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My parents have been making payments on long-term care policies for 20 years. I'm skeptical of the policies. Does anyone have experience using them? Was it hard to get the insurance company to pay out? Were there lots of exclusions? Was the coverage adequate? Thanks in advance.

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My dad is 90 and lives in an AL facility. He has paid on a LTC policy with Met Life since 2000. He is no longer able to drive, shop and cook for himself or pay his own bills. None of those things are mentioned in his policy, so he is currently not able to use it because he is too high functioning according to his policy. For example to fail eating you would have to be no longer able to use a spoon or a fork, not just be unable to go out and buy your own food as my dad is. My dad originally got the policy after my mother passed away thinking he would be covered when he could no longer take care of himself. So far he has had to use other means to fund his care which included selling his house. His policy was marketed to him as a way to stay in his own house, but it does not kick in until someone needs skilled nursing. He is still paying the premium because with early dementia and severe anemia due to a blood cancer, he may need the policy in the future. But given my father's experience my husband and I have decided to self insure our LTC needs. We are lucky to have the means to do that.
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After paying premiums on a LTC policy for 4 years, we decided we could have invested that amount of money and been better off.
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My answer hopefully provides you with much better hope. My mother was 72 when she got her insurance through Genworth Financial services. It cost her about $3500 a year. She started using it at 82. We had to wait 4 months for the majority of it to kick in before using it from being in an Assisted Living facility. She was able to access some of it when we had home care for a month or two, and yes there some a small deductible, but other than that we have been very very pleased with it. Yes, we had to meet certain criteria when we enacted or initiated it's use and there were new questions everytime we moved her to a new facility or an annual review, but she passed all of those easily because she really did need it. It paid out for about 4.5 years as that was the plan she had. It all has to do with the plan. There are so many variables so really study the plan and get the person or persons who sold the plan to your mother, or the company it is with to explain your exact plan. In the end, we got over $250,000 to help us out, an average of $61,000 a year or so. Not bad and it was the smartest thing my mother ever did. All I had to do was fax it a copy of my mother's facility bill and they put money into her account like clockwork each month to cover the portion that was allowable. For my mom, she got a daily amount of about $175 in the last year. It started with $150 per day and her policy added $5 more a day for the next few years until it reached $175 a day. Her daily care was more than that so we used all of our monthly allotment. If the care is less than your daily allotment, they pay for just that amount and the leftover just stays in the bank so to speak and it just helps lengthen your overall allotment as it were. Every policy is different, but if you have a good one, it really does help. And yes, it is a bit of a pain at the beginning to get the ball rolling for them to start paying out, but once it does, you are good to go.
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I agree with Alexander's answer. Invest your money and stay away from LTC. Wish we had.
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My parents had LTC ins with Met Life. Thank God for that policy. I have been able to keep them both in their own home "Together" since 2010. (see note below) Mom had a stroke and needed help with ADL's ( Activities of Daily Living) and my Fathers started when he was diagnosed with Early onset Parkinson's and Alzheimer's and had Cognitive Impairments..
Their Primary Doctor was my first resource and he had a Home Health Care Agency come out to do an evaluation. I believe that with so much fraud, Insurance companies need to take precautions against false claims But at the same time, If a Policy Holder truly meets certain requirements , They will pay the benefit.
I mentioned keeping my parents in their own home. I also learned that with the LTC Benefit, We had a better selection of Facilities should we need to go that route.
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In my mother's case I think privately investing the premium amount monthly would have been wiser. What she has paid in premiums as of today equal over half the policy value.
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The only experience I had was second hand. The insurance company started their position at, "That is absolutely not covered," and ended up, after much negotiation and reporting them to the state's regulatory board, covering for most of the cost of a live-in caretaker.
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Policies vary greatly. My husband's parents and my parents all spent almost 10 years each in assisted living. So I 20 years ago bought a "cadilac" policy with home care, day care, assisted living and nursing home coverage, plus inflation protection. So far we have put more in that taken out - BUT this year with my husband in day care 3 days a week the benefits are much higher than the premiums. Soon he will need full time care - and the policy will pay 90% or more of the cost. If we follow our parents' examples we will be far ahead of the game.
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Wow, sdbike, it sounds like Genworth really came through for you and your family. Thanks much for sharing.
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My dad (90) and stepmom (75) have had LTC insurance through CalPers, which I think they got when they got married 15 years ago. Not kicked in yet, but we are hoping to get them into assisted living; unfortunately, my stepmom's policy includes home care, but my dad's the one who needs that, but good to see some positive notes here.
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