 on: September 06, 2018, 06:35:46 AM »
What exactly is your concern?

That you won't get an inheritance? You probably won't if she gets Alzheimer's.

That she'll end up in a crappy home? She won't if she enters self pay in a nice home that accepts Medicaid from formerly self pay patients.

I don't get what you are worried about.
No not concerned that I won't get an inheritance.

Concerned about her running out of money and i gess about that whole concept of entering self pay place with/without alzheimers and then transferring to medicaid.

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LTC insurance is not the answer to that.

Call so e facilities and talk to some of them. Worrying in a vacuum won't help anything.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #32 on: August 06, 2020, 09:17:33 PM »
Your mom's best bet is to plan to spend down the $200k and then go on Medicaid, for which you will have to sell the house after she passes to pay the Medicare lien.  She can't afford a good policy at her age, and this insurance salesman/"adviser" is going to sell her something that provides him a commission and not a lot of benefits for her.

Her income is definitely too low for her to be able to afford a decent long-term care policy. If the kids want to pay the premium they should get a Long-Term Care Partnership policy which would be able to protect all of her assets from Medicaid.
Hi Bucs4ever

Just re-visiting this thread of mine and in rereading it noticed this language you used of "protecting dollars from Medicaid". What do you mean by that?




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Sibley

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #33 on: August 09, 2020, 05:02:24 PM »
Not Bucs, but Medicaid has a clawback. You should be able to find the rules for the appropriate state via google. Basically, if you try to give away all your money/assets so Medicaid will pay the LTC costs, Medicaid can do a lookback for however long (5 years?) and then go after that money. It's a way to discourage people from trying to cheat.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #34 on: August 09, 2020, 06:09:58 PM »
Not Bucs, but Medicaid has a clawback. You should be able to find the rules for the appropriate state via google. Basically, if you try to give away all your money/assets so Medicaid will pay the LTC costs, Medicaid can do a lookback for however long (5 years?) and then go after that money. It's a way to discourage people from trying to cheat.
Ok. What about not give away but use/sell?

Like if we were to sell her house and spend down the proceeds for a couple years on  a LTC place, would they then have any way of coming after money that was gone?


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Another Reader

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #35 on: August 09, 2020, 06:58:19 PM »
If the money is spent on her care and you can document that, no problem.  It's when assets are diverted for the benefit of others that the problem occurs.

Car Jack

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #36 on: August 09, 2020, 07:10:53 PM »
The numbers are a bit alarming.  $40k is not enough to pay for my wife's Aunt's SUBSIDIZED assisted living facility.  I think how she ended up is ideal.  She applied for the assisted living facility run by her city.  To qualify, she had to be low enough income with low enough assets.  She just barely qualified, but did.  An apartment opened up (meaning someone died) and she moved in.  Cost is about $4500 a month and includes meals.  They have an in house prescription service that took a lot of work on my wife's part to coordinate with her insurance.  Anyways, the way this works, she private pays until she spins all her assets down.  They then accept her income.  In her case, a state pension and small annuity.  After moving in, we prep'd her house for sale and a real estate broker who works with her attorney found a buyer for an As Is sale.  I describe the house, built in 1890 as being held together by the lead paint, asbestos and knob and tube wiring.  That money, of course will help pay for her care.  And it should.  Nobody in the family expects any kind of inheritance.  When she needs to step to a nursing facility, they have that attached and the move will require nothing different.  If she had gone into the nursing home from the start, that's about $12k a month.  This is in the second largest city in New England.

This kind of entry is in my humble opinion ideal.  For someone who has slyly given away all their money to family, then waited the 5 years, then what?  If they're able to find a bed at even an assisted living facility, it's typical that 2 to 3 years must be full private pay.  Where's that $4k or $5k a month going to come from?  Ok....so instead, they look into a medicaid facility.  What's the waiting time for those near you?  10 years?  Good luck.
« Last Edit: August 09, 2020, 07:14:01 PM by Car Jack »

jjones1438

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #37 on: August 10, 2020, 09:30:07 AM »
OP, good luck with this. My parents fell hook, line, and sinker for LTC on top of a bunch of annuities from their snake oil salesman / "advisor", makes me freaking sick to my stomach.

An easy test to determine if they even understand what they have suckered into is to ask simple broad questions such as, "So can you tell me about the LTC your guy sold to you? How does it work? How much does it cost? What are the benefits? How did you decide which option you thought would be best for you? What do you hope to achieve with LTC? Etc."

After seeing your thread, I asked these questions over the weekend and my parents responses confirmed my unfortunate hypothesis, "So once X year hits, we receive X per month, but if we wait a few more years, we receive Y per month"... Knowing the math made no sense, a few minutes later, Dad realized that was the Annual amounts, the fact that they did not know this basic answer is beyond alarming.

Another observation. These "advisors" try to position these products as a no brainer decision based on the payout structure, who gets what, how much it pays, etc. but anyone with common sense knows the explanations (at least the ones provided to me by my parents), do not add up.

It sounds like your Mom is open minded to your thoughts, that is great! While it will be challenging to even understand these products, for sure, stick by her side and play referee. These scum of the earth "advisors" want nothing more than to isolate your Mom, then scare the living hell out of her to get her to sign up (FEAR = their #1 Sales Tactic and be prepared to diffuse this), so they get their commission, its sickening and makes my blood boil thinking about these people that make their living preying on the elderly (well not all, just the vast majority). Good luck!

wenchsenior

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #38 on: August 10, 2020, 09:48:38 AM »
Your mom isn't impoverished. She has a modest income, and assets. So she lives off that income, which she should be able to do with a paid for house.

Should she need long term care, she doesn't go into some crummy place, she goes into a nice place where she pays a bunch of money every month, but you make sure that AFTER she spends down her money, the very same place will accept Medicaid.

You would sell the house, and pay for her care with HER assets, until they are gone. Then Medicaid pays.

The places that are incredibly nice and never accept Medicaid are more than $40k/year anyway - long term care is extremely expensive.

Seriously, I have been through this with my mom and my in-laws. LTC insurance is for people who need to shelter assets for a spouse, or who have major family money.

This.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #39 on: August 10, 2020, 09:57:31 AM »
The numbers are a bit alarming.  $40k is not enough to pay for my wife's Aunt's SUBSIDIZED assisted living facility.  I think how she ended up is ideal.  She applied for the assisted living facility run by her city.  To qualify, she had to be low enough income with low enough assets.  She just barely qualified, but did.  An apartment opened up (meaning someone died) and she moved in.  Cost is about $4500 a month and includes meals.  They have an in house prescription service that took a lot of work on my wife's part to coordinate with her insurance.  Anyways, the way this works, she private pays until she spins all her assets down.  They then accept her income.  In her case, a state pension and small annuity.  After moving in, we prep'd her house for sale and a real estate broker who works with her attorney found a buyer for an As Is sale.  I describe the house, built in 1890 as being held together by the lead paint, asbestos and knob and tube wiring.  That money, of course will help pay for her care.  And it should.  Nobody in the family expects any kind of inheritance.  When she needs to step to a nursing facility, they have that attached and the move will require nothing different.  If she had gone into the nursing home from the start, that's about $12k a month.  This is in the second largest city in New England.

This kind of entry is in my humble opinion ideal.  For someone who has slyly given away all their money to family, then waited the 5 years, then what?  If they're able to find a bed at even an assisted living facility, it's typical that 2 to 3 years must be full private pay.  Where's that $4k or $5k a month going to come from?  Ok....so instead, they look into a medicaid facility.  What's the waiting time for those near you?  10 years?  Good luck.

You lost me at the end jack.

Sounds like you are trying to say something different from the other recent posters? But I'm pretty sure they are all correct...if ever needed we should get her into a nice place private paying that will accept Medicaid when she needs it, should then spend down her assets, sell the house when the time comes, spend that down, then go into Medicaid.

Are you suggesting something different? Your comment about wait times...do I need to look into facilities now then if the wait times are so long? That would be silly..she's perfectly fine living at home for the foreseeable 10-15 years

jjones1438

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #40 on: August 10, 2020, 10:05:02 AM »
Also, this article was very informative. Major takeaways - https://eggstack.com/blog/2019-07-28-Long-Term-Care-Insurance-is-a-Waste-of-Money/#:~:text=The%20cost%20of%20long%2Dterm,your%20coverage%20will%20be%20denied.&text=Like%20whole%20life%20insurance%2C%20if,just%20a%20big%2C%20stupid%20waste.

1) The majority of nursing home stays are less than 90 days. People either get better or they don’t. If they get better, they go back home. If they don’t, well, that’s the other way to leave a nursing home in less than 90 days. Only 25 percent of nursing home stays last more than a year, and only five percent last more than two years.

2) If you have long-term care insurance and you actually need it, there is a strong possibility that the insurance company will deny your claim. Most policies have multiple exclusions including a 90-day exclusion period. As mentioned, most nursing home stays don’t last 90 days so you get nada.

3) Over the course of decades it is entirely possible that your insurance company will go out of business. The financial meltdown of 2008 saw titans like Bear Sterns, Merrill Lynch, and Countrywide get tossed onto the trash heap of history.

#2 is freaking scary. Assuming the stats are correct, a 90 day exclusion period would be destroying the vast majority of cases, that is freaking robbery.

wenchsenior

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #41 on: August 10, 2020, 12:21:18 PM »
Also, this article was very informative. Major takeaways - https://eggstack.com/blog/2019-07-28-Long-Term-Care-Insurance-is-a-Waste-of-Money/#:~:text=The%20cost%20of%20long%2Dterm,your%20coverage%20will%20be%20denied.&text=Like%20whole%20life%20insurance%2C%20if,just%20a%20big%2C%20stupid%20waste.

1) The majority of nursing home stays are less than 90 days. People either get better or they don’t. If they get better, they go back home. If they don’t, well, that’s the other way to leave a nursing home in less than 90 days. Only 25 percent of nursing home stays last more than a year, and only five percent last more than two years.

2) If you have long-term care insurance and you actually need it, there is a strong possibility that the insurance company will deny your claim. Most policies have multiple exclusions including a 90-day exclusion period. As mentioned, most nursing home stays don’t last 90 days so you get nada.

3) Over the course of decades it is entirely possible that your insurance company will go out of business. The financial meltdown of 2008 saw titans like Bear Sterns, Merrill Lynch, and Countrywide get tossed onto the trash heap of history.

#2 is freaking scary. Assuming the stats are correct, a 90 day exclusion period would be destroying the vast majority of cases, that is freaking robbery.

I think the raw stats are persuasive, but family history has also to be taken into account. Of the 3 of my 4 grandparents who lived to old age, all 3 needed long term care for >3 years.  That was without dementia being a factor in any of the three case, which can make the stays much longer. 

ETA, I'm still not arguing for LTC in most cases. None of my grandparents had it. One was quite wealthy and self payed.  Two were poor already, paid down assets and went on Medicaid, and eventually the state took their house.   

There are cases where it can be useful, but mostly that includes protecting a spouse who would otherwise be left destitute.  My wealthy grandmother had no spouse to protect, and my poor grandparents couldn't afford LTC insurance so it was a moot point.  The longer living spouse paid for the shorter living souse, and was indeed left pretty much destitute until she too went into care. That was a tough period.
« Last Edit: August 10, 2020, 12:25:26 PM by wenchsenior »

jjones1438

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #42 on: August 10, 2020, 12:36:34 PM »
Also, this article was very informative. Major takeaways - https://eggstack.com/blog/2019-07-28-Long-Term-Care-Insurance-is-a-Waste-of-Money/#:~:text=The%20cost%20of%20long%2Dterm,your%20coverage%20will%20be%20denied.&text=Like%20whole%20life%20insurance%2C%20if,just%20a%20big%2C%20stupid%20waste.

1) The majority of nursing home stays are less than 90 days. People either get better or they don’t. If they get better, they go back home. If they don’t, well, that’s the other way to leave a nursing home in less than 90 days. Only 25 percent of nursing home stays last more than a year, and only five percent last more than two years.

2) If you have long-term care insurance and you actually need it, there is a strong possibility that the insurance company will deny your claim. Most policies have multiple exclusions including a 90-day exclusion period. As mentioned, most nursing home stays don’t last 90 days so you get nada.

3) Over the course of decades it is entirely possible that your insurance company will go out of business. The financial meltdown of 2008 saw titans like Bear Sterns, Merrill Lynch, and Countrywide get tossed onto the trash heap of history.

#2 is freaking scary. Assuming the stats are correct, a 90 day exclusion period would be destroying the vast majority of cases, that is freaking robbery.

I think the raw stats are persuasive, but family history has also to be taken into account. Of the 3 of my 4 grandparents who lived to old age, all 3 needed long term care for >3 years.  That was without dementia being a factor in any of the three case, which can make the stays much longer. 

ETA, I'm still not arguing for LTC in most cases. None of my grandparents had it. One was quite wealthy and self payed.  Two were poor already, paid down assets and went on Medicaid, and eventually the state took their house.   

There are cases where it can be useful, but mostly that includes protecting a spouse who would otherwise be left destitute.  My wealthy grandmother had no spouse to protect, and my poor grandparents couldn't afford LTC insurance so it was a moot point.  The longer living spouse paid for the shorter living souse, and was indeed left pretty much destitute until she too went into care. That was a tough period.

This is a fair point. I do not know the answer to this, but do the policy writers look into this as well? Seems like a valid point and if there is a history, perhaps they adjust the policy to be more expensive for that subset of people? Or maybe not, and they just assume it will all even out over time and over thousands of policies written.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #43 on: August 10, 2020, 12:54:28 PM »
OP here
just so we're clear, all this "don't take LTC insurance" thinking still applies even if my mom ends up with dementia or Alzheimer's right? Just want to make sure you commenters didn't miss that point..she has some diagnosis that has something to do with her brain and loosely relates or is a risk factor for Alz/dementia but I don't really know what the diagnosis is.



wenchsenior

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #44 on: August 10, 2020, 03:27:59 PM »
Also, this article was very informative. Major takeaways - https://eggstack.com/blog/2019-07-28-Long-Term-Care-Insurance-is-a-Waste-of-Money/#:~:text=The%20cost%20of%20long%2Dterm,your%20coverage%20will%20be%20denied.&text=Like%20whole%20life%20insurance%2C%20if,just%20a%20big%2C%20stupid%20waste.

1) The majority of nursing home stays are less than 90 days. People either get better or they don’t. If they get better, they go back home. If they don’t, well, that’s the other way to leave a nursing home in less than 90 days. Only 25 percent of nursing home stays last more than a year, and only five percent last more than two years.

2) If you have long-term care insurance and you actually need it, there is a strong possibility that the insurance company will deny your claim. Most policies have multiple exclusions including a 90-day exclusion period. As mentioned, most nursing home stays don’t last 90 days so you get nada.

3) Over the course of decades it is entirely possible that your insurance company will go out of business. The financial meltdown of 2008 saw titans like Bear Sterns, Merrill Lynch, and Countrywide get tossed onto the trash heap of history.

#2 is freaking scary. Assuming the stats are correct, a 90 day exclusion period would be destroying the vast majority of cases, that is freaking robbery.

I think the raw stats are persuasive, but family history has also to be taken into account. Of the 3 of my 4 grandparents who lived to old age, all 3 needed long term care for >3 years.  That was without dementia being a factor in any of the three case, which can make the stays much longer. 

ETA, I'm still not arguing for LTC in most cases. None of my grandparents had it. One was quite wealthy and self payed.  Two were poor already, paid down assets and went on Medicaid, and eventually the state took their house.   

There are cases where it can be useful, but mostly that includes protecting a spouse who would otherwise be left destitute.  My wealthy grandmother had no spouse to protect, and my poor grandparents couldn't afford LTC insurance so it was a moot point.  The longer living spouse paid for the shorter living souse, and was indeed left pretty much destitute until she too went into care. That was a tough period.

This is a fair point. I do not know the answer to this, but do the policy writers look into this as well? Seems like a valid point and if there is a history, perhaps they adjust the policy to be more expensive for that subset of people? Or maybe not, and they just assume it will all even out over time and over thousands of policies written.

I don't know.  They can turn people down flat for preexisting conditions, but I don't know how much they can dig into family history legally speaking.  We bought a LTC policy to cover my husband while he was in his early 50s and had no preexisting conditions.  He doesn't even know his father, so there was no tracking that side of the family even if the company wanted to. However, they turned me down flat (I was in my early 40s with some mild preexisting conditions, but I'd been tested multiple times for some of the scary autoimmune diseases and that scared them off, even though I've turned up negative on all those tests). 

We wanted insurance b/c my husband is older and the considerably higher earner (so to protect assets for me if he went into care), and we wanted insurance for me b/c my health seems somewhat questionable, with elevated risk for some very unpleasant and expensive diseases.  And we are likely to be in the asset window (1-2 million $) where paying out of pocket for more than a year or so would be very hard, but we have enough assets that we do want to try to protect them in at least some scenarios.

So I don't think it's always a bad call.  Just not a good call for most people, given their assets and average household income.

BikeFanatic

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #45 on: August 10, 2020, 03:55:08 PM »
My experience around here, total care nursing home for relative with dementia 400 a day 12500 a month. We paid down his stash, but poor guy died after a year. Medicaid would pay after all assets are
Liquidated . Can not give away any assets nor sell them less than market value. For example he had a second home and we had it appraised twice in order to be sure we paid fair market value when he had to sell.
The spouse had given away some money and Medicaid lawyer said someone had to pay it back. They looked at 5 years of checking account statements to verify everything.

Dicey

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #46 on: August 17, 2020, 07:29:27 AM »
OP here
just so we're clear, all this "don't take LTC insurance" thinking still applies even if my mom ends up with dementia or Alzheimer's right? Just want to make sure you commenters didn't miss that point..she has some diagnosis that has something to do with her brain and loosely relates or is a risk factor for Alz/dementia but I don't really know what the diagnosis is.
Oh fuck, I am uniquely qualified to chime on this one. MIL bought LTC from Allstate in 1988. In her dementia decline, she let the policy lapse. We did backflips to get it reinstated and were thrilled when we were successful. Our happiness was an illusion, alas. We kept her at home with us for over six years. We finally put her in a board and care, waited the 90 days, then submitted the paperwork. After waiting another 60 days, Allstate denied the claim and the initial appeal. The policy is vaguely worded. They insist they will only pay for a Skilled Nursing Facility, except MIL does not need that level of care. She clearly is incapable of caring for herself. Also SNF's cost so much more that even if we put her in one and they paid, it would be more OOP per month. We plan on appleaing it, but those plans are currently on hold because...

Five weeks ago she fell and broke her hip, which required surgery. Then she had a blood clot. Then low O2 levels, then a UTI, then C-Diff. She's been juggled quite a bit - to the acute hospital three times, a Skilled Nursing Facility, and her Board & Care. We have paid for the B&C the whole time so she doesn't lose her place, and the hospital usually manages to discharge her before Medicare takes over full payment (7 days). They tried to discharge her 2 days after the C-Diff admittance and we have appealed that decision to Medicare, so she's in still in the acute hospital, in limbo right now. The B&C won't take her back because C-Diff is contagious and puts them at too much risk. The SNF won't take her because they had a staffer test positive for Covid while MIL was there. F-U-C-K.

IMO, the best thing you can do is be your mother's advocate. Let her spend down her assets until she qualifies for aid, then strongly advocate for her good care. You are much more likely to get reasonably good results if you are an active presence. Family oversight makes a huge difference in the level of care/concern received.

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #47 on: August 17, 2020, 10:59:16 AM »
OP here
just so we're clear, all this "don't take LTC insurance" thinking still applies even if my mom ends up with dementia or Alzheimer's right? Just want to make sure you commenters didn't miss that point..she has some diagnosis that has something to do with her brain and loosely relates or is a risk factor for Alz/dementia but I don't really know what the diagnosis is.
Oh fuck, I am uniquely qualified to chime on this one. MIL bought LTC from Allstate in 1988. In her dementia decline, she let the policy lapse. We did backflips to get it reinstated and were thrilled when we were successful. Our happiness was an illusion, alas. We kept her at home with us for over six years. We finally put her in a board and care, waited the 90 days, then submitted the paperwork. After waiting another 60 days, Allstate denied the claim and the initial appeal. The policy is vaguely worded. They insist they will only pay for a Skilled Nursing Facility, except MIL does not need that level of care. She clearly is incapable of caring for herself. Also SNF's cost so much more that even if we put her in one and they paid, it would be more OOP per month. We plan on appleaing it, but those plans are currently on hold because...

Five weeks ago she fell and broke her hip, which required surgery. Then she had a blood clot. Then low O2 levels, then a UTI, then C-Diff. She's been juggled quite a bit - to the acute hospital three times, a Skilled Nursing Facility, and her Board & Care. We have paid for the B&C the whole time so she doesn't lose her place, and the hospital usually manages to discharge her before Medicare takes over full payment (7 days). They tried to discharge her 2 days after the C-Diff admittance and we have appealed that decision to Medicare, so she's in still in the acute hospital, in limbo right now. The B&C won't take her back because C-Diff is contagious and puts them at too much risk. The SNF won't take her because they had a staffer test positive for Covid while MIL was there. F-U-C-K.

IMO, the best thing you can do is be your mother's advocate. Let her spend down her assets until she qualifies for aid, then strongly advocate for her good care. You are much more likely to get reasonably good results if you are an active presence. Family oversight makes a huge difference in the level of care/concern received.

Frick what a story. That is terrible.

Well thanks for chiming in.
 And in terms of "being a presence" to advocate for her care?
.. sucks I just moved a few states away from my mom. :/

Although my older sister lives right down the road from her and is really good at all that stuff too, which was a big part of me being down to move away.

And really, hopefully all this stuff is like 20 years away, when she's 88 instead of 68.
Thanks again

FrugalFisherman10

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #48 on: August 26, 2020, 10:21:49 AM »
Ok I've got a further development.
I am now under the impression Medicare does not pay for long term care.
My mom mentioned this today.

She said our plan of paying out of her assets and then switching over to Medicare would have worked back in the day perhaps, but Medicare does not pay for long term care. So I googled it. According to the screenshots in my attachments, sure enough, Medicare does not pay for LTC. So what say we now? Are we screwed - and should buy some LTC Insurance?
« Last Edit: August 26, 2020, 10:29:28 AM by FrugalFisherman10 »

MayDay

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Re: LTC insurance for Mom - prepping for call tomorrow with Agent
« Reply #49 on: August 26, 2020, 01:24:52 PM »
Oh for Peet's sake!

It's Medicaid that will pay for LTC.