Long-term care insurance

User Forum Topic
Submitted by Hobie on July 30, 2019 - 6:31pm

Our current health care system is set up to take care of those who are productive in society. When those folks get mental, medical, mobility, age related physical ailments, etc. long term care is severely lacking.

Not true. It is there, but hugely expensive. Do your parents have $7-12k/month per person for long term care available?

Can you afford to pay these kind of costs?? Time to look into long term care insurance for yourself. Just saying'.

It sucks to have to deal with this. When loved ones, who were once sharp and brilliant devolve into not able to speak, clean themselves...

Tough enough on the emotional side let alone the financial side. Do yourselves a favor ( really your kids )and buy long term care insurance.

Start early when it's more affordable.

Submitted by flu on July 30, 2019 - 8:29pm.

How does long term care insurance work?

Submitted by Hobie on July 31, 2019 - 5:57am.

This covers Nursing Home and in home care. Not medical treatment per se but costs for assisted living facility, aids to help dress, clean, feed people who are physically unable and living at home.

I'm told that if you are smart you would buy Long Term Insurance early in life. The policy would compound so you stop paying after a number of years. You can get policies adjusted for inflation and direct payout of remaining policy beneficiary.

Depending on what other medical conditions exist on top of a person with dementia, for example, can live for years but need daily assistance. Relying on family members to step in is not prudent. Medicaid will step in if the patient is destitute. Quality of care becomes an issue at that point.

Submitted by Myriad on July 31, 2019 - 11:05am.

The general info out that is that LTC insurance is really expensive now and only provided by a few providers (since they vastly underestimated the costs a decade ago).
Is there some quantifiable data on the costs now at various ages?

Submitted by Alice on August 1, 2019 - 10:44pm.

The insurance companies messed up their actuarial models and tried to jack up their rates after making promises they could not afford: https://www.latimes.com/business/story/2...

Submitted by Hobie on August 2, 2019 - 3:13am.

Myriad wrote:
Is there some quantifiable data on the costs now at various ages?

http://www.insurance.ca.gov/01-consumers...

Scroll to bottom of each carrier for rates. It sure would be great if there was an excel file of this data .

Good article Alice!

Here is data of rate increases:
http://www.insurance.ca.gov/01-consumers...

Submitted by flu on August 4, 2019 - 1:28am.

What choices do we have among the carriers of long term insurance?

Submitted by Hobie on August 4, 2019 - 2:18am.

Cal Department of Insurance has some good stuff

List of Companies:
https://www.insurance.ca.gov/01-consumer...

Select a company, pricing is at bottom of list:
https://www.insurance.ca.gov/01-consumer...

As mentioned by piggs, not cheap any longer. And now it looks most have about a 3 year max cap on benefits. Except Knights of Columbus at a 10year cap.

I'm new to this so I am learning what the term language all means and slowly getting up to speed.

Note- for inflation they are using 5% compounding. Interesting when thinking about a 3 year benefit period and the difference in pricing.

Submitted by flu on August 4, 2019 - 7:17pm.

Hobie wrote:
Cal Department of Insurance has some good stuff

List of Companies:
https://www.insurance.ca.gov/01-consumer...

Select a company, pricing is at bottom of list:
https://www.insurance.ca.gov/01-consumer...

As mentioned by piggs, not cheap any longer. And now it looks most have about a 3 year max cap on benefits. Except Knights of Columbus at a 10year cap.

I'm new to this so I am learning what the term language all means and slowly getting up to speed.

Note- for inflation they are using 5% compounding. Interesting when thinking about a 3 year benefit period and the difference in pricing.

Thanks for the info.

Submitted by temeculaguy on August 7, 2019 - 1:27am.

I bought it about 18 years ago, sounded great and wasn't too expensive to buy in my 30's, luckily i was able to add Mrs TG a few years ago at thrice the price only because i had an existing policy. A few years back I tried to by my parents a policy and was told to pound sand. I hate to admit it, but it was a factor in why we got legally married from domestic partners so I could add her, well that and the step grandchildren starting to ask questions, grandma's boyfriend sounds creepy. Sadly the benefits and price are long gone today. I got $150 a day benefit with no cap on length ($35/mo for me, $100/mo for her) but nothing today comes close. I honestly think the gov't should make it a tax deduction or find other ways to encourage it because it reduces the public's liability.

For those of you whose plan has an eye toward retirement, it's essential but unfortunately no longer available. I've heard nothing from any politician on either side of the aisle about it, but it's actually an opportunity for some politician to embrace. If you will have a six figure retirement income, medicare won't cover your LTC, so it's up to you. Sure $4,500 a month won't cover the high end places, but it's a nice offset. For the spouse of someone who needs it, they might be wiped out paying for LTC and keeping up the primary home. I'm glad Hobie brought this up, it's a bigger deal than that lack of attention it gets.

But then again, my parents earthquake insurance policy in effect for almost 50 years has no deductable and 100% replacement value, I would love to buy that but it was long gone by the time I bought my first home.

Insurance companies are not in the business of losing money, if you are lucky enough to get a policy that ends up in your favor, keep it in force.

Submitted by The-Shoveler on August 7, 2019 - 7:10am.

My Mother who is near 90 now has had to use in home as well as a nursing home care for brief periods over the last 15 years now.

Neither was really a good way to live long term.

Also beware of in-home care, I have heard stories of care takers emptying bank accounts etc... forcing will changes etc...

Submitted by Hobie on August 7, 2019 - 7:49am.

Seriously, I think the government already has long term care costs on their radar. I think we are in agreement social security with become nonviable in the near decades.

Now you have a bunch of folks needing expensive end of life care and no way to pay for it, what is government to do. Answer: Physical assisted suicide.

Some politicians have been pitching the foundational ground work to sway public perception in this direction. Including shooting arrows at religious beliefs and institutions.

Risking the tin-foil hat club, you can argue devaluing life is already very active in the pro-choice movement couched in female rights.

Not to go full tilt political, but interesting to consider.

However, I still politicians are not necessarily that forward thinking, but always just looking for hot buttons to secure short term votes to keep themselves alive. (pun intended)

Submitted by flu on August 7, 2019 - 8:05am.

Sigh... I will look into long term insurance for me and others ...

But for me it seems a waste of money... I really don't want to live if I have to be confined to an assisted living facility when I am old. I think the cheaper option for me would be to invest in a Smith and Wesson.

Submitted by Hobie on August 7, 2019 - 9:19am.

While I disagree in principle to offing oneself, I now have a very different perspective on quality of life issues. Maybe if explicitly discussed in a medical directive so as the fam can hope to understand the wish to avoid pain, quality of life, burden to others, etc. and better cope. Then the bitter pill may be a bit more tolarable to all.

Qualification: Between you, your fam, God, and probably your long term doctor only. No government involvement at any level.

Submitted by Myriad on August 7, 2019 - 9:58am.

Hobie wrote:
Now you have a bunch of folks needing expensive end of life care and no way to pay for it, what is government to do. Answer: Physical assisted suicide.

If they really want to sell it, the government could offer an offset. Instead of spending $200k on Medicare, people that go for euthanasia, would get $50k in cash. Then people can go enjoy the $50k, and not spend a year in/out of hospital/hospice care.

I wonder what's the % of people that just die before LTC really kicks in. The insurance companies have to factor that in too.
Sometimes I joke that if I can't eat solid food or have to become a vegan, that seems like a good time to go.

Submitted by flu on August 7, 2019 - 10:53am.

Hobie wrote:
While I disagree in principle to offing oneself, I now have a very different perspective on quality of life issues. Maybe if explicitly discussed in a medical directive so as the fam can hope to understand the wish to avoid pain, quality of life, burden to others, etc. and better cope. Then the bitter pill may be a bit more tolarable to all.

Qualification: Between you, your fam, God, and probably your long term doctor only. No government involvement at any level.

Well, the way I look at it, if you have really have a debilitating illness, and there's no chance of recovering to a reasonable quality of life, there really isn't a point. Your QOL sucks, it becomes both a financial burden and a burden on everyone else's life. For example, late stage dementia, or terminal cancer or anything terminal for that matter. It's painful for the individual, it heartbreaking for everyone else..

I have an advance directive, but I'm not sure how far it goes. My understanding it describes what to do in the situation an individual is an a vegetative state and on life support. It authorizes people to pull the plug. But it doesn't apply to the situation in which you are alive and suffering.. I'm not sure if CA is a right to die state or not...

Edit: actually, since 2016, CA is a right to die state..
https://en.wikipedia.org/wiki/California...

Submitted by Hobie on August 7, 2019 - 2:11pm.

Looks like you can deduct long term insurance from a health saving account. But.....

With annual premiums north of say $4000/yr you are only allowed to use ~$780 from your HSA, which is the deductible amount. Something, but nowhere near enough to encourage this method. PIA recordkeeping too.

Or, you can itemize and claim full expense for policy outside of HSA but you will probably bump up against the 7.75% AGI cap.

Again, not favorable.

https://www.kiplinger.com/article/retire...

Submitted by FlyerInHi on August 7, 2019 - 3:43pm.

One of my aunts is 102 and still wears make up and dresses up to receive guests. She looks better than her daughter. Ask her to share photos of the past and she runs upstairs to fetch the albums.

Do you tech guys not believe is longevity breakthroughs to come up?

Submitted by The-Shoveler on August 7, 2019 - 4:38pm.

Maybe, maybe not

Nothing is certain, nothing last forever.
(well maybe instances in spacetime)

Some get lucky some don't, sometimes being lucky is its own curse.

All my mothers old friends are no longer alive (other than complaining about that once in a while she is mostly happy).

She may out live some of her children.

Submitted by scaredyclassic on August 8, 2019 - 7:34am.

Wait.are my best days behind me

Submitted by The-Shoveler on August 8, 2019 - 8:48am.

LOL I guess it depends on what it is you want IMO.

At some point you do kind of have to just go for it.

Clock is ticking.

Me I am happy about 80% of the time doing what I am doing (I guess that is enough).

I got no big plans.

Submitted by scaredyclassic on August 8, 2019 - 10:22am.

I'm not particularly averse to dying. It's fairly repetitive at this point, life.

My wife says I'll feel different if I'm actually dying. But is that really the time to ask my preferences?

I'm not averse to living either, but only if I'm pretty healthy. I think my tolerance for pain, decay and difficulties is low, but, people adapt.

Still, there may yet be something worth sticking around for. I want to see where ebikes are technologically in 2025.

I want to make a few more bucks.

I'd like to got to jalama beach. I'd like to get it under control. I'd like to not care anymore

I want to want something. Or want to want to learn. I'd like to want to want to want to want to want to want to want.

I want stop wanting.

I want to be free from want ut I dont want to want it.

I'd like to see it all work out. I'd like to see it work its way in. I'd like to borrow some money. I'd like to not be wiped out.

I'd like to be supported in the lifestyle to which i have become accustomed and accosted and police blottered, farther and farther from where i started,

I dont want to be a martyr or a religious sex symbol, gimbling and gyrating all up and down the uncertain state.

I want david berman to set this post to music, but that's not possible .

I want the silver jews renamed to "long term care insurance", which actually isnt a bad name for a band or a self help book.

I want to rent a room at our lady of perpetual care's house but sadly I'm stuck in mister temporary assisted living's town.

But I'm not buying long term care insurance. I got the earthquake insurance, the dental insurance, the car insurance, the life insurance, the AAA towing insurance but i forgot I needed long term caring and now it's too late because the cost of caring is too damn high.

Roll the die, babee. I want to go to the top of the charts. I want to shut down but I want to stay open for business. I want to slash my prices but keep adding value.

Submitted by FlyerInHi on August 8, 2019 - 11:59am.

I have a friend who is 50yo. His wife is 21. If they stay married, she’ll take care of him I suppose.

Submitted by temeculaguy on August 9, 2019 - 12:24am.

I notice a lot of the comments mention "I" as far as one's wishes go. I pay the premiums because I am not going to tell my wife's adult children that her alzheimers was too much so I decided to have her put down. I lost sleep for a month because I put a 14 year old terminally ill dog down, don't ask me to do that to a person. We can all be brae about ourselves, but if you have a spouse, it changes the decisions making process.

Submitted by scaredyclassic on August 9, 2019 - 8:20am.

temeculaguy wrote:
I notice a lot of the comments mention "I" as far as one's wishes go. I pay the premiums because I am not going to tell my wife's adult children that her alzheimers was too much so I decided to have her put down. I lost sleep for a month because I put a 14 year old terminally ill dog down, don't ask me to do that to a person. We can all be brae about ourselves, but if you have a spouse, it changes the decisions making process.

Ok, you sold me.

Submitted by scaredyclassic on August 9, 2019 - 8:36am.

Ltci is terrifying, depressing and maybe a RIP off now. Put it all together and who wouldnt want to live in denial. If you're collecting, your life realllly sucks. You're in need of way more than some help, you're helpless, which is frightening, like being paralyzed.

The thought of going broke spending money that yields so little pleasure. Yuck.

Maybe it's best to be divorced and partition out assets, take a life estate in your home and feed to kids, all well in advance of your decline?

Must be planners who deal with this.

Man I hope I die. My tiny empire, crumbling to pay for help with my poop.

Submitted by The-Shoveler on August 9, 2019 - 11:45am.

My Mother has "scan" health plan (I think there is a small extra premium for LTC) up to 6 months nursing home and in-home help.

This helped us greatly during her brief stays after some necessary surgery (still they try to throw you out the door ASAP and way before you are really ready, probably the same for any ltc insurers, if they can find a way to kick you out they will IMO).

If it becomes necessary maybe contact
https://www.nhscare.com/

Maybe this is where it pays not to have a big gov pension.

Submitted by flu on August 9, 2019 - 12:37pm.

scaredyclassic wrote:
temeculaguy wrote:
I notice a lot of the comments mention "I" as far as one's wishes go. I pay the premiums because I am not going to tell my wife's adult children that her alzheimers was too much so I decided to have her put down. I lost sleep for a month because I put a 14 year old terminally ill dog down, don't ask me to do that to a person. We can all be brae about ourselves, but if you have a spouse, it changes the decisions making process.

Ok, you sold me.

+1

Submitted by FlyerInHi on August 10, 2019 - 11:50am.

scaredyclassic wrote:

Man I hope I die. My tiny empire, crumbling to pay for help with my poop.

I am obsessed with money not because I love money but I want to live a long time. I also want to buy longevity treatment when new discoveries are made. I doubt health insurance will pay.

Submitted by Myriad on August 11, 2019 - 11:10am.

temeculaguy wrote:
I notice a lot of the comments mention "I" as far as one's wishes go. I pay the premiums because I am not going to tell my wife's adult children that her alzheimers was too much so I decided to have her put down. I lost sleep for a month because I put a 14 year old terminally ill dog down, don't ask me to do that to a person. We can all be brae about ourselves, but if you have a spouse, it changes the decisions making process.

I guess if you've never had a conversation with your parents, that's what will happen. I'm 39 and my mom and I already agree that she would not prefer to have to sit in hospice until she dies. What's the point of staying alive if there's no quality of life.
I haven't done the calculation on insurance yet, but I wonder if it's just better to self-insure. The problem I see is whether the LTC premiums will keep rising after you get a policy and how easy it will be to get actual payments 40 years from now.

Submitted by FlyerInHi on August 13, 2019 - 12:18am.

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