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My parents wisely both purchased long term care insurance policies some 20 years ago. It is the only saving grace they have to being able to afford living in a nice assisted living facility. According to their policies, they have a 90 day elimination period for which they need to self pay before the insurance company will begin reimbursing them for the costs incurred. I certainly understand business and the need to make a profit. I get that, but every time I call the insurance company who holds their policies, whomever I speak with (you can NEVER speak to the same person twice -- I've tried!), states, "now just because (insert whatever) doesn't mean that your claim has been approved". I lay awake at night worrying that the insurance company is going to find some way to find anything so that they don't have to pay out the claim. My mom is the one who needs the assisted living. She repeatedly falls (has broken off her front teeth and in another fall, broke her wrist). She now walks with a walker, needs assistance with dressing/undressing, bathing, etc. It seems like the claim should be approved, but, again, stranger things have happened. They gave notice on their independent senior living apartment and so I have to move them, but I don't want to move them and then have to move them again if the claim isn't approved. Has anyone else had experience in dealing with long term care policies? Anything for which I should be aware? My mom's doctor, the social worker, and the assisted living location for which I'm planning to move them all concur that assisted living is what is needed, but I'm still guarded. Transamerica is the insurance company through which the policies are written. I'm told by everyone who hears about their particular policies, "oh, they have Cadillac policies"; meaning, these types of policies are no longer written, apparently, as they are good ones. Oof. This is hard!! Thank you for listening.

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My husband has ltc insurance, and our experience so far has been good with having coverage for home health aides. He initially had Medicare coverage for home health services, rn, pt,ot, with aides a few hours a week for bathing help. His ltc policy had a 90 day waiting period and they considered the Medicare covered period as counting toward that. He had initially had evaluation from the home health agency who sent that to the ltc company for verification of coverage. After one year, the ltc company sent a contracted nurse to reevaluate to verify continued need. He paid quite a bit in premiums over the years, but once he started using the insurance, premiums stopped.
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Reply to newbiewife
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My parents have paid LTC premiums for years but nobody can tell them what their policy covers. My dad was even told “You have to actually be admitted to a SNF to find out what’s covered!”
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Reply to XenaJada
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My wife and I bought an LTC policy about 10 yes before she was diagnosed with AD (actually it was mixed dementia probably with VaD). Our premiums were very reasonable and the policy benefits were excellent. I'm still only paying under $500/qtr for $273,000 worth of coverage. While in MC my wife's policy paid $125/day which was about 2/3 of the facilites charge. The policy was a godsend for us. Unfortunately, most companies no longer sell LTC policies because it's not profitable (including our carrier John Hancock; my policy is still inforce). The facility has to be approved by the company. Any reputable MC facility should be approved. We did not buy inflation protection which would have been considerably more costly. Every 3 yrs JH sent us 3 options: pay a higher premium with increased max limit; pay a less higher increased premium and keep the existing benefits; continue to pay the current premium with reduced benefits. I,too, paid a 90 day elimination period. When I sent my invoice in for the previous month, I was reimbursed within 10 days. Her premium was also waived during her MC residency. Over the prior 10 yrs, her premium was about $18,000. The benefit paid by JH for her 15 months of MC was about $57,000. I was very pleased. Today fewer companies are selling LTC insurance and the premium is significant. Some companies offer a combined life and LTC insurance product. If you use any of the benefit for LTC, the life coverage is reduced by that much. I still recommend people consider the hybrid policy.
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Reply to sjplegacy
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I will say here that you are lucky if you have a good policy. Your note to us here serves as a cautionary tale because I have seldom heard tales of people who had LTC work out well for them. I hope you are the exception and that you will post here frequently to update us on your experience. You can do invaluable good for those on this page.
The problems I have seen with LTC involve seniors spending huge amounts of money on these policies to have to them work out little if at all for them. Some of the policies deny insurance be paid for any facility without a full time RN. Guess what? That almost doesn't every exist at all. In fact, any ALF will have an on duty medication "nurse" usually a tech, for medications. Even Memory care seldom has an RN on duty at all times. So you get to hear "the facility isn't covered". I hope you NEVER have to hear it, but do let us know.
I hope others will post here that they have had positive experiences. I truly would love to hear that. For me, saving your money for age, and being at the time you get there "self-insured" is the answer, but it sure isn't an easy answer in our times.
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Reply to AlvaDeer
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