Long Term Care

[SF HAWKEYE]

My Grandparents had the LTC coverage and my Grandma ended up living there for 17 years. She went from basically having her own apartment to having a smaller apartment that they checked on her all the time, to living in a room where she had a full time nurse the last 2 years of her life. She was 95 when she passed and spent the last 2 years blind from eye cancer and vertigo so bad she couldn't get out of bed. I can't imagine how awful that would be.

My dad said his friend sold them that insurance in the early 80's and he's so glad they got it. Saved them 100's of thousands apparently.

My other grandma lived the same sort of thing but only for 4-5 years. She didn't have LTC and it basically sucked her entire life savings away and they were pretty well off. It was a really nice facility though.

My wife works in an assisted living facility now in the memory care unit. It was really hard on her the first month, but it's getting better. She has really grown attached to the people and it scares her to think that they will be dying off. Her facility is brand new and it's like a resort. The bad thing is that the residents are always complaining about the care givers who DGAF about them. She is basically doing their jobs as well.

Pretty crazy hearing the life stories of some of the residents and the companies they started and the amazing lives they've lived and now they are walking around naked at times or don't remember what they did 5 minutes ago or where they're at. It's a very rewarding job for her to know how much she is enriching their lives at the end. Their families are so grateful for all she does.

 

[Urohawk]

Stats say 50% of Americans won't need long-term care. Those that do have a median stay in assisted living of 22 months. 60% of those move to skilled nursing care. Once in a nursing home average stay is for a year, with 21% living 5 years.

Unless you have a family history of living a long time, I wouldn't waste the money on premiums. Start saving now and invest the equivalent cost for premiums and ear mark for long term care.

My financial guy says its a rip off most people won't live long enough to use or if they use it will only be in short term before they die so they will never exceed the premiums invested.

 

[theiacowtipper]

I won’t argue what you have seen or not seen because obviously I wasn’t there. However, nursing homes don’t put in feeding tubes. Hospitals put in feeding tubes. As with any medical procedure, a physician is the one who performs that procedure.

 

[cfbfan23]

My F-I-L bought a really good LTC policy back in the 80’s. My M-I-L has macular degeneration and has gone blind. My F-I-L (passed away last year) suffered a stroke about 7 or 8 years ago. It was just after that when they started collecting on the policy. They kind of make you go through hoops before they finally start shelling out cash. Eventually, they relented.

That policy has allowed them to stay living in their home of 30 years. Now it’s just my blind M-I-L living alone in that house. We would like her to move into assisted living, but she wants no part of that. She is of sound mind, so she has every right to stay in her home. The policy pays up to $12kish per month. It’s enough to get her a really good amount Of in-home care. If she needs more, she has enough income to cover it.

LTC has worked out well for her, but those type of policies cost a fortune these days. Unless you have a Time Machine, you’re almost always going to be better off not buying a policy and investing the cash you would have spent.

 

[dandh]

Stats say 50% of Americans won't need long-term care. Those that do have a median stay in assisted living of 22 months. 60% of those move to skilled nursing care. Once in a nursing home average stay is for a year, with 21% living 5 years.

Unless you have a family history of living a long time, I wouldn't waste the money on premiums. Start saving now and invest the equivalent cost for premiums and ear mark for long term care.

My financial guy says its a rip off most people won't live long enough to use or if they use it will only be in short term before they die so they will never exceed the premiums invested.

It's insurance. You don't insure against what is likely to happen, but against events that will create substantial damage if they occur. I hope we never need it, but if we do our entire life savings won't be wiped out. It's worth the peace of mind for us.

 

[BHawkeye199999]

My wife works in an assisted living facility now in the memory care unit. It was really hard on her the first month, but it's getting better. She has really grown attached to the people and it scares her to think that they will be dying off. Her facility is brand new and it's like a resort. The bad thing is that the residents are always complaining about the care givers who DGAF about them. She is basically doing their jobs as well.

Pretty crazy hearing the life stories of some of the residents and the companies they started and the amazing lives they've lived and now they are walking around naked at times or don't remember what they did 5 minutes ago or where they're at. It's a very rewarding job for her to know how much she is enriching their lives at the end. Their families are so grateful for all she does.

Yeah.

Many caregivers are like fast food workers; completely clueless.

In their defense, they're basically paid minimum wage. You get what you pay for.

 

[joelbc1]

WE have had it for many, many years. Policies we have allow for refund of premiums if the policy was never used by the surviving spouse. THAT is a lot of money for a policy that is 20-30+ years old.....It ain't cheap....

 

[bunsen82]

I won’t argue what you have seen or not seen because obviously I wasn’t there. However, nursing homes don’t put in feeding tubes. Hospitals put in feeding tubes. As with any medical procedure, a physician is the one who performs that procedure.

Obviously that is true (let’s be a clear a nursing home can’t do anything without a doctor order), but what will a doctor do if a resident continues to lose weight, due to aspiration issues from say a stroke and difficulties eating and you have one family member insisting they want everything done to keep them alive and essentially claiming the doctor isn’t doing enough to help the patient improve and you have a nursing home that is caught in a tough spot of trying to manage the weight loss and avoid skin deterioration due to lack of nutrition but will also raise a situation of a reduction in ADL’s.. I had one client that had a severe stroke. I believe there was minimal brain activity. The wife wanted to let him pass, his mother said he would get better and stronger. They put in a feeding tube. He lived another 15 years effectively brain dead because of the feeding tube. All I meant to say is without a living will or an IPost as you stated medical interventions can be put into play that the patient never wanted. The nursing home I was at also had to do CPR on 3 ladies over the age of 95 and 2 of them with severe dementia because a DNR was never signed for various reasons. I believe all 3 had fractured ribs during the CPR and only one survived, one with severe dementia, that patient passed away a month later. Look I have never been on the doctor or hospital side, but I have seen several times where doctor orders were made that I don’t think the doctor felt was in the best interest of the patient. However in my opinion they were either worried about a lawsuit, just wanting to effectively satisfy a difficult family member that is extremely persistent, stop getting constant notifications or requests from a nursing home that the nursing home is legally required to do or doing a personal favor in their mind.

My initial post I essentially had 2 separate ideas in my head that became 1 sentence that wasn't clear. I appreciate the clarification and I edited the post. I have been out of long term care for a decade, so some of my knowledge is getting a tad outdated. Iposts were coming out just as I left. That is definitely something I am interested in.

However, part of the reasons above is why I got out of healthcare. The primary reason was even a decade ago it was difficult finding qualified and caring staff that would always show up to care for patients. Obviously things have gotten much worse on that front since Covid. Secondly was healthcare is being driven in my opinion by a fear of lawsuits and trying to avoid negative outcomes from government investigative agencies. Nursing homes are being forced to take and care for more difficult patients than ever in trying to keep their censuses up. Look at Iowa where governor Reynolds closed much of the behavioral units. Where did those people go? To nursing homes where for most of them should never be. If any interaction occurs between patients those all have to be self reported and in some cases the agencies can be punitive in my opinion. I understand the reasonings for the oversight, and there are bad homes or bad actors out there however in the past where it seemed to be a partnership to make sure individuals were getting the best care anymore it just feels like a stick. However healthcare in my mind is effectively dying because quality staff is getting burned out or retiring and the level of care is rising while funding is effectively declining causing an inevitable crisis in the field. Nursing homes survived effectively off of skilled care patients. Those reimbursements were drastically cut several years ago. So what you saw was nursing homes drastically increased the private pay rates to offset that reduction. A nursing home loses money generally on any Medicaid patient. In 2006 my lowest private pay rate at my facility $100 a day. It is now up 70k to 100k a year and it will continue to go up.

 

[bunsen82]

We bought ltc insurance in our early 50s and still have it. My wife chafes at the annual premiums, but every financial advisor we have consulted about it reinforces my thinking that it is valuable and wothwhile. In addition to paying some of the cost at the time, it also allows the spouse to keep financial assets equal to the benefits paid yet qualify for the Medicaid spend down if needed. Like most ltc plans, ours also pays for in home care.

If you have an older policy and you have already been paid on it then yes it can be good. The old policies were actually very good. You also have to watch what they will pay out for. Do they cover assisted living ect. My grandmother went to a nursing home age 97 after a fall and for more than anything effectively being lonely. She provides all her own ADL’s and I don’t believe the policy was going to pay out yet. some policies also have distinctions between nursing home and assisted living days. Any more many of the policies are glorified saving accounts as the caps are extremely low. An individual can achieve the same outcome in some cases by creating effectively their own LTC policy. If you can find a policy that is truly like an insurance policy then yes it can be valuable.

 

[dandh]

If you have an older policy and you have already been paid on it then yes it can be good. The old policies were actually very good. You also have to watch what they will pay out for. Do they cover assisted living ect. My grandmother went to a nursing home age 97 after a fall and for more than anything effectively being lonely. She provides all her own ADL’s and I don’t believe the policy was going to pay out yet. some policies also have distinctions between nursing home and assisted living days. Any more many of the policies are glorified saving accounts as the caps are extremely low. An individual can achieve the same outcome in some cases by creating effectively their own LTC policy. If you can find a policy that is truly like an insurance policy then yes it can be valuable.

Ours is actually insurance. You could not duplicate it yourself, although if you have sufficient income you could potentially save enough and create a fund that would ensure you'd have enough money to cover any contingency. But this would actually need a ton more funding than the premiums we pay. And, as Joel mentioned, it's not cheap. Our premiums are currently well over $6000 per year for both of us, and will likely increase in years to come.

I think people should discuss long term care funding and mitigation of ltc expense with their financial planner instead of making a decision based on what they hear or read on a message board. It's too complicated to explain well here, and the potential ramifications of not having a plan to address these costs are huge.

 

[cfbfan23]

I think people should discuss long term care funding and mitigation of ltc expense with their financial planner instead of making a decision based on what they hear or read on a message board. It's too complicated to explain well here, and the potential ramifications of not having a plan to address these costs are huge.

Of course it's always best to not rely on a message board for your critical financial decisions, but, almost all financial planners are going to tell you to not purchase it. There are no more good deals to be found in this area......GE's long-term care policies written 30-40 years ago have haunted them for well over a decade now and has caused an amazing amount of damage to their balance sheet.

If you bought your policy 20+ years ago, you're looking pretty good right now. You should be commended for your foresight. I will warn you that if/when you need to legitimately start collecting on your "covered" costs, they are not going to make it easy on you. Make sure your kids/potential guardians are aware of the policy and everything it covers. It's still a battle we have with my M-I-L's insurance carrier. They do pay, eventually.

 

[seminole97]

She was 95 when she passed and spent the last 2 years blind from eye cancer and vertigo so bad she couldn't get out of bed. I can't imagine how awful that would be.

My dad said his friend sold them that insurance in the early 80's and he's so glad they got it. Saved them 100's of thousands apparently.

No disrespect intended to your grandma, but it boggles my mind to see how our society dumps resources on someone in that situation (how much was spent from 90-95?) versus the first five years of someone’s life.

 

[ICWestfan]

My wife (no pics) and I, both 67, have put away a very nice chunk of money for retirement. We have a nice home and a vacation home - we drive nice cars and can give money to our kids. Our only debt is a very manageable mortgage on the vacation home that I could pay off, but it's only 2.625% interest. We are financial set ..... except for long term care.

Since I turned 50, I have looked at long term care insurance every few years, but it just didn't seem like a good deal. Now, skilled care facilities are crazy expensive and the LTC Insurance plans I have seen are nothing but glorified savings accounts - you give $300,000 to an insurance company today and it will pay you $360,000, IF you go into a skilled care facility AND you qualify for the benefit.

My father was stayed in perhaps the nicest and best skilled care facility in the area in 2020 and it was $8,000 a month. My mother-in-law stayed is a "nice" facility (but not the best) in 2022 and it was $9,000/mo. I doesn't take an actuary or economist to see where this is going.

I know there are a lot of "experienced" (old) HROT'ers out there. What have you done, or are planning to do, about a possible future in a nursing home? 🤷‍♀️

You "young" whippersnappers- go ahead and make your jokes!

Are you on Medicare? Are there LTC plans available through that source? Reason I ask is the FIL really went down the tubes at the end of his life and bounced between an assisted living facility and a nursing home which was not covered or was minimally covered by Medicare. He paid a ton OOP for his care. His medical needs were adequetely covered but the living situation was not.

 

[Hawk_4shur]

Are you on Medicare? Are there LTC plans available through that source? Reason I ask is the FIL really went down the tubes at the end of his life and bounced between an assisted living facility and a nursing home which was not covered or was minimally covered by Medicare. He paid a ton OOP for his care. His medical needs were adequetely covered but the living situation was not.

I don't think so, but I'll look into it.

Medicaid is a program that will cover nursing home care, but you have to be broke to qualify.

 

[dandh]

Of course it's always best to not rely on a message board for your critical financial decisions, but, almost all financial planners are going to tell you to not purchase it. There are no more good deals to be found in this area......GE's long-term care policies written 30-40 years ago have haunted them for well over a decade now and has caused an amazing amount of damage to their balance sheet.

If you bought your policy 20+ years ago, you're looking pretty good right now. You should be commended for your foresight. I will warn you that if/when you need to legitimately start collecting on your "covered" costs, they are not going to make it easy on you. Make sure your kids/potential guardians are aware of the policy and everything it covers. It's still a battle we have with my M-I-L's insurance carrier. They do pay, eventually.

From linked (paywall) story:

Second on the list, surprisingly: Not buying long-term-care insurance, to pay for a nursing home or similar. This was a regret by 40% of those polled. There is a widespread misapprehension, especially among non-retirees, that Medicare will pay for your stay in a nursing home. It won’t (except in narrow and quite brief exceptions). You’ll have to pay for it yourself. Medicaid will step in, but only when you have run out of money.

These are the top 5 'financial regrets' of Americans over 50

One of the great problems with retirement planning is that by the time we realize the big mistakes we've made it's usually too late to do anything else.

www.marketwatch.com

From another linked article (pay attention to #4):

Five ways LTC insurance can protect your health, assets, and family​

1. Since an LTC policy pays for help with everyday activities, you won't have to pull money from your bank account to pay for assistance.
2. Having an LTC policy means keeping up with your medical care because you know you can afford whatever arises.
3. An LTC policy takes the weight of worry off your family, knowing you can pay for care.
4. LTC insurance can make the difference between spending down your assets to meet Medicare eligibility requirements and leaving money behind for your heirs.
5. An LTC policy can minimize the anxiety sometimes associated with aging.

5 Ways Long-Term Care Insurance Can Protect Your Assets

If you ever need long-term care, you may find it quickly depletes your bank accounts and estate. Here, we cover the ways long-term care insurance can preserve your assets.

www.fool.com

Asset protection is the primary reason we have long term care insurance. If I'm in the facility for several years my wife can keep our assets equal to the amount of benefits paid out ( plus our house), as follows:

Minnesota Long Term Care Partnership
The Long Term Care Partnership gives Minnesota consumers the ability to protect assets up to the amount of long-term care coverage they purchase.

If your financial planner does not incorporate a plan to addressltc costs and the impact on your assets, she is not doing her job, imo.

 

[NoleATL]

This may not be the answer you're looking for but I'd stop life extending treatment after age 70.

Most Americans want to live forever but quality of life is usually very bad after age 80. Alzheimer's disease, physical disabilities, etc. explode after age 80. I just had a neighbor die from dementia. She was 88 and had dementia for 13 years.

This article makes a lot of sense, IMO.

Why I Hope to Die at 75

An argument that society and families—and you—will be better off if nature takes its course swiftly and promptly

www.theatlantic.com

Wow... I like to measure time against events... such as when I got a new dog, I would probably be over 50 when it died... or, when this car is paid off I'll be over 40... etc...

I'm currently 59 and my husband and I have been together for 18 years... Should I die at 75, that is less years into the future than we have been together. And, the time we've been together has flown by... Time is precious, my friends.

As to the topic, we currently have LTC insurance through his job (and paid by his employer) but I imagine it will end when his employment does and picking up the premiums won't be worth it... I say this now, and hope I have the guts to do it when the time comes, but if I get some sort of deadly illness, dementia etc, I want to off myself so as to eliminate a lot of the suffering for my husband. Given his outlook on such things, me doing so would not be as tragic to him as if I lived in a horrible situation for an extended time.

 

[dandh]

I don't think so, but I'll look into it.

Medicaid is a program that will cover nursing home care, but you have to be broke to qualify.

Yup, down to $2000 in assets, iirc.

 

[NoleATL]

Medicaid is a program that will cover nursing home care, but you have to be broke to qualify.

I'm not the expert and I don't know the details but I have 2 friends whose parents transferred assets legally to qualify.

 

[Hawk_4shur]

I'm not the expert and I don't know the details but I have 2 friends whose parents transferred assets legally to qualify.

I'm familiar with the strategy. But, I don't think I want to go there.

 

[Moral]

I just pay mine with the reverse mortgage. It is practically free.

 

[cfbfan23]

From linked (paywall) story:

Second on the list, surprisingly: Not buying long-term-care insurance, to pay for a nursing home or similar. This was a regret by 40% of those polled. There is a widespread misapprehension, especially among non-retirees, that Medicare will pay for your stay in a nursing home. It won’t (except in narrow and quite brief exceptions). You’ll have to pay for it yourself. Medicaid will step in, but only when you have run out of money.

These are the top 5 'financial regrets' of Americans over 50

One of the great problems with retirement planning is that by the time we realize the big mistakes we've made it's usually too late to do anything else.

www.marketwatch.com

I'm not at all surprised by those stats. They missed out when LTC was "affordable." They regret it now because new policies are prohibitively expensive. I bet they regret not investing in MSFT when it IPO'ed and AAPL when the Ipod debuted.

End-of-life an take a looooong time and it is not cheap. Even if you own a policy from 30 years+ ago, the premiums have gone up and up. But at least you're grandfathered in.

 

[cfbfan23]

I just pay mine with the reverse mortgage. It is practically free.

 

[dandh]

I'm not the expert and I don't know the details but I have 2 friends whose parents transferred assets legally to qualify.

Yes, but they have moved the look back period to 5 years to close that loophole, so you have to do it at least that far in advance now.

 

[dandh]

I'm not at all surprised by those stats. They missed out when LTC was "affordable." They regret it now because new policies are prohibitively expensive. I bet they regret not investing in MSFT when it IPO'ed and AAPL when the Ipod debuted.

End-of-life an take a looooong time and it is not cheap. Even if you own a policy from 30 years+ ago, the premiums have gone up and up. But at least you're grandfathered in.

Our policy is not that old, and it still offers protection as I outlined in amended post #55. People would be smart to plan for ltc funding/ asset protection if they have a meaningful amount of financial assets, imo.

 

[cfbfan23]

Our policy is not that old, and it still offers protection as I outlined in amended post #55. People would be smart to plan for ltc funding/ asset protection if they have a meaningful amount of financial assets, imo.

You said your annual premiums are approx. $6K. I've got a few questions....sorry if you may have answered them earlier.

1. How old are you and your wife?

2. When did you buy the policy?

3. How long is the coverage for? My M-I-L is covered until she dies. I don't think they still write those kind of policies any more....although I could be wrong.

4. How much is the annual coverage?

5. What were the premiums 5 years ago (if applicable)...just curious? We saw pretty large premium increases for my in-laws in the years leading up to the point where they actually started collecting on it.

6. When/how does the insurance kick in? I ask because getting money from Genworth for my M-I-L is like pulling teeth. My wife (no pics) literally has had to write a letter to the Florida Insurance Commissioner twice for her mom over the last 7 years.

 

[bunsen82]

Ours is actually insurance. You could not duplicate it yourself, although if you have sufficient income you could potentially save enough and create a fund that would ensure you'd have enough money to cover any contingency. But this would actually need a ton more funding than the premiums we pay. And, as Joel mentioned, it's not cheap. Our premiums are currently well over $6000 per year for both of us, and will likely increase in years to come.

I think people should discuss long term care funding and mitigation of ltc expense with their financial planner instead of making a decision based on what they hear or read on a message board. It's too complicated to explain well here, and the potential ramifications of not having a plan to address these costs are huge.

Dan- I absolutely agree if you have a financial planner you should discuss with them. Yet only 35% of people have one, although of the posters here that percentage may be higher. This is a discussion board to at least pique interest to talk to someone more knowledgeable in their field than what anyone on here knows. At least something here can give you a semi baseline or the ability to ask more questions. Most people start looking at LTC insurance much later in life generally age 55-65 when nursing home isn't so far off, paying a much higher premium than had they started at a younger age.. When it works LTC insurance is great. When you are fighting with the policy to try to get coverage it is difficult. The other issue is realizing the long term care insurance is capping out and it is not covering the health care needs that you expected. My opinions are strictly mine. I looked at one policy when I was around 25. I think the premiums were around $1500, and benefits would cap out around 300,000. That is effectively a 4% return. I can create that. There is also an aspect of net wealth. For me personally LTC insurance makes sense if you think your assets will be between 400k and 2 million. 400k is enough wealth to try to protect, below that and the premiums will take away more from potential net wealth. At 2 million with earnings you can effectively fund your healthcare expense with a 5% earnings so you are effectively self insured. It is all a risk reward. For some cases individuals would still consider LTC insurance.

Healthcare and long-term care is also going to be going through some major changes in the next several decades I feel. The current model for Longterm care doesn't look viable to me so I am not sure that the LTC policies of today will cover my needs in 4 decades.

 

[bunsen82]

I'm not the expert and I don't know the details but I have 2 friends whose parents transferred assets legally to qualify.

You would have to do that 5 years prior technically to qualify for medicaid.

 

[dandh]

You said your annual premiums are approx. $6K. I've got a few questions....sorry if you may have answered them earlier.

1. How old are you and your wife?

2. When did you buy the policy?

3. How long is the coverage for? My M-I-L is covered until she dies. I don't think they still write those kind of policies any more....although I could be wrong.

4. How much is the annual coverage?

5. What were the premiums 5 years ago (if applicable)...just curious? We saw pretty large premium increases for my in-laws in the years leading up to the point where they actually started collecting on it.

6. When/how does the insurance kick in? I ask because getting money from Genworth for my M-I-L is like pulling teeth. My wife (no pics) literally has had to write a letter to the Florida Insurance Commissioner twice for her mom over the last 7 years.

Really effing old. Well, actually upper 60s. Bought it 17 years ago, coverage is 3 years apiece but can use spouse's coverage if not used, so up to 6 years of benefit amount over any length of time six years or longer. Current annual is a little over $90k, and has a 5% annual increase, so it will be over $200k in our mid-80s (over $1.25 m max), and even higher in our 90s. I figure we may have to kick in another $10-20k or so now per year, maybe $40-60 K later, but that is doable. Premiums have gone up by about 35% in last 5 years. Coverage commences upon approved claims, and includes in-home care and assisted living care. It is not perfect, and we still may go broke if we're in there forever, but it is far better than nothing, imo.

The ideal path would be to have enough assets/income that you could pay for it from pocket change, but most of us will never be there.

 

[cfbfan23]

Really effing old. Well, actually upper 60s. Bought it 17 years ago, coverage is 3 years apiece but can use spouse's coverage if not used, so up to 6 years of benefit amount. Current annual is a little over $90k, and has a 5% annual increase, so it will be over $200k in our mid-80s (over $1.25 m max), and even higher in our 90s. I figure we may have to kick in another $10-20k or so now per year, maybe $40-60 K later, but that is doable. Premiums have gone up by about 35% in last 5 years. Coverage commences upon approved claims, and includes in-home care and assisted living care. It is not perfect, and we still may go broke if we're in there forever, but it is far better than nothing, imo.

The ideal path would be to have enough assets/income that you could pay for it from pocket change, but most of us will never be there.

I think that's a pretty good policy you have (especially that 5% increase).

 

[seminole97]

I'm not the expert and I don't know the details but I have 2 friends whose parents transferred assets legally to qualify.

As I recall, you have to do it well in advance. They can go back I think a few years to claw back money if the heirs try to divvy things ahead of time and declare the parent indigent.

 

[bunsen82]

Really effing old. Well, actually upper 60s. Bought it 17 years ago, coverage is 3 years apiece but can use spouse's coverage if not used, so up to 6 years of benefit amount over any length of time six years or longer. Current annual is a little over $90k, and has a 5% annual increase, so it will be over $200k in our mid-80s (over $1.25 m max), and even higher in our 90s. I figure we may have to kick in another $10-20k or so now per year, maybe $40-60 K later, but that is doable. Premiums have gone up by about 35% in last 5 years. Coverage commences upon approved claims, and includes in-home care and assisted living care. It is not perfect, and we still may go broke if we're in there forever, but it is far better than nothing, imo.

The ideal path would be to have enough assets/income that you could pay for it from pocket change, but most of us will never be there.

If that same policy were available today I would tell many others to very much consider it, however that is just not the case from my experience. You policy covers likely 95% of the potential outcomes for your healthcare needs.

 

[Funky Bunch]

LTC insurance is looking similar to Florida homeowners insurance. This is for the plan for federal employees but I imagine its industry-wide.

OPM to suspend applications for Federal Long Term Care Insurance Program | Federal News Network

OPM will try to “establish sustainable premium rates” during upcoming two-year suspension on new applications to the Federal Long-Term Care Insurance Program.

federalnewsnetwork.com

 

[bunsen82]

Elderly residents of unlicensed home pay up to $9,500 per month, state says - Iowa Capital Dispatch

An unlicensed home for the elderly in Des Moines has been operating since 2017, with tenants paying up to $9,500 per month.

iowacapitaldispatch.com

Iowa drops its case against nurse accused of running unlicensed care facility

The state agency that oversees nursing homes in Iowa has dropped its case against an Iowa nurse accused of running an illegal, unlicensed care facility.

www.3newsnow.com

I know this entity went through being accused of illegal operating as a nursing home, but after selling an the care portion was able to continue. But this is what I foresee Care will be in decade or two. The large facilities in many communities cannot maintain the costs. More of residential care situation. Individuals would rather live in this type of environment. It used to be in Iowa you could house up to 8-12 people and avoid most of the nursing home regulations. I am not currently finding the information in the Iowa code. I think nursing homes are going to push back on these type of entities but if this is how people want to age, I can see this as a reasonable option. Those with more money can pay for the private pay method. However, the more institutional care set up would be for the medicaid and skilled patients.

 

[515Hawkeye]

Move assets immediately out of your name either through gifts or trusts. Live past the look back periods. In Iowa my guess is less than 3% do not accept Medicaid. That number will go to zero as nursing homes need income and in general people are not wise with their money. Once you are in a facility you will not be treated any different day to day whether you are cutting a check or not. Assets will remain in tact or will be used in look back but that would be the end game either way. Or take a chunk of change and place it it a paid up life insurance with someone other than yourself as owner.

At least in rural iowa, I believe many “farmers” or well to do are imploring this strategy anyway.

 

[Formerly Rockymtnole]

When I get to that point I’m hoping to be physically and mentally capable enough to steal the car keys and make one last drive straight off a cliff.

Didn’t work all these years and make all this money just to fund Trad’s expense account.

 

[Urohawk]

It's insurance. You don't insure against what is likely to happen, but against events that will create substantial damage if they occur. I hope we never need it, but if we do our entire life savings won't be wiped out. It's worth the peace of mind for us.

Oh I understand the idea of being insured. Want to be clear my response is not personally attacking your decision because obviously you know what's best on your side. My disagreement for LTC is the following:

1. It's super expensive with current policies.
2. Many people won't need it or if they do it's not for long.
3. And primarily, if I need long term care my life savings won't matter at that point. I'll be waiting for life to end and not have anything to spend it on.

 

[SoProudNole]

This thread is making Trad hungry for a Marriott breakfast buffet.

 

[Urohawk]

Really effing old. Well, actually upper 60s. Bought it 17 years ago, coverage is 3 years apiece but can use spouse's coverage if not used, so up to 6 years of benefit amount over any length of time six years or longer. Current annual is a little over $90k, and has a 5% annual increase, so it will be over $200k in our mid-80s (over $1.25 m max), and even higher in our 90s. I figure we may have to kick in another $10-20k or so now per year, maybe $40-60 K later, but that is doable. Premiums have gone up by about 35% in last 5 years. Coverage commences upon approved claims, and includes in-home care and assisted living care. It is not perfect, and we still may go broke if we're in there forever, but it is far better than nothing, imo.

The ideal path would be to have enough assets/income that you could pay for it from pocket change, but most of us will never be there.

Sounds like a great policy. I don't think they exist like that any more.

 

[praguehawk]

If that same policy were available today I would tell many others to very much consider it, however that is just not the case from my experience. You policy covers likely 95% of the potential outcomes for your healthcare needs.

You seem to really have a handle on the pricing of these types of policies. To get an idea how much LTC policies would cost today and what's available, what would be the options for a 50 year old couple in decent health today?

 

[dandh]

Sounds like a great policy. I don't think they exist like that any more.

Don't know, as I haven't shopped for it recently. Seems like someone should be able to have a decent product in this area if they had top-notch actuaries. But, maybe there's more/easier money to be made elsewhere