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sharynmarie Asked October 2012

Should I get a long-term care policy?

My father passed away in 2003 at the age of 76 due to Alzheimer's Disease. My mother was diagnosed with Dementia/Alzheimer's two years ago. My paternal grandfather died from dementia, and 3 of my mother's siblings died from dementia. I believe my chances of developing dementia is higher than the average Yogi Bear, Lol!! I don't want my husband to lose everything to take care of me. I want him to have a home to live in and money for his own needs. Any advice on this, I would be grateful!!

Kashi60 Nov 2012
Thank you all for your insight and comments. I wonder if there is a way to find out about a current LTC policy and how is is paying out/working for folks who are using it. I bought LTC for me and my husband when the Fed'l Gov's came out with LTC plans for federal workers...so it's been out there and in effect for about 10 years. I wonder if there is a way to find out how it is working for folks.

igloo572 Nov 2012
Sharynmarie - there's always something.....you just need to make sure NH takes your mom's specific policy & this means speaking directly with whomever in the business office who does this. Not admissions as they are all about selling imho.
I think the big sticky is the RN supervision as most NH are heavy on assistants and outside of the DON (director of nursing who is THE GOD or goddess @ a NH) there may not be RN's for all shifts for the requirement of the LTC policy. A RN can make oodles more $ working hospice than working in a NH even if they are working at the same NH. + less stress. DItto for home health RN's.

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sharynmarie Nov 2012
Igloo~It sounds the same as my mom's policy. Home Health is supervised by a RN and it covers taking care of medical needs which means the person has to need help with showering, going to the bathroom, eating. It does not cover as you said a person in mid stage Alzheimer's who can't take care of their finances, a person who could get scammed over the phone. I didn't know that some NH won't take it, I hope that is not a problem with my mom's cuz that will suck if it is after all that is paid into it.

igloo572 Nov 2012
Kashi - most LTC polices vett the policy by documentable ADL's - usually 2 out of 6 or 3 out of 6. ADL's seem to be the industry standard. If you have a disease like Parkinson's or need LTC due to a traumatic injury then meeting those standards is a done deal. But for dementia, most in the early & mid stages still are OK on ADL's so LTC won't pay out until it's latter or end stage dementia. This is something to carefully think about before you sign up for a LTC policy.

My mom is Lewy Body Dementia, mid 90's and in a NH (for 2 years) and to this day still can do most ADL: walks with a walker, potty, eat, and on a good day is totally lucid and know's who's who both staff & family. Now there is no way she could live on her own because she had hallucinations on occasion, cannot do her medications or be aware of the weather to dress appropriately and many other things needed for living at home on her own. But if she had a LTC policy, they wouldn't pay a dime as my mom is still good on ADL's.

My mom's NH does private pay & takes Medicare & Medicaid BUT DOES NOT take any LTC policy. Mom is on Medicaid. When I asked why no LTC policies, he told me that the reporting requirements by the insurance companies are so detailed as to staffing, the qualifications needed on staffing, time sheets, etc just flat require too much time for the often pitiful amount of reimbursement that they don't do it. One of our friends mom has a very good LTC policy but she is one of those who absolutely hates having "strangers" in her apt, so forget actually using the policy, as the policy requires a certified or other legit nursing or health care service provider. So they pay out of pocket for a low wage with no medical training sitter. I know I'm rambling, but my point is that LTC insurance is a gamble. That's why I think the "hybrid" life insurance/LTC policy's are the best best in that it allows for more flexibility for the family. But realize these cost lots more.

Kashi60 Nov 2012
Gee, that's is strange Shaynmarie..that your mother's policy doesn't cover dementia....but I guess dementia would eventually lead to issues with the ADLs....

sharynmarie Nov 2012
Thanks igloo. My mom's policy is like that in fact, she has dementia and must meet 2 out of 6 ADL's but they are all for physical nothing to do with dementia. We had hoped to be able to use it for home healthcare to keep her home longer, but that isn't going to be possible because of the ADL's.

igloo572 Nov 2012
You might look to getting a "hybrid" life insurance policy that has LTC benefits. This is sometimes called an accelerated death benefit (sounds spooky!). Usually the LTC benefits are limited to the death benefit less 10 - 15% - for me this is good as you have a fixed amount to plan back from. Not all insurance agents or estate planners or brokers/advisors are familiar with doing hybrids so you may have to ask around to find ones who understand and do these. If you do a hybrid, you might want to add an "indemnity" benefit to the LTC rider on the insurance policy. This allows you to put the insurance policy in an irrevocable trust and still use the LTC benefit for care but if you die before the benefit amount is used completely, the balance is left tax-free and NOT counted as part of the estate so no probate.

As with all these things, understanding the fine print is critical and many policies require documented assistance needed with 2 or more ADL's and often beginning dementia folks don't meet this level of documentation or have a waiting period for cognitive loss from dementia before payment.

sharynmarie Oct 2012
Thank you all!! I appreciate the detailed info to ask about when I check this out. Any other details will be appreciated also!! Have a great evening everyone!!

abby33 Oct 2012
My husband and I are in the process of purchasing long-term care insurance now. We both work for the State and we can purchase a group policy. I am 49 and can get good coverage for $84/month. This will not go up with age unless premiums go up for everyone. My husband is 58 and he can get pretty good coverage for $117/month. He is also a retired Marine, so both of us will be entitle to Aid and Attendance benefits if we need them. For me, I'd rather pay for the insurance and not need it than to need it and not have it. My mom is in assisted living and has not LTC insurance. She will be eligible for Aid and Attendance benefit and some point which will be helpful. I definitely think you should purchase LTC insurance.

steviegirl Oct 2012
If I were still working, I would look into it but I'm a 24/7 caregiver for my mom. Lost my job 4 yrs ago and I'm now 52 hoping to find something at least part time to get me out of the house a bit. Doesn't look like a purchase for LTC is in my future now. Glad mom has it for her.

NewportOC Oct 2012
I have LTC thru John Hancock. It was offered thru my employer at group rates, which makes it more appealing. Mine also acts as life insurance should something happen to me prior to needing to use it for LTC. Considering what we are experiencing with our loved ones, I just couldn't see NOT having LTC insurance at this point.

steviegirl Oct 2012
If you can afford it -- I guess get it. It helps but it's not a slam dunk. My mom has it and the premiums are high and it only pays half of what it costs to have someone come in like $12o a day. Her particular policy only covers 2 yrs of nursing home and I know she will need more than that (she doesn't think so but it's reality. So time will tell. Also a lot of facilities don't even take LTC policies.They'll say yes to medicare and yes to medicaid but no to LTC. Interesting. For now it's better than nothing b/c when I do get respite care it covers the $120 a day but as her needs progress to more skilled care it may reach it's limit. And the premiums are expensive and went way up last year. Can't imagine that premiums will go down. For me, it's a no brainer, I have no $$ so I dont' have to ponder these thoughts.

sunflo2 Oct 2012
Absolutely! Get it if you can afford it. With all of us living longer and longer, and healthcare costs climbing, it is absolutely necessary. Research it; get various quotes and compare policies. My husband and I recently purchased and we have individual and combined benefits (such as if one uses more than the other, he/she can tap into others policy); also don't go with the cheapest as daily benefits, upper limits, etc. vary. Ask around to your friends to see what they have or who they recommend. Sometimes it is available through your employer as well -- although that might not be the best policy/coverage. Have the agent thoroughly go thru the policy options with you and be able to clearly articulate various likely scenarios that can happen -- in and out of care for example, limitations, etc.

Kimbee Oct 2012
YouTube was by a nonprofit, u can find it this way: LTC INS101

Kimbee Oct 2012
Sharyn-thanks for asking this great ?. Scott, thx for helpful YouTube. Seeme-great way to use $ from mom. I'm in NC too-would u mind sharing name of bank or C U ? I recall my dad had long term care ins, n that it could be transferred to other family members, I believe, after death. My dad's went to his wife who will transfer to her kids. I NEED me LTC ins., thx!

sharynmarie Oct 2012
Thank you Scott. I will check out the video!!

scottl Oct 2012
Long term care insurance is a good product to insure both your health and assets. It also covers medical and non-medical care services, which Medicare and other insurance dont usually cover.

sharynmarie Oct 2012
Good Idea seeme!! My mother's policy is a good one that will also cover home health care, however, she has to meet 2 out 6 categories use it and at which time she will probably have to be place in a NH which it also covers up to a certain amount. We were told that many of the LTC policies went bankrupt and did not end up paying out for many people. I will start with the bank, that is a good idea!! Thank you.

seemeride Oct 2012
I was very fortunate to be able to buy LTC coverage with one lump sum that was left to me by my mother. I don't have kids and my husband will always have his military retirement. I don't have to pay any premiums and there is even a death benefit like regular life insurance. I found this out by talking to the investment division of our bank. Maybe you could start there...........

sharynmarie Oct 2012
Thank you for all the responses. It gives me a starting point to begin. My husband said, this is not the way it works, I am suppose to die before you!! My mom's policy was started back in the late 1990's. She pays over $300.00 a month and the premium has only gone up around $50.00 during all this time. I don't know what I would have to pay at age 54 or if I could afford it if it is as high as my mothers. My husbands family tends to live well into their nineties without Alz/dementia. My mil passed away in 2009 from heart disease that was passed on by her father, her only sibling also has heart disease but her sibling is more physically active than my mil was willing to be. I am going to check into it because I don't want my husband strapped financially with my care and I don't want our daughter to have to be financially strapped with caring for me either, especially if we decide to move near her after my husband retires in 8 years. Thank you, it's all good advice that I am going to use!!! Hugs to everyone!

Kashi60 Oct 2012
Yes, it can be expensive...and it's a toss up as to when to buy it...if you buy it younger it is cheaper but you are paying for a longer period of time (if you don't have to use it !). I took it out on me when I was 50 (11 years ago) and my premiums are only about $60/month and the coverage is unlimited time, facilities only with inflation factored in..so make sure that your policy has inflation protection. Mine was NEVER suppose to go up but it did (even with inflation protection) and I had to pay a little more or lose some coverage. My husband;s was a little different as he was in his 70's when we took it out and it costs more and is only for a period of 5 years. Thank goodness we got it the year before he had to have bypass surgery or I'm sure he would not have been able to get it. So think about that too...you have to be healthy to get it!! So you can't wait too long. Also remember to get a decent daily rate but also any retirement pension, etc. will/can also go toward the costs of the care....soo you can keep your premiums down somewhat.

treatmenttime Oct 2012
I think every person should somehow fit Long Term Care Insurance into their budget while they are healthy. My MIL doesn't have it, my FIL does....the difference in care and availability of quality care is astounding!
My husband and I are only 48 and 50 and we have begun the process so we get in on the great rates. FIL waited til he was 71 and his rates are about $500/mo. The other thing we learned is to not put each other as "responsible party", we only put "self", I do not want him to get saddled with any medical debt that may be incurred that isn't covered by any insurance.

JessieBelle Oct 2012
The problems with LTC are many. First, many people cannot afford the premiums, which are very high. Second, the amount allowed per day is often insufficient to cover LTC costs unless a higher premium is paid for more coverage. Third, the length of time that the policy will cover can be too short unless a higher premium is paid for more coverage. Finally, many people have found their premiums escalating with age to where they could no longer afford the premiums. This was at the time they were most likely to need the policy.

When purchasing a policy it is good to look at the options -- how much per day, how long, and how much it costs. Are the premiums going to stay the same or increase with age?

For people who cannot afford LTC insurance, most states have a partnership program with Medicaid. The premiums are less that other LTC insurance plans. You can only qualify for Medicaid. The good things, though, is there is no spend-down or recovery for partnets. It is a good way to go for people who are still fairly young and not wealthy.

Kashi60 Oct 2012
I would say definitely yes to getting long term care esp. since you have such a family background of dementia/Alzheimer's. I got it for both me and my husband. I got it for me because I don't have any children (if I did, I certainly would not want them to have to take care of me!)...I got it for my husband because I don't want to deplete all of our savings, etc for his care if it comes down to it. I look at it as life insurance for myself. Of course, the downside is ..you may never use it!! But from a lot of comments on this website, a lot of people are taking care of elderly parents and in most cases it causes a lot of problems ...I think everyone should try, if they can, to plan and try to take care of themselves since folks are living a lot longer..thanks to meds. My parents are still living...in their 80's..but you never know what will happen. They don't have long term ins...so not sure what will happen...

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