Is long-term care insurance worth it?

@Agingmyself,
I'm not sure why you would say that good companies don't offer long-term care insurance anymore. Some of the biggest and strongest insurance companies in the country sell long-term care insurance: Massachusetts Mutual, Mutual of Omaha, New York Life, Northwestern Mutual, State Farm, Thrivent, Transamerica, all sell long-term care insurance and they are all very large and very strong companies.

Once a company sells a policy they can't cancel your policy (unless you don't pay your premium on time.) If a company stops selling new policies, they still have to honor all of the policies they've already sold. My relative's policy is with John Hancock. They've stopped selling new policies, but they have to honor all claims of all the policies they've sold previously.

@Christine73,
My policy is with Allianz.
My relative's policy is underwritten by John Hancock.

With the coming tax cuts and ballooning government deficit, you can be sure that major government cutbacks are looming. Without insurance, anyone with means could easily be wiped out financially.

It's been my observation that the policies offered and the companies offering them change all the time. A policy issued 10 years ago is no longer even offered, or a good company no longer offers LTC at all, etc. And prices and benefits vary greatly.
Our advisor pitches one to us about every year. Actually, they seem to be more attractive than what was available 2 or 3 years ago; and we almost applied this year, then backed out.
I think you just need to do some comparison shopping for available plans, considering your own personal plans. If you think you will have a family member care for you at home, obviously, make sure the policy you buy will pay for that.
Another consideration: There will probably be a physical required, and you will have to be in good health to be accepted.

Thanks LTC Shop! Just curious, what companies are these LTC policies with?

@DigitalBAnker- Pre-paying for your funeral/final disposition is an allowable Medicaid "spend down" expense. It won't count against you.

It sometimes seems like there's just no good solution. Healthcare is expensive. Unjustifiably expensive. Prohibitively expensive.

My facility is $14,000 a month. The other day, I saw an aide sleeping in the dining room when she was supposed to be making sure people didn't choke to death. I can't imagine anywhere how a share room (in most cases), 15-20 minutes of a CNA's time per day (who makes $16 an hour), 3 cafeteria style meals plus snacks, and the *presence of an LPN ( a friend who's an LPN told me that means "low-paid nurse") merits $14,000 a month!

But when you add to the mix the fact that many of these people have no other option, it becomes supply and demand and the price skyrockets. The same reason some cancer drugs cost so much. Certainly, the ingredients and production are not much more expensive than many other reasonably priced drugs (I used to work in the pharmaceutical industry), but when you factor people's desperation to live to the equation, you get away with murder!

And sure, the facility needs to keep the lights on and pay the social workers and the financial people and buy supplies, etc, etc, but, for a 30-resident unit, they are pulling in (and this is assuming everyone is on Medicaid paying $8000 a month instead of $14,000) $240,000 A MONTH. And most of these places smell like urine. Are ya kidding me?

My relative bought her LTCi policy 10 years ago when she was in her mid-sixties. She bought a policy with a "graduating" premium, meaning that the premium increased each year as the benefits increased. Most policies don't work that way, but in her case, it was the best policy for her and she was comfortable paying the increases each year. Over the past 10 years she's paid about $30,000 in premiums. She's on claim now and her premium has stopped. Her policy has a little less than $400,000 in total benefits. Her monthly benefit is a little less than $10,000. She only needs about $7,000 per month right now for her care. The unused $3,000 remains in the policy. Her policy should last about 5 years.

To answer Christine's question, my wife and I share a long-term care policy that has $870,000 of benefits. It pays $7,250 per month per person, if we need care. We bought it in our forties so our premium is about $60 each per month. We don't have any inflation benefit on it. I am comfortable using our own assets/income to cover the cost of care that exceeds $7,250 per month. I am in my 50's now and we are both still healthy, so we might buy another policy to supplement our current policy.

There are some LTCi policies that can pay a family member to provide care. If your mom is 92 and she's had her policy for 15 years, I assume she was age 77 when she purchased the policy. Nowadays it usually does not make sense for someone that age to buy long-term care insurance because the premiums are so high at that age. For someone age 75+, it usually makes more sense to buy an annuity with a long-term care "multiplier". It would only make sense to buy this annuity if  the person had at least $500K net worth because they'd have to put about $100K into the annuity to make it worthwhile.

My mom is 92. She is very healthy. My dad (before he passed) insisted she get LTC. I recently read the contract and was shocked at how little she will get! She's put well over 100,000 over the last 15 years. I am a CNA, I plan to take care of her. LTC WILL NOT PAY ME!!! They require she get an aid from an agency! I worked for agencies before starting my own business, I would NEVER have someone from an agency take care of her. I wish I would have intercepted the LTC before she put so much money into it.

As mentioned here, you can apply for Medicaid but only if you're eligible and have limited resources and very little money. If you're ineligible, then it's either get long-term care insurance or drain your savings paying for your own care and have nothing for your heirs or your funeral/disposition

A lot of GREAT answers here. For those who have LTC insurance, it would be so very helpful if you would provide real life examples of the pricing (premiums, increases, cost of care, etc.) if you feel comfortable doing so. Hey, we're all anonymous, right?

OP, you might want to do some research now on what care would look like without LTC insurance. Tour facilities you could see yourself being willing to use, set up an appointment with the admissions and financial person and ask them to be straight with you.

When my mother went into a facility, she was already on community medicaid. Because she had medicaid already in place, and not "pending" as a private pay person would, she jumped to the head of the line. They just wanted to guarantee payment. A person on Medicaid is more of a guarantee than a private pay person whose funds have run out. Just a different way of looking at things.

As for the type of facility she got into, it is nicer than 90% of the facilities in our area (Long Island, NY). She has a private room since the dementia unit is all private rooms. It is not by any means the best of the best. The staff to patient ratio is just average. The cream of the crop facilities would not even look at us once I mentioned Medicaid (I think there were 3 of those) but by and large, there were a handful of very decent facilities that accepted a Medicaid person without a private pay period.

It's worth mentioning that there are relatively few outstanding facilities, period. I contacted about 26, almost every facility in my county and a number of facilities in neighboring counties. I did a LOT of tours, some twice. There were only 3 that I would consider a dream facility, and they weren't that big, so even if you have the money, what are the chances of getting into one of those?

I applied to 5 facilities. The others I don't think I would send a dog there. (There are a LOT of bad facilities.) One accepted her, and it's quite nice, comparatively. It doesn't hurt that it's in one of the most expensive neighborhoods in NY. I've heard "the nicer the neighborhood, the nicer the nursing home," but you'd have to test that in your own state.

When you talk about nursing homes, you're talking about quality of care. We have some outstanding aides, who I wish I could clone, and also some lousy ones we have to complain about and get removed from my mom's care. Mom is fortunate to have me, her "helicopter daughter" right on top of things. That's how we make this work. We MAKE it work.

But what about those of us who have no kids? We NEED to be in those top notch facilities, and we need a strategy to get there, which may or may not include LTC insurance. Do lots of research. Ask questions. Talk to people who've been there, and plan for yourself.

Great question!

Gifting assets to a family member can have terrible tax consequences. In order to gift a 401(k) or any other type of Retirement Account, you'd have to pay tax on ALL of it. If you've got $500K in a retirement account and you "gift" it to a trusted family member, you'll have to pay almost $200K in federal income taxes (plus state income taxes). Gifting real estate has similar consequences.

From both my mother's and my dad's LTC, I know that it did not and does not cover 100% of expenses. Plus, I had to pay the nursing home first, send the bill in and the LTC reimbursed me their percentage which I believe was 80%. I'm not sure how you are going to predict when to start the 5 year spend down?

My game plan. Putting everything in a trusted family members name. Then can do a spin down if needed. Doing this 5 years before care is needed protects the house and such. LTC can run out too fast! Would much rather put that money in a whole life policy where cash could be pulled if needed. However the owner of the policy also needs to be in another name too.

We took out LTC in 90's w alternative care. This allows me to have a private caregiver in our home not to exceed daily $ & years we subscribed for. I suggest you take someone using LTC w you when inquiring. There was so much I didn't think or know about but found out when wanting to use it. We were blessed to get what we have as cheaper to have caregiver at home to give relief & adult day care so I stay healthy & can provide rest of daily hrs. As long as possible. It also extends money longer than 5 yrs. Hubby w alz. I continue to pay on mine & pray never use it. It is a lot of paper work but have retired. I understand much more expensive now. My advice if rich get high coverage if not don't get it. If I must put hubby in memory care will get half paid of cost till $ subscribed to runs out. Who knew we'd ever use it but blessed to have the agent present it to us many yrs ago.

My husband has Alzheimer's and has been in a nice memory care assisted living for one year. Thanks to a LTC policy I don't worry about money and know that he is safe and well cared for. Yes LTC is expensive but though we made payments for 15 years that amount was recovered after 4 months. No additional payments made to his LTC insurance after he entered AL and prescription medicine covered also. Yes, my LTC insurance monthly costs have increased dramatically but I still think that it is worth it.

The answer will vary with each individual.

thank you everyone for sharing your experiences. You've given me much to think about that I had not considered. Good luck to all of us.

Sorry Srimble B but having a reputable company does not assure you anything. My Dad did his due diligence and paid more than avg in the 80's for a great company in good standing and that company formual did not pan out. So dad pays more and more and is is saving his. No guarantee on ANY company large or small. The company is just as much a gamble as wheter you get to use or not.
Folks if you have it use it.

My mother benefited greatly from her LTC policy for it protected her investments and other money.

My dad is currently benefiting from a LTC policy but it will end next May.

Since, I inherited quite a bit of money from my mother, I looked into LTC for myself. I learned that you can't buy it if you are on disability which I am.

I bought a policy for myself in 2011, one day before my 64th birthday (when the premium would have gone up). Hubby had been diagnosed with dementia one year earlier, and care was costing $6K/mo for a single caregiver at home. Fortunately he was a good earner & saver so we were able to pay this but it occurred to me that although we might be able to cover one person's extended illness we'd be in deep doo doo if the same thing happened to me. I went to a presentation (not by an insurance person!) that explained that if you could afford it the way to go was a single premium policy with an inflation rider and a lifetime payout benefit. I consulted a Dave Ramsey ELP insurance guy and a couple of others and settled on a policy which starts at $6K/mo for the first $150K paid out. It's also a life insurance policy--anything I don't use goes to my heirs. Then I added the lifetime benefit and the 5%/year inflation rider (which about doubled the premium!). It's supposed to pay for a facility or home care and is pretty comprehensive. It did cost me $138K, which I know is prohibitive for most people, but in the worst case it's just expensive life insurance, and in the "best" case (if you want to call it that!) it will subsidize my care for the rest of my life. As I watch our net worth dwindle with the now $15,000/month I pay for my husband's care (and it's worth every penny--his caregivers are wonderful!), it gives me a great deal of relief to realize that I've put something in place that should help a lot if I need the sort of care he requires. I'm also seriously considering a CCRC for myself when the time comes (don't plan to move hubby). I've just started my research but have determined that some of them work with existing LTC insurance, and I had a "free" lunch and a tour of one which has a good reputation and is quite attractive. My parents made a "life-care" deal, where they paid a lump sum "endowment" into one of these places and their monthly fee ("rent") remained the same (with COL increases of course) when my dad required care in the onsite facility for FOUR YEARS and mom stayed on in the apt, and then she was in the LTC facility herself for a year a while later. Five years of LTC cost would have definitely wiped them out! We had decided years ago that we could self-fund but we weren't thinking of more than a couple of years each. As hubby goes on and on and shows no sign of dying any time soon, I am glad I did what I did.

If you're relative has a policy that can run out of benefits in 3 years or so, check to see if the policy is a "long-term care partnership" policy. These policies will allow your relative's assets to be protected from "Medicaid spend down" and "Medicaid estate recovery" even though the policy has run out of benefits. 44 states have approved these programs. CT, NY, IN, and CA started their "LTC Partnership Programs" in the early 1990's. Other states started offering these programs around 2005.

When my relative decided to file a claim on her long-term care policy I did NOT handle her claim for her. Even though I’m a licensed insurance agent 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 in about 3 weeks.

They handled the claim for free. 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 process long-term care insurance claims. They know all the ins and outs of getting a claim approved quickly.

My wife and I faced this issue earlier this year. We were looking at facilities in our area for a relative. We were told that there was a long waiting list. When we explained that our relative would be using long-term care insurance to cover the full cost of care, we were told that there was no waiting list. The waiting list only applied to those who were relying on Medicaid because the facility had reached their Medicaid limit. If the availability of Medicaid "beds" is this limited now, how long will the Medicaid waiting list be after the proposed cuts in Medicaid?

Don't be fooled into thinking that a Medicaid funded facility is going to be anywhere near what most of us would think would be acceptable. Unless you do as one person noted above and make sure that you save money every month so that you can pay the FORTUNE that long-term care costs, I have found that you're better off with a long-term care policy. I agree with everything noted above -- it kept going up every year, my mom paid a TON into it, it was a nightmare and took forever to get it going (and I was out-and-out LIED to by the insurance person who was supposed to process it for us; she had been fired by the time I figured it out), and it doesn't pay enough. But it is the ONLY way that I've been able to get my mom into a nice community. I live 11 hours away and have not yet been able to change my job so that I can be with her; my siblings provide almost no help for her. Things are tough, but they would have been much worse if she hadn't been smart enough to begin a LTC policy at age 62. She didn't realize that it only covered 3 yrs of care, but it has been better than any other option for us. Some of the other people in her community were able to get plans that cover them until death -- I don't know what we will do when my mom's 3 yrs are up. I'm hopeful that I will be able to retire and move to where she lives by then. She can then live with me, altho' I have no delusions that this will be easy. Her friends who do not have LTC policies are in Medicare-funded communities that are not nearly as nice as her's. It was a huge fight to convince her to move at all. Insurance companies are not our friends, but unless we're independently wealthy, excellent savers, or die early we're really dependent on them. My mom's LTC payment combined with her SS currently cover the costs of her facility, and she's only at Level 2 of care. I'm heading toward 64, so really have to get a policy for me, too.

My two friends for whom I was made their POA each had LTC insurance. The wife's policy was for a higher amount as she was 17 years younger than her husband and they assumed he would go first and she would need a higher amount later in time as costs rise. They each had a yearly step-up increase built in. As it happened, the wife developed frontal temporal dementia and the husband short term memory problems. The wife's condition was more serious and I got them into a memory care apartment in June of 2015. There was a 90 day waiting period before any pay out, so the wife got one month of coverage before passing. All those extra dollars went away. The husband's policy for a lesser amount each month did get used up. We just got the last check last month. It covered about 1/4 of the monthly cost, so it helped. I just finished selling their town home and the money from that will pay for another 14 months or so. He gets half of his wife's retirement check each month, plus his retirement and social security. And they had money in an IRA that will get tapped when these other funds run out. He is also eligible for veteran's benefits when he becomes poor enough. This facility said they would take public financing after 18 months of regular pay for their apartment and care and we are well past that now. They assured me they would never have to leave as they provide care to the very end. And from all that I have seen, their care is quite good. They are attentive and watchful for changes and new needs with this aging process and loss of mental acuity. My wife and I just took out LTC and we are 74 and 73 respectively. It will be paid for our of our investments, not our monthly living money. For the two of us, it is around $5200 a year. We looked into it, weighed the pros and cons and decided to do it now that I am more familiar with care costs because of taking responsibility for my two friends. I assumed we could pay for care costs out of our monthly income, around $5,000 a month, but that wouldn't even pay for one person, let alone a couple. Selling the house would bring in a big chunk of cash, but we are trying to have an estate to leave our children, too, if we can. The LTC policy might make that more possible. I think the insurance companies count on people not living in a care facility all that long once they get there. As more of us live longer lives, though, it is putting pressure on the companies and they have to raise rates. Your policies can have a built in inflation clause that increases the amount each year. You pay extra for that, of course. It is tricky to weigh the pluses and minuses in this. For my friends, the husband got all his benefits, while the wife got one month's worth. Some LTC policies have a guaranteed pay out to the estate, too, like a life-insurance policy. That makes it a little more attractive to me.

I have heard it was a blessing for some people. I truly don't know that much about it. However, other people have paid a fortune into it and found it devastating to find out all the hidden requirements where it did NOT pay or paid very little. I suggest if you are interested and can afford it, hire an expert to look it over and tell you if it is right for you.

My spouse served during the war and now has ALZ but if you have over Ninety thousand in assets including your house you pay 90 percent of all your income. It's not easy but he could not be getting better care than the VA facility he is in. It is clean, bright, and the staff could not be more caring to all the patients. When my funds run out they will put a lien on the house but will not make me move. When I move or pass on they will take what is owed and the rest will go to my family. My sister and I are still wondering who will fair better with LTC or me who did not sign up years ago.

Years ago, Dad purchased a LTC policy from a well-known provider for Mom. She entered AL-Memory Care last April. I Initiated a claim with the insurance company, really didn't expect much in way of return, but we are now receiving a bit less than $1900 in monthly benefits. This benefit will continue for 3 years before "running out". Granted, the payment doesn't come near covering the (nearly) $8000 monthly bill, but every little bit helps. We'll take it!