Is long-term care insurance mostly a rip off?

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Just found out mom's only covers if she can't walk or eat (has to be both or no coverage?) I thought that her LTC would help her with home care needs and eventually a nursing home only to find out that apparantly her financial planner got her into only will kick in if 2 criteria AT THE SAME TIME are met -- can't walk at all (doesn't count walking with assistance). AND can't eat. That means can't lift a fork to her mouth. Doesnt' mean that she can't get/make her meals which she can't now. Doesnt' that make this LTC useless? I mean wouldnt' medicare cover these costs w/o LTC? My mother purchased this is the hopes that she would have something so she wouldnt' have to sell all her assets if she needed to go into a nursing home (Which right now she won't even entertain -- although I have). Now it seems she's paying for a policy that is b.s. and not worth having. Am I right? Anyone else out there with similiar stories or knows what this means?

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LTC insurance used to be much better than it is now. I think these policies started to get to expensive for insurance companies to keep offering them. Note that as you get older, the premiums on these policies increase, so that people are often forced to give up on them before they ever get any benefit from them. So, yes, I think they are mostly a ripoff.
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For those looking to purchase LTC insurance, you may not be eligible if you have health conditions. Many years ago, we were taking out additional insurance from my husband's employer and one of the things his contact asked him about is if he would be interested in LTC insurance. My husband agreed to look into it and applied. At this time he was in his late 30's and had diabetes and high blood pressure. He was turned down because they said he was too much of a risk.
A few years later, I worked for a financial planner with one of the largest companies in the U.S. One of his clients informed me that her sister (also a client) had purchased LTC insurance and the particular plan had so many stipulations that they did not feel it was worth the preminum paid. Read all the fine print, make certain you realize what the premiums are and if they change coverage at a certain age. And if you are in a nursing home and someone is telling you that you or your family doesn't qualify, ask someone else...then ask their boss..then ask again...then call the company (in other words be the pain in the well...ya get the picute). ;)
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Kedwards, I am sorry you are havingso much trouble with your Mom's LTC carrier. Have you spoken directly with the insurance agent that sold her the policy? I worked for a Life and LTC agent for 15 years, and I know there are a few highly rated and reputable carriers out there. The agent should be able to answer your questions as well as directly intervene with the carrier regarding the coverage issues. If that does not work, you might try contacting your State Dept of Banking and Insurance, because insurers are very highly regulated and they want to know when companies are defrauding consumers. I have been touting the benefits of LTCI on various threads and am a firm believer that it is better to pay even $4000 a year in policy premium rather than $4000 a month 'rent' to a nursing home. The really good policies give the same amount of daily (or monthly) benefit for NH care as well as Home Care, which if utilized, allows the Senior to age in place as long as possible. I have personally witnessed this aspect of coverage for 3 seniors, which enabled them to remain at home with virtually round the clock care, thanks to the high LTC benefit amount they purchased years ago. The major carriers in the LTC market have been John Hancock and MetLIfe. Genworth has also been a major player, but I'm not sure they are still in the market. First, make sure you find a well qualified agent who has earned the "CLTC" designation. They have to comply with ongoing continuing education to maintain the designation. AC has information regarding LTC insurance under the 'Money & Legal' tab, then 'Insurance Matters'. Just FYI, although I have no idea who he is, I was surprised to see Scott Olson, "CLTC" offer factual information regarding this issue that we all can use. Thanks, Scott.
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Thank you danaisle for your answers!! The neurologist appt. is in one week.
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When a claimant is diagnosed with dementia ("cognitive impairment"), it usually trumps the "activities of daily living" requirement. Once the neurologist verifies the symptoms, she should qualify for in home care benefits. More than likely, she'll then be evaluated by a nurse to determine a plan of care. That's what happened with my mom and her policy. Good luck!
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That is what my mother's LTC will do after she has had the evaluation by a neurologist. They will send someone to her house to evaluate her needs. I do not know about the elimination period prior to being placed in a SNF but our hope is to keep her home a while longer with home health care.
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The reputable companies send someone to evaluate the claimant and develop an appropriate plan of care. They often have elimination periods where they prefer the insured receive in-home care, after which they'll pay for care in a facility. If they haven't offered to send someone to do an evaluation, you really should ask. You can also talk to the broker who sold the policy to your mother. Good luck!
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My mother's LTC policy requires that she not be able to 2 out of 6 ADLS. Her agent did tell us that many insurance companies that sold LTC policies went broke and therefore forfeited on the policies. I think it is best to talk with an Elder Law Attorney to help make this decision. My mother can feed herself, but I do know that she is not always eating like she should because making herself meals is getting too complicated for her to figure out. I think that would count as 1 ADL, plus she is not bathing herself regularly because she probably forgets due to the Alzheimer. I think that too would count as another ADL. She needs assistance with both of those activities for daily living. We are currently waiting for a neurologist appt. with her for an evaluation then we will be contacting her LTC policy. I'm hoping it works out!
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In my experience, my mother's LTC policy with Genworth has been a HUGE help and I would have a hard time affording care for her at the level she's receiving without it. My mother has dementia and psychosis and lives in a group home. About 80% of her monthly expenses are covered by her policy. Genworth is the most reputable and well-established player in this field. My husband and I have our policy with them. I hope I never have to use it, but if my husband or I get sick and need long term care, it will help to keep us from being wiped out and enable us to get services we need to maintain some quality of life.
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I am thinking of buying a LTC policy but after reading your reviews it scares me. I can get one through the government which is cheaper but doesn't have the options that Transamerica has like when someone dies before 65 you don't pay their cost. Etc. I really don't trust Transamerica. Something about their plan. Which one would be better Scott or someone that know about LTC. Thanks.

John
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