Do you have long term care insurance?

[tvguy]

Just got notice that our premiums will be going up $900 a year, each, for my wife and I. First increase in the 20 years I have had it. Asking around surprised how many people don't have this coverage. I got it when we were in my 40's, so our premiums are lower by a whole lot. My Financial Planner suggested last year we price shop to be sure what we had was the best deal. The lowest quote we got....at age 64 was double what we are paying.
So I would suggest everyone look into coverage when they are younger because that seems to be the only way to get the lowest premium.

 

[Marrila]

Yes we have it.
It's not easy or cheap to get good coverage now at even a younger age.

 

[barkley]

people should also look to see what the coverage actually covers. some people are shocked when the time comes and they go to look at their parents' policies to find that they are not written to cover what many presume is covered.

 

[kdonnel]

I plan to just be a burden to my kids. Well my actual plan is to die before I am a burden.

I am very much in favor of allowing self assisted euthanasia to prevent the social and economical burden placed on the living when the dying linger.

 

[tasha99]

We have some, but it's inadequate. I would guess that most people's coverage isn't actually that much help. Ours is for three years, but only covers a couple thousand a month. The nursing homes I worked in were more like 10K a month, so it's just a drop in the bucket.

 

[_19disnA]

people should also look to see what the coverage actually covers. some people are shocked when the time comes and they go to look at their parents' policies to find that they are not written to cover what many presume is covered.

Very true. You really have no idea the specific nature of future medical issues that may require assisted living or a nursing home. If you buy something that doesn't cover your specific issues, the money you spent on it won't be worth what you paid into it. Make sure to read ALL of the fine print and understand what is/isn't covered before agreeing to buy it. If the seller can't clearly describe the coverage or makes it sounds like ALL issues are covered, I would walk away and look elsewhere.

 

[dvcgirl67]

I plan to just be a burden to my kids. Well my actual plan is to die before I am a burden.

I am very much in favor of allowing self assisted euthanasia to prevent the social and economical burden placed on the living when the dying linger.

1000% agree. The way that many of us die in this country is a sin.

We're going through all of this right now. My MIL is almost 88....had a couple of strokes a couple of years back and has gone through a slow decline in the years since. The frequency of hospitalizations increased and then about two months ago she went in after a fall at home and was transferred to a rehab facility to regain her mobility two weeks later. Well that was six weeks ago and it's been determined that she will not regain the ability to stand/walk...and so the decision has been made to admit her permanently as a resident of the long term care facility....same place, just other side of the building. My husband and I looked into bringing her home with private care, but the price is astronomical. The only other option would have been to find someone "off the books", and by the time we began looking into that my MIL started to get increasingly confused and yelling out. And so we had to look out for both of them and made the decision to admit her permanently.

And so my in-laws do have a LTC policy, and in their circumstance, it's not going to help them at all. They took it out over 30 years ago....no idea what their premiums were. But in their case....it was money wasted. It will help the nursing home out a bit, but not much. I don't know what they paid for the policy, but they took out the policy in their early to mid-60s. It pays $80 a day, or $2400 a month for about 6 years. The cost of the nursing home (in NJ) is over $13,000 a month....and it's not what I'd consider to be a very good one....it's mediocre. It was chosen by my FIL because we have a family member there who works in admissions....and that made him feel better....and so we wanted to support his decision. The really nice ones around here are a part of Life Care facilities....where you plunk down hundreds of thousands of dollars and start out in an apartment....the assisted living facility and long term care facility are on site at those places....presumably for when you need them.

Now we're in the process of learning about the "Medicaid Spend Down"....which is a world we had no idea about. Basically, my in-laws own their home outright (about 350K) and have about 180K left (in a savings account and IRA), and social security. They were amazing savers but very, very conservative investors throughout their working lives....and they retired in 1998, and got aggressive based on the advice of a "financial advisor".....well, we many of us know what the market did in 2000-2001....went down over 50%....and that's when they panicked, and pulled their money out. I'm honestly amazed they still have 180K left as the money hasn't been invested in over twenty years. They were able to enjoy their retirement though....took a number of trips on their own dime, with us funding a few in their later years.

So now...with my FIL an incredibly healthy 91 (could easily live another 10 years+), is called a "spouse in the community".....and since the house is under the medicaid threshold....he gets to keep the house. The other 180K now gets split in half, he keeps 90K and his social security. The other 90K and my MIL's Social Security goes to the nursing home.....but, then we learned about the "spend down". And while it kind of feels shady....this is apparently what everyone does.....you quickly buy approved items/repairs....to "spend down" my MIL's side....essentially as fast as you can... before the nursing home gets it. It's really a terrible plan, and has to be a big part of the reason that LTC is sooooo expensive, and that over 60% of all LTC residents are fully on medicaid. The wild part is that the nursing home referred us to a "Medicaid Application Agency"....to *help* us with the application, but also the spend down. Also...conveniently for this company....their $7,800 fee is considered a part of the spend down. So...now we're looking to upgrade my FIL's car, get him a new roof and other large expenditures. It's just nuts.

As for my husband and I....we're not getting LTC insurance. We're in a position to afford home care and/or a LTC facility and pay out of pocket. We're both extremely adamant that we don't want to die in a place like that....but understand that it sometimes happens and is out of one's control.

 

[georgina]

At one time DHs employer offered some through payroll deduction, but the cost was high coverage wasn’t great. We decided against it. We have substantial resources and will hope don’t need 10+ years of intensive long term care.

 

[jalapeno_pretzel]

We don't have it yet (mid 40s). I've heard advice to get it once you turn 60. From what I've heard though, the offerings have really declined in the past couple of decades, and policies you can get today are really not great compared to what you could get back in the 90s.

I will say though, we have a real issue with geriatric medical care in the US. My FIL spent his final 2 months being bounced around between hospital, rehab, semi-independent living, hospital, rehab, hospital. I felt like it was hot potato - no one wanted to keep him. The hospital wanted to discharge him as soon as they possibly could, and the rehab places weren't quite equipped for what he needed, and no one seemed to want to take charge of his medical situation or needs. There was no continuity of care, no collaboration between specialists, and no one ever even gave us a prognosis. It was all left to the family members, who don't have any medical expertise. It pretty much was like working a 2nd full time job for DH to try and get his care and living situation on track. I've seen this with other family members as well. It was horrible, and in retrospect we probably had it easier than many do. I don't know what the answer is, but the situation we have now is really pretty dismal.

 

[dvcgirl67]

We don't have it yet (mid 40s). I've heard advice to get it once you turn 60. From what I've heard though, the offerings have really declined in the past couple of decades, and policies you can get today are really not great compared to what you could get back in the 90s.

I will say though, we have a real issue with geriatric medical care in the US. My FIL spent his final 2 months being bounced around between hospital, rehab, semi-independent living, hospital, rehab, hospital. I felt like it was hot potato - no one wanted to keep him. The hospital wanted to discharge him as soon as they possibly could, and the rehab places weren't quite equipped for what he needed, and no one seemed to want to take charge of his medical situation or needs. There was no continuity of care, no collaboration between specialists, and no one ever even gave us a prognosis. It was all left to the family members, who don't have any medical expertise. It pretty much was like working a 2nd full time job for DH to try and get his care and living situation on track. I've seen this with other family members as well. It was horrible, and in retrospect we probably had it easier than many do. I don't know what the answer is, but the situation we have now is really pretty dismal.

This is 100% the case. You have to have a family member advocating for your loved one endlessly.....and still there are big gaps in continuity of care. With my MIL...while she's confused and now yells....and has had a couple of strokes, otherwise she's very stable and is eating real well. So...this could go on for some time. And we literally just got word now that there's a big covid outbreak at the facility...and my MIL and her roommate both have symptomatic covid.

 

[tvguy]

1000% agree. The way that many of us die in this country is a sin.

It pays $80 a day, or $2400 a month for about 6 years. The cost of the nursing home (in NJ) is over $13,000 a month....and it's not what I'd consider to be a very good one....it's mediocre.

Now we're in the process of learning about the "Medicaid Spend Down"....which is a world we had no idea about.

My cousin is an RN in Canada and she describes long term care as "warehousing of seniors" When her mom had a stroke and needed full time care, they kept her home and she and her younger brother took care of her 16 hours a day. Their older brother lives in Australia and was able to pay for 8 hours a day for an outside caregiver to come into the home to help give them a break.

Yes, the coverage varies. My mom had a combo Long Term Care/Life Insurance policy. She cashed in a $75,000 life insurance policy and paid a single premium of $75,000. The plan paid $3,000 a month for 3 years. If you did not use $75,000 in coverage, your heirs got that money back, and if you did, but didn't spend the entire $75,000 your heirs got the balance. Her care in 2013 cost $4,300 in a Residential Care Facility for the Elderly, so I had to pay the balance out of her monthly Social Security and pension benefits. The price range was $3,000 to $6,500 a month for Long Term Care in 2013.

My coverage currently pays $7,250 a month. That amount automatically goes up by 5% a year. It started at about $4,000 a month if I recall correctly when I bought it. It pays for 6 years care.

And one thing with every Long Term Care Policy I have seen is, the insurance coverage doesn't kick in until the person has been in Long Term Care for 3 months. So you have to pay for the first 3 months.

We dealt with the Medicaid Spend Down situation with my wife's Grandparents. Only sticky thing we had was the next door neighbors wanted to buy the house, but thought the Medicaid appraisal was high. This was 1997 in a small town in Illinois, and the neighbors wanted to pay $7,000 for the house. Medicaid appraised it at $14,000, so double what they wanted to pay, or $7,000 more depending on your perspective.

 

[shh]

The lack of any autonomy or control over one's own passing and the horrendous experience sick elderly folks endure is so backwards - and absolutely nuts on many levels - and the main reason why it is allowed to continue, imo, would risk running afoul of forum rules and upsetting others who feel differently, so I'll abstain.

Let's just say, based upon TOO much experience in this arena, if I received a dementia or terminal diagnosis, I'm buying a one-way ticket to switzerland.

Long term care is a nice idea, but today's policies aren't designed for what you really need to insure against: a long tail/black swan situation. Many people with decent savings can cover the first couple of years of care on their own - it's the 10, 15+ year black swan diagnosis (rare overall, but devastating when it happens) that LTC needs to protect against. Unfortunately, today's LTC policies are often the opposite - it covers a few years, then you're still on your own.

 

[ronandannette]

No, and I've never even heard of such a thing. Perhaps because all the basics of long-term elder-care are covered by Canada's universal health-care system? I could see it being useful to fund an upgrade to a swanky private facility though - there are many here and they can be pricy, although the actual medical component is still publicly funded.

 

[CdnCarrie]

Not sure if we have such a thing in Canada.

 

[barkley]

I plan to just be a burden to my kids. Well my actual plan is to die before I am a burden.

I am very much in favor of allowing self assisted euthanasia to prevent the social and economical burden placed on the living when the dying linger.

this is very honestly one of the reasons we chose to move to our current state but moreso b/c i saw my mother suffering her final year and praying for death to relieve her agony.

The wild part is that the nursing home referred us to a "Medicaid Application Agency"....to *help* us with the application, but also the spend down. Also...conveniently for this company....their $7,800 fee is considered a part of the spend down.

this is crazy that someone charges for this, let alone this much!!! i supervised a medicaid unit and one of our jobs was to meet with people, go over their financial circumstances and tell them if they applied for medicaid if they would be eligible and if not-how to structure their assets/income to qualify. the idea was to help protect the income and assets for a surviving spouse/minor children so that THEY did not have to end up on public assistance.

 

[dvcgirl67]

My cousin is an RN in Canada and she describes long term care as "warehousing of seniors" When her mom had a stroke and needed full time care, they kept her home and she and her younger brother took care of her 16 hours a day. Their older brother lives in Australia and was able to pay for 8 hours a day for an outside caregiver to come into the home to help give them a break.

Yes, the coverage varies. My mom had a combo Long Term Care/Life Insurance policy. She cashed in a $75,000 life insurance policy and paid a single premium of $75,000. The plan paid $3,000 a month for 3 years. If you did not use $75,000 in coverage, your heirs got that money back, and if you did, but didn't spend the entire $75,000 your heirs got the balance. Her care in 2013 cost $4,300 in a Residential Care Facility for the Elderly, so I had to pay the balance out of her monthly Social Security and pension benefits. The price range was $3,000 to $6,500 a month for Long Term Care in 2013.

My coverage currently pays $7,250 a month. That amount automatically goes up by 5% a year. It started at about $4,000 a month if I recall correctly when I bought it. It pays for 6 years care.

And one thing with every Long Term Care Policy I have seen is, the insurance coverage doesn't kick in until the person has been in Long Term Care for 3 months. So you have to pay for the first 3 months.

We dealt with the Medicaid Spend Down situation with my wife's Grandparents. Only sticky thing we had was the next door neighbors wanted to buy the house, but thought the Medicaid appraisal was high. This was 1997 in a small town in Illinois, and the neighbors wanted to pay $7,000 for the house. Medicaid appraised it at $14,000, so double what they wanted to pay, or $7,000 more depending on your perspective.

That's what it feels like...."warehousing". I feel in some ways like we're being backed into a corner because we're having to make these decisions for really both of them....looking at qualify of life for the two of them. My FIL was able to completely care for her....until she couldn't stand/walk.....then it's game over. And now that she's increasingly confused with yelling...etc, his quality of life would also disappear. We're trying to get a neuro consult for her to see if there's something we can do about this new development. The timing isn't good for us as far as us or other family members caring for her. We both have another 4=5 years to work. My sister in law has to work another 6-8 years...until she's at least 70 or she might have been a good candidate as she's a nurse. My FIL is now adamant that he does not want to go to a LTC facility, and so we'll need to come up with a plan for him down the road.

It sounds like your policy would cut down on the burn rate of your nest egg is one of you needs LTC care...which is a good thing. In the case of my in-laws, we'll likely spend 50-60 grand on things my FIL needs....the nursing home gets the rest, plus her Social Security every month. Until the covid outbreak, he visits with her every day for at least 4 hours. And we have a family member there as I said. She sleeps an awful lot, and doesn't engage really with anyone very much other than her husband...and that's diminishing as well. As I said though...she's eating really well and her major organs are still strong, so I fear it will be awhile. Thankfully she is only going to get palliative care....no feeding tubes or anything like that. We worry about him, but he's resilient. We gave him a laptop and he loves it...brings it with him so he can watch movies and things on Netflix. He even figured out how to connect to wifi at the nursing home.....a remarkable 91 year old!

The medicaid spend down is a little more complicated when there's still a spouse in the community....you're sort of "ring fencing" assets to protect them. He's also only allowed a certain income. He's below the assets amounts and also the income. We've sent my in-laws money for years to supplement their income....for some "fun money" if you will...and found out only recently that they didn't spend any of it. So the 80 grand we sent them over the last 8 years or so is sitting in a checking account....and so now that's part of the spend down. He'll keep half of that and half of the 100K they had left in the IRA....and we'll obviously continue to supplement my FIL's income so he can enjoy the rest of his life. The one silver lining in all of this is that he is now able to play more golf and has rejoined some clubs and organizations that he's had to drop in the last two years while caring for his wife. He actually played 18 holes today.....and it's only in the last few years that he got a golf cart....he's going to live awhile for sure.

 

[ronandannette]

I plan to just be a burden to my kids. Well my actual plan is to die before I am a burden.

I am very much in favor of allowing self assisted euthanasia to prevent the social and economical burden placed on the living when the dying linger.

Interesting turn of phrase, instead of medically-assisted suicide. I've never heard it before.

 

[dvcgirl67]

this is very honestly one of the reasons we chose to move to our current state but moreso b/c i saw my mother suffering her final year and praying for death to relieve her agony.



this is crazy that someone charges for this, let alone this much!!! i supervised a medicaid unit and one of our jobs was to meet with people, go over their financial circumstances and tell them if they applied for medicaid if they would be eligible and if not-how to structure their assets/income to qualify. the idea was to help protect the income and assets for a surviving spouse/minor children so that THEY did not have to end up on public assistance.

I know...it's quite the racket. What surprised us was that it doesn't seem to be in the nursing home's best interest as this other company is directing/guiding you to spend what's left as fast as you can. I will say this...it's already been a ton of work just getting all of the documents ready for the medicaid application people....and so now that we have all that, for $7,800, they can do the rest of the work. It's kind of smart, because they know that their fee is a part of the spend down....and the way we're looking at it now, is either he gets it or the nursing home gets it. It doesn't matter to us. And he did tell us that the nursing home will likely get about 1/3 of the money or 30K-ish....because the application takes a bit of time. And so spending 60K should take us too long with the price of everything these days. We'll upgrade his Toyota Camry....he wants a hybrid Camry, but cars are tough to find. And then a new roof. That would leave us with about 10 grand to spend on some smaller house repairs that make sense...and that'll be it.

 

[MillauFr]

We have some, but it's inadequate. I would guess that most people's coverage isn't actually that much help. Ours is for three years, but only covers a couple thousand a month. The nursing homes I worked in were more like 10K a month, so it's just a drop in the bucket.

And that is the main problem with these plans. My dad lives in a medium to low cost of living place and they are charging $10k per month. No one is going to sell you a policy that will pay $10k per month for several years. Those policies are simply unavailable.

 

[Pea-n-Me]

1000% agree. The way that many of us die in this country is a sin.

We're going through all of this right now. My MIL is almost 88....had a couple of strokes a couple of years back and has gone through a slow decline in the years since. The frequency of hospitalizations increased and then about two months ago she went in after a fall at home and was transferred to a rehab facility to regain her mobility two weeks later. Well that was six weeks ago and it's been determined that she will not regain the ability to stand/walk...and so the decision has been made to admit her permanently as a resident of the long term care facility....same place, just other side of the building. My husband and I looked into bringing her home with private care, but the price is astronomical. The only other option would have been to find someone "off the books", and by the time we began looking into that my MIL started to get increasingly confused and yelling out. And so we had to look out for both of them and made the decision to admit her permanently.

And so my in-laws do have a LTC policy, and in their circumstance, it's not going to help them at all. They took it out over 30 years ago....no idea what their premiums were. But in their case....it was money wasted. It will help the nursing home out a bit, but not much. I don't know what they paid for the policy, but they took out the policy in their early to mid-60s. It pays $80 a day, or $2400 a month for about 6 years. The cost of the nursing home (in NJ) is over $13,000 a month....and it's not what I'd consider to be a very good one....it's mediocre. It was chosen by my FIL because we have a family member there who works in admissions....and that made him feel better....and so we wanted to support his decision. The really nice ones around here are a part of Life Care facilities....where you plunk down hundreds of thousands of dollars and start out in an apartment....the assisted living facility and long term care facility are on site at those places....presumably for when you need them.

Now we're in the process of learning about the "Medicaid Spend Down"....which is a world we had no idea about. Basically, my in-laws own their home outright (about 350K) and have about 180K left (in a savings account and IRA), and social security. They were amazing savers but very, very conservative investors throughout their working lives....and they retired in 1998, and got aggressive based on the advice of a "financial advisor".....well, we many of us know what the market did in 2000-2001....went down over 50%....and that's when they panicked, and pulled their money out. I'm honestly amazed they still have 180K left as the money hasn't been invested in over twenty years. They were able to enjoy their retirement though....took a number of trips on their own dime, with us funding a few in their later years.

So now...with my FIL an incredibly healthy 91 (could easily live another 10 years+), is called a "spouse in the community".....and since the house is under the medicaid threshold....he gets to keep the house. The other 180K now gets split in half, he keeps 90K and his social security. The other 90K and my MIL's Social Security goes to the nursing home.....but, then we learned about the "spend down". And while it kind of feels shady....this is apparently what everyone does.....you quickly buy approved items/repairs....to "spend down" my MIL's side....essentially as fast as you can... before the nursing home gets it. It's really a terrible plan, and has to be a big part of the reason that LTC is sooooo expensive, and that over 60% of all LTC residents are fully on medicaid. The wild part is that the nursing home referred us to a "Medicaid Application Agency"....to *help* us with the application, but also the spend down. Also...conveniently for this company....their $7,800 fee is considered a part of the spend down. So...now we're looking to upgrade my FIL's car, get him a new roof and other large expenditures. It's just nuts.

As for my husband and I....we're not getting LTC insurance. We're in a position to afford home care and/or a LTC facility and pay out of pocket. We're both extremely adamant that we don't want to die in a place like that....but understand that it sometimes happens and is out of one's control.

Don’t forget to pay for their funerals! So sad, I’m sorry you and your family have to deal with all this.

That's what it feels like...."warehousing". I feel in some ways like we're being backed into a corner because we're having to make these decisions for really both of them....looking at qualify of life for the two of them. My FIL was able to completely care for her....until she couldn't stand/walk.....then it's game over. And now that she's increasingly confused with yelling...etc, his quality of life would also disappear. We're trying to get a neuro consult for her to see if there's something we can do about this new development. The timing isn't good for us as far as us or other family members caring for her. We both have another 4=5 years to work. My sister in law has to work another 6-8 years...until she's at least 70 or she might have been a good candidate as she's a nurse. My FIL is now adamant that he does not want to go to a LTC facility, and so we'll need to come up with a plan for him down the road.

It sounds like your policy would cut down on the burn rate of your nest egg is one of you needs LTC care...which is a good thing. In the case of my in-laws, we'll likely spend 50-60 grand on things my FIL needs....the nursing home gets the rest, plus her Social Security every month. Until the covid outbreak, he visits with her every day for at least 4 hours. And we have a family member there as I said. She sleeps an awful lot, and doesn't engage really with anyone very much other than her husband...and that's diminishing as well. As I said though...she's eating really well and her major organs are still strong, so I fear it will be awhile. Thankfully she is only going to get palliative care....no feeding tubes or anything like that. We worry about him, but he's resilient. We gave him a laptop and he loves it...brings it with him so he can watch movies and things on Netflix. He even figured out how to connect to wifi at the nursing home.....a remarkable 91 year old!

The medicaid spend down is a little more complicated when there's still a spouse in the community....you're sort of "ring fencing" assets to protect them. He's also only allowed a certain income. He's below the assets amounts and also the income. We've sent my in-laws money for years to supplement their income....for some "fun money" if you will...and found out only recently that they didn't spend any of it. So the 80 grand we sent them over the last 8 years or so is sitting in a checking account....and so now that's part of the spend down. He'll keep half of that and half of the 100K they had left in the IRA....and we'll obviously continue to supplement my FIL's income so he can enjoy the rest of his life. The one silver lining in all of this is that he is now able to play more golf and has rejoined some clubs and organizations that he's had to drop in the last two years while caring for his wife. He actually played 18 holes today.....and it's only in the last few years that he got a golf cart....he's going to live awhile for sure.

Chances are good what will be her downfall will be aspiration (due to neurological changes with swallowing). When that happens and she has frequent pneumonias and can no longer eat, it’s the time you start hospice care (or before). The facility may ask you to hire a private caregiver if she continues to yell. There are some medications and other aspects of care that can help that, too. Good luck with this.