My wife & I both took out LTCI over 2 decades ago. My wife has terminal cancer & has been in 4th stage since April 2019. She was hospitalized Nov, went to nursing facility for rehab then stayed in Nursing facility because of feeding tube in stomach. After three weeks, she regained her swallowing ability & started to eat thru mouth again. Her Humana stopped paying for nursing when she got off rehab. Genworth requires new patients to pay for first 50 days of care. The private rooms are $278.00 a day & the policy only pays $88.00 a day, that’s $168.00 a day more than we would have to pay out of pocket, once we eliminated the 1st 50 days. I had to put her on Hospice & move her home because we couldn’t pay over $6K a month for nursing care.

Now that she is home, she has a small bedroom next to our MB & the hall ball next to her room. Hospice payed for hospBed & tray table. Genworth refuses to recognize that I am caring for her 24/7 & managing all her meds which include 5 med times a day. 8am - 9 pm. Helping her to walk, do home shores(laundry, dishes, paying bills, buying groceries, picking up meds from pharmacy, driving her to Dr’s appointments. & oncall 24 hrs. Tried hiring professional help to help with House keeping/meal prep, that was a disaster, she could cook mech soft foods as prescribed & didn’t like doing hose keeping but spend most of the time chatting with Estela about her life experiences.

we were able to get Gemworth to approve 10 hrs a week to hire a maid service to clean the house every week. Tried to get them to approve a Chef for Seniors to cook meals & their technical team refused to approve it saying we could hire someone to cook & do light house cleaning. We had already tried that but they didn’t budge, even when I asked how it was different to hire a maid service that only cleans homes?

They suggested I put her back in Nursing Home, that means get into astronomical debt.

If I were to hire someone to do my 24/7 caregiving job, I would have to pay them less than $4. an hr., who’s going to work for that amount, of our daily rate is only $88. a day? The total amount accumilated In the policy is $192,000.00 & 6 yrs to use it.

Estela only has a few weeks - several months to live. I asked them, what happens to the unused portion? The said, you lose it?

The worst thing about it is that both of us have identical policies. I believe this is white color crime but when I called the TX State Ins. commission, the rep said they could do anything about it?

Estela & I are 80 yrs old. I also think this is old age discrimination.

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LTC insurance is often got, and at great price, without a whole lot of thinking. Sometimes it works out well, and often it does not. Some of the policies are so prohibitive that they don't work at all. For instance some only cover a facilitiy with a full time 24/7 RN. THAT doesn't happen. Period. Just doesn't happen. So policies and what happens IF have to be combed through carefully, as with all insurance, before purchased. For now your best bet is to go to the company and find the policy, get them in writing. If you feel that it is something you can "fight" I am afraid you are in for lawyering up, which means more money. And yes, no matter what you pay into insurance, let us say for a home you have had for 50 years, if you do not USE it you LOSE it. My Dad used to say "get all the insurance you can, and hope someone ELSE has to use the funds"--in otherwise hope that you stay well, and have no fires and floods. Good luck. Update us if you find out anything.
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