As a caregiver, I now think much more about planning for my own healthcare needs in my elder years. Does anyone have a good experience with long-term care insurance? Is it worth it?
@WizerOne--How long were the parent(s) receiving long-term care, and what kind? If both parents are each in a nursing home for considerably more than a decade (or one parent for a quarter of a century), I could see that happening.
Nobody needs an inheritance from me, either. I just decided to get LTC ins in event that something happened to me similar to what's happening with my husband. We decided years ago to "self insure" because we figured we had enough saved so we could afford a couple of years each in a nursing home. Well, we could have. But now we are going on 8 years with my husband needing 24/7 help with everything, but he just got kicked off hospice because he isn't sick enough (Parkinsons but decline is imperceptible). He could go on for years, he's healthy other than the dementia & parkinsons. I can absorb this for a few more years, but I didn't want to spend the rest of my life worrying that the same will happen to me. Plus, since I don't have anybody, who would see to it that I got decent care in a Medicaid facility? If I don't use my policy, it turns into life insurance. Admittedly, the LI benefit isn't much more than the premium I paid, but I was really only interested in the additional life time benefits and inflation protection, which made it expensive. As with any insurance, the idea is to be able to cover a DISASTER. One hopes not to have to use car insurance; I hope not to have to use my LTC insurance!
If one is single and has no children, then it simplifies the matter somewhat. If I were forced to spend everything on a nursing home out of my own pocket such that I had to go on Medicaid, what difference would it make? (The only other family members I have are well-enough off that they don't need an inheritance from me.) Paying for the insurance is expensive and thus a guaranteed loss of money versus a need I might never have (or might have for only a short time) with a backup system (Medicaid) in place.
The Long Term Care Ins. that came out in the 90's has changed sever times and is just not worth buying, even if you need it. Univ. Life has also changed, by adding Living Benefits that can be used for Long Term Care. Also if you don't use it, you can use, your beneficiaries will get it.
I am very dubious about this product. It is very expensive and I wonder is you save the amount of the premiums and they were properly invested there would be enough money to pay for your own care when the time came. I have also done assessments for long term care and the slightest thing can get a refusal, plus I have also looked after patients who really needed the benefits and the insurers dragged their feet and the patient died without any help. In my opinion it is a very two edged sword especially as we don't know now what will happen to medicare and medicaid. There is also the problem of many poliies being limited for number of years they will pay.
Then again ours says if not in use for certain amt of days you start over w elimination period. Ugh! We've alz no chance of that. W/O it I would be a basket case. Keeps me w free hrs. Even tho nites arnt always perfect retired so can sleep during day.
Keep a copy of the letter from the insurance company stating that the elimination period was fulfilled. Most policies state that the elimination period only needs to be fulfilled once per life.
LTCShop: what a great service for the home health agency to provide! Is this common for hha's to do this? I finally secured benefits for my mom from her LTC. It took from March to August before benefits started. But I am grateful. I may have her taken off claim in about a month so because she's doing well & I want to preserve her benefits. Any tips for minimizing problems if I need to restart her benefits would be appreciated.
When my relative decided to file a claim on her long-term care policy a few months ago I did NOT handle her claim for her. Even though I’m a licensed insurance agent and I’ve specialized in long-term care insurance for over 20 years, I didn’t handle her claim.
We contacted one of the national home care agencies and they handled it for us. This particular home care company processes thousands of long-term care insurance claims every year. All we had to do was sign a couple of HIPAA forms and they took care of the rest. The claim was approved within 3 weeks.
They handled the claim for free because they wanted my relative to use their agency for her care.
It makes sense. The home care agencies get paid by the long-term care insurance companies. They have a financial incentive to set up a system to successfully and quickly process long-term care insurance claims.
@Ceecee65, when someone buys long-term care insurance they choose their waiting period. Most policies offer waiting periods of zero days, 30, 60, 90, 100 or 180 days. According to the most recent industry survey, 94.2% of policies have a waiting period of 100 days or less. Only 3.9% of policies have a 180-day waiting period.
No, No, No. Did I remember to say, No? Lordy, I've been dealing with Mom and Dad's LTC insurance company for months. I've provided every single detail required on their claim form (which is A LOT). They then claim the caregiver, facility, home health care, etc. company is not responding to their need for more information. Like all insurance companies, their main objective is to keep their money. There are SO MANY caveats to each claim. Plus, most have a 6 month waiting period before they'll begin payment. Many elderly folks die within 6 months of moving to a care facility. So, to wrap up. NO, do not buy LTC insurance.
@badandy, Can you share some specifics about the suit? I couldn't find anything about it online. According to the annual reports published by the NAIC, in 2015, CNA incurred $824,492,319 in claims. In 2014, CNA incurred $694,455,842 in claims. In 2013 CNA incurred $650,624,104 in claims.
Long-term care insurance premiums are based upon your age (and health) at the time that you apply. The older you are when you apply for a policy, the higher the premium.
I have been holding my tongue to see what others have to say about LTC. Now, let give you my 2 cents.
My husband had LTC through my work five years ago, and that was three years before his Alz diagnosis. On the one hand, he was lucky that he got in just in time, because now he would not be qualified to enroll. On the other hand, we didn't know he would get sick so soon, so he only signed up for a 3-yr policy. We now wish he had signed up for the "indefinite" policy with the highest daily benefit amount ($450/day). We would have been financially stable if he had done so, even having to pay a much higher monthly premium. Here's why:
Several months ago, my husband had a crisis that caught me off-guard. That was the first time I had first-hand experience what delusions looked like. Wow, it was scary and heart-breaking. I put him in memory care while I worked out a better care option for him. The monthly cost in memory care was $9,000 a month! He stayed there for two months and we were $18,000 poorer. His LTC policy only paid half, which helped a bit. But if he had purchased the "indefinite" policy with the maximum DBA, we would not have to pay a dime. And once you have been approved for claims, LTC stops collecting your premium and anything you paid after the approved date would be refunded to you. So, even if my husband had paid $1500/mon in premium, it would still have been cheaper than $9000 a month.
I do not know what I will do after the 3-yr policy is gone. Right now, I can only focus on one day at a time.
I think if you are super rich like Trump, Gates, and other billionaires, there is no reason to by an LTC policy - for obvious reasons. But if you are a normal person like most of us, an LTC policy is a good idea, because the cost of caregiving is VERY expensive, and it gets more expensive as more care is needed later.
Not sure if my post helps, but everyone's situation if different.
Do all LTC policy premiums go up when one turns 64? I'm heading toward 64 in less than a month and have been dilly-dallying about a LTC policy. It has definitely helped my mom (now 87), as much as a pain as it was to work with the company. There seem to be several knowledgeable folks on this thread. I was planning to be out of town for most of the next few weeks (with Mom, of course) -- should I try to rush to get a policy before my birthday? Thanks for your help!
I don't know the answer, but in my case the (single premium) was to go up on my birthday. I don't think it was necessarily because it was my 64th birthday. Also, I didn't have to "rush", I'd been studying it for quite a while and just hadn't signed the final paperwork so I used the fact of my upcoming birthday to motivate myself to stop agonizing and get it done.
Hi LTC shop! I will dig up my statistics. I am not referring to rate increases, although very common to go up over 40% . I am referring to unethical denials . Reference the Class Action Lawsuit of Gwen B Daluge vs CNA Financial Corporation.
Thank you, Agingmyself, for your explanation. That was very kind of you.
You're 100% correct that LTC insurance offerings have changed from what was sold 15 years ago. However, the changes have not been for the worse, but for the better.
15 years ago, most states did not have LTC Partnership Programs. If your policy ran out of benefits you were out of luck. Today, 44 states have these programs. Consumer can protect most, if not all, of their assets if they buy a policy that has an amount of benefits equal to (or near) their net worth.
Badandy's concerns about rate increases would be correct if long-term care insurance companies were allowed to price their new policies, available for sale today, the same way they priced their policies 15 years ago.
Fortunately, insurance regulators do NOT allow any policy purchased today to use the old pricing assumptions. Also, 41 states have passed very strict pricing regulations for any policy purchased today. These new regulations have removed any profit incentive from rate increases.
Now that’s good news and that’s bad news. The bad news is that a policy purchased today costs more than a similar policy that was purchased 15 years ago.
The good news is that because of the new regulations and because today’s policies are priced more conservatively, any policy purchased today has a very low chance of having a large premium increase.
Badandy, do you have a source for your statistics? According to study done by the Dept. of Health & Human Services only 4% of LTCi claims are denied and the denial rate decreases to 2.4% within 12 months.
Here's a link to the chart twitter.com/LTCShop/status/942606001768873984
Here's a link to the entire study published by Dept. of HHS: ltcfacts.org/wp-content/uploads/2015/04/ltci-claims-audit
Last year 254,910 people received benefits from their LTC insurance policies. In that same year, there were 50 lawsuits filed against LTC insurance companies. For every 5,000 claims paid there was just 1 lawsuit filed.
The LTC policies that have had disputes over claims have mostly been policies that did not meet the federal guidelines for LTC insurance.
The most important policy terms (e.g. how to know if you qualify for benefits) have been standardized by the federal gov’t. The policies that meet those guidelines are very clear in terms of when you qualify for benefits.
There are 44 states that have Long-Term Care Partnership Programs. I'm not sure why Mr. Roberts thinks Massachusetts is the only one. Other states LTC Partnership Programs have the flexibility of protecting any type of asset (not just your home) from Medicaid liens.
Only a knowledgeable agent can answer your question. Hybrid polcies (combinantion life/LTC, and life/annuity) are outselling straight LTC policies at this time. Not necessarily because they are better, but because many people are reluctant to place their money into any instrument without a guaraneed ROI. The underwriting is generally less stringent than straight LTC policies.
A little off topic, though WizerOne did mention it-- My sister-in-law's family insurance policy (ACA) soared to the tune of an $840 PER MONTH increase in 2018. e.g. premium will cost $2,600 per month! Who can afford that also with high deductible?
LTCShop, Sorry if my earlier post seemed to imply that no good companies offered LTC. As you say, that's not the case. I was just opining that the offerings change so often that it is hard to make comparisons; and you can't base your own decision on the experience of someone else, because the coverage they collected on probably is not available today, not from another company or even the same one. My relative's experience with John Hancock is an example--good company, paid as promised--but, as you said, they don't offer LTC now.
Mr. Roberts, Indiana also has an asset-protection approved plan similar to what you described. I'm going to check out the Shoppers Guide you mentioned.
Just be aware: Long Term care seems like a great plan, but know the statistics. Only approximately 50% of claims get approved. More and more companies are raising premiums and " re-interpreting contracts " to lower their claim exposure, thus raising profits. Meaning people who planned on those benefits for retirement care, are not getting them. It's a constantly changing dynamic. Litigation against Long Term care companies Have double since 2012, as more people attempt to start claims and get denied.
Long Term Care Insurance is a valuable part of an estate plan for people who have substantial assets, savings and income. If you do not have substantial assets and income to fund the premiums, consider other long term care planning methods.
The National Association of Insurance Commissioners publishes a Shopper’s Guide that outlines what to look for in a LTC Insurance policy. Compare policy offerings and consider:
What are the policy's limitations on home care? Are Home Care Costs Covered at all? How may days per week? What Services are Covered? Does the policy pay family members for care giving? Does the policy pay for 24 hour a day home care? (most do not) What level of physical and mental impairment does it take to get the policy to pay benefits? Eligibility for coverage is based on whether or not a person can perform Activities of Daily Living. Make sure you understand the policy’s definition of ADL's. People who are unable to perform these Activities of Daily Living, and who can't obtain adequate nutrition, usually require a caregiver to support them from 12 to 24 hours each day. ADL's include: Dressing Bathing Toileting Eating Walking Shoppers Guide is at: https://www.ltcfeds.com/epAssets/documents/NAIC_Shoppers_Guide.pdf
(Don't confuse ADL's with Independent ADL's, which are the activities that enable a person to live independently in a house or apartment, such as: preparing meals, performing housework, taking medication, going on errands, managing finances, and using a telephone.)
My state, Massachusetts, is unique because it has a Long Term Care Insurance incentive program that exempts an elder’s home from Medicaid liens, and protects the home from estate recovery. No other state in the union has this protection. three important features that must be found in the policy: 1) coverage for at least two years of long term care, and 2) a daily benefit dollar amount of $125 and 3) elimination period (days on which services are provided to an insured before the policy begins to pay benefits) not longer than 365 days in a nursing facility or a deductible of no more than $54,750.
Because the Massachusetts law measures these requirements at the time the policy is purchased, elders can use the qualifying insurance policy to pay for community-based home care before they enter a nursing home, without fear of being disqualified by the two year requirement. The purpose of the law is to protect elders who use their long term care insurance for community-based care, so they can remain in their homes as long as possible.
I have also done assessments for long term care and the slightest thing can get a refusal, plus I have also looked after patients who really needed the benefits and the insurers dragged their feet and the patient died without any help.
In my opinion it is a very two edged sword especially as we don't know now what will happen to medicare and medicaid. There is also the problem of many poliies being limited for number of years they will pay.
We contacted one of the national home care agencies and they handled it for us. This particular home care company processes thousands of long-term care insurance claims every year. All we had to do was sign a couple of HIPAA forms and they took care of the rest. The claim was approved within 3 weeks.
They handled the claim for free because they wanted my relative to use their agency for her care.
It makes sense. The home care agencies get paid by the long-term care insurance companies. They have a financial incentive to set up a system to successfully and quickly process long-term care insurance claims.
Like all insurance companies, their main objective is to keep their money. There are SO MANY caveats to each claim. Plus, most have a 6 month waiting period before they'll begin payment. Many elderly folks die within 6 months of moving to a care facility.
So, to wrap up. NO, do not buy LTC insurance.
Can you share some specifics about the suit? I couldn't find anything about it online.
According to the annual reports published by the NAIC, in 2015, CNA incurred $824,492,319 in claims. In 2014, CNA incurred $694,455,842 in claims. In 2013 CNA incurred $650,624,104 in claims.
Long-term care insurance premiums are based upon your age (and health) at the time that you apply. The older you are when you apply for a policy, the higher the premium.
My husband had LTC through my work five years ago, and that was three years before his Alz diagnosis. On the one hand, he was lucky that he got in just in time, because now he would not be qualified to enroll. On the other hand, we didn't know he would get sick so soon, so he only signed up for a 3-yr policy. We now wish he had signed up for the "indefinite" policy with the highest daily benefit amount ($450/day). We would have been financially stable if he had done so, even having to pay a much higher monthly premium. Here's why:
Several months ago, my husband had a crisis that caught me off-guard. That was the first time I had first-hand experience what delusions looked like. Wow, it was scary and heart-breaking. I put him in memory care while I worked out a better care option for him. The monthly cost in memory care was $9,000 a month! He stayed there for two months and we were $18,000 poorer. His LTC policy only paid half, which helped a bit. But if he had purchased the "indefinite" policy with the maximum DBA, we would not have to pay a dime. And once you have been approved for claims, LTC stops collecting your premium and anything you paid after the approved date would be refunded to you. So, even if my husband had paid $1500/mon in premium, it would still have been cheaper than $9000 a month.
I do not know what I will do after the 3-yr policy is gone. Right now, I can only focus on one day at a time.
I think if you are super rich like Trump, Gates, and other billionaires, there is no reason to by an LTC policy - for obvious reasons. But if you are a normal person like most of us, an LTC policy is a good idea, because the cost of caregiving is VERY expensive, and it gets more expensive as more care is needed later.
Not sure if my post helps, but everyone's situation if different.
Reference the Class Action Lawsuit of
Gwen B Daluge vs
CNA Financial Corporation.
You're 100% correct that LTC insurance offerings have changed from what was sold 15 years ago. However, the changes have not been for the worse, but for the better.
15 years ago, most states did not have LTC Partnership Programs. If your policy ran out of benefits you were out of luck. Today, 44 states have these programs. Consumer can protect most, if not all, of their assets if they buy a policy that has an amount of benefits equal to (or near) their net worth.
Badandy's concerns about rate increases would be correct if long-term care insurance companies were allowed to price their new policies, available for sale today, the same way they priced their policies 15 years ago.
Fortunately, insurance regulators do NOT allow any policy purchased today to use the old pricing assumptions. Also, 41 states have passed very strict pricing regulations for any policy purchased today. These new regulations have removed any profit incentive from rate increases.
Now that’s good news and that’s bad news. The bad news is that a policy purchased today costs more than a similar policy that was purchased 15 years ago.
The good news is that because of the new regulations and because today’s policies are priced more conservatively, any policy purchased today has a very low chance of having a large premium increase.
Here's a link to the chart
twitter.com/LTCShop/status/942606001768873984
Here's a link to the entire study published by Dept. of HHS:
ltcfacts.org/wp-content/uploads/2015/04/ltci-claims-audit
Last year 254,910 people received benefits from their LTC insurance policies. In that same year, there were 50 lawsuits filed against LTC insurance companies. For every 5,000 claims paid there was just 1 lawsuit filed.
The LTC policies that have had disputes over claims have mostly been policies that did not meet the federal guidelines for LTC insurance.
The most important policy terms (e.g. how to know if you qualify for benefits) have been standardized by the federal gov’t. The policies that meet those guidelines are very clear in terms of when you qualify for benefits.
Sorry if my earlier post seemed to imply that no good companies offered LTC. As you say, that's not the case.
I was just opining that the offerings change so often that it is hard to make comparisons; and you can't base your own decision on the experience of someone else, because the coverage they collected on probably is not available today, not from another company or even the same one.
My relative's experience with John Hancock is an example--good company, paid as promised--but, as you said, they don't offer LTC now.
Mr. Roberts, Indiana also has an asset-protection approved plan similar to what you described. I'm going to check out the Shoppers Guide you mentioned.
Thank you both for your informative posts.
More and more companies are raising premiums and " re-interpreting contracts " to lower their claim exposure, thus raising profits. Meaning people who planned on those benefits for retirement care, are not getting them. It's a constantly changing dynamic.
Litigation against Long Term care companies
Have double since 2012, as more people attempt to start claims and get denied.
The National Association of Insurance Commissioners publishes a Shopper’s Guide that outlines what to look for in a LTC Insurance policy. Compare policy offerings and consider:
What are the policy's limitations on home care? Are Home Care Costs Covered at all? How may days per week? What Services are Covered?
Does the policy pay family members for care giving?
Does the policy pay for 24 hour a day home care? (most do not)
What level of physical and mental impairment does it take to get the policy to pay benefits? Eligibility for coverage is based on whether or not a person can perform Activities of Daily Living. Make sure you understand the policy’s definition of ADL's. People who are unable to perform these Activities of Daily Living, and who can't obtain adequate nutrition, usually require a caregiver to support them from 12 to 24 hours each day. ADL's include: Dressing
Bathing
Toileting
Eating
Walking
Shoppers Guide is at:
https://www.ltcfeds.com/epAssets/documents/NAIC_Shoppers_Guide.pdf
(Don't confuse ADL's with Independent ADL's, which are the activities that enable a person to live independently in a house or apartment, such as: preparing meals, performing housework, taking medication, going on errands, managing finances, and using a telephone.)
My state, Massachusetts, is unique because it has a Long Term Care Insurance incentive program that exempts an elder’s home from Medicaid liens, and protects the home from estate recovery. No other state in the union has this protection. three important features that must be found in the policy: 1) coverage for at least two years of long term care, and 2) a daily benefit dollar amount of $125 and 3) elimination period (days on which services are provided to an insured before the policy begins to pay benefits) not longer than 365 days in a nursing facility or a deductible of no more than $54,750.
Because the Massachusetts law measures these requirements at the time the policy is purchased, elders can use the qualifying insurance policy to pay for community-based home care before they enter a nursing home, without fear of being disqualified by the two year requirement. The purpose of the law is to protect elders who use their long term care insurance for community-based care, so they can remain in their homes as long as possible.