How does private long-term care insurance work if you’re retired, living at home and need in-home care?

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How does private long-term care insurance work if you’re retired, living at home and need in-home care?

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Home Care Long Term Care Insurance Paying for Care

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You need to read the terms of the contract, as many will cover in-home care. You should also call the company issuing the policy to verify the terms, and ask questions if anything isn't clear. I believe most policies require the care to be provided through an agency and they have a list of approved agencies in your area. My husband, who had Parkinson's, had LTC through MetLife which had bought out the original company he'd signed up with. We had to pay the agency weekly, then at the end of the month would submit copies of the bills to get reimbursed. To get started, the company had to have documentation of his need for in-home care. In his case, he'd been getting home health services through Medicare because he had an acute case of shingles that left him with nerve damage from his spine that basically paralyzed one leg so he couldn't walk (that fortunately did improve so he was able to walk again with a rollator). MetLife got his records from that agency and that was all they needed to start. About a year later, they did send a contracted nurse to recertify him. They also got records from the home health agency.

One pleasant surprise was that once my husband began using the LTC funding we no longer had to pay the annual premiums.

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I have a great LTC policy which is not sold anymore. I have a cap
of $600,000. It is a cash payout. I do not need to use any certified
agencies and the entire benefit can be used for in home care. I
can have a friend or significant other take care of me. I put this in
place when I was 55 years old and I am now 79. It is not the plans
that are a problem. It is that the need to be put in place when you
are much younger and the right policy needed to be put in place.
Now is too late. They lost money on my type of policy and do not
sell it anymore. You should look into a life insurance with a critical
care clause. This is very popular now. You can take the face of the policy
for care. Of course, this needs to be put in place when healthy. My
partner has this in place.

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My LO purchased LTC at the age of 68 back in 1993.
It covered lifetime benefit – unlimited
Daily nursing home benefit - $100
Daily professional service level 1 - $50
Daily basic services level two - $50
Lifetime therapeutic device benefit -$10,000
Lifetime home health care benefit – unlimited
Maximum daily adult day care benefit -$25
Maximum lifetime adult day care benefit – 365 days
Each ambulance trip - $250
Maximum number of trips – 4 trips

As of 2016 the premium was $7,638.70
As of 2017 the premium was $9,326.80

In 2017 the LTC premium was schedule to change
2019 for $11,387.90
2021 for $13,904.80

July of 2017 I discontinued the LTC policy due to the increase premiums. She was 93 yrs. old, we never filed a claim.

The LTC company which is now called Transamerica Life offered a Contingent Nonforfeiture Benefit when the policy is dropped during the year of scheduled premium increase due to inability to pay.

Contingent Nonforfeiture Benefit means the policy holder receive a percentage of premium money paid. In my LO case it was about $90,000.

She died in 2012 at the age of 98+, we never filed claim.

Be aware of inflation. When the policy was purchased in 1998 it may have covered the cost. In 2012 it only covered a portion of cost due to inflation.

I hope this give you ideas of what to ask.

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For others who may be reading this and thinking of taking out a LTC insurance policy, be sure to get one with an inflation clause. The premiums may be a bit more but it's well worth it.

(4)

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Uunoxy, Welcome to the Forum.

LTC insurance varies widely according to/dependent on the policy. All the information will be in the fine print, and in most cases there is a lot of it.

Do read your policy thoroughly, write down your questions, and then contact the policy number on your forms with your questions.

Wish you the best.

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It also doesn't hurt to have your elderlaw/estate planning attorney to review any poicy before you purchase it. I had ours do it and she raised a number of questions by e-mail. I passed the questions on to the person who was selling the policy and received satisfactory answers. I know that my long-term care insurance wouldn't cover everything, but by selling my residence, using savings/investments, and my pensions/Social Security (holding out until age 70 for the largest benefit), my long-term care insurance and other resources could probably fund five years in a nursing home and seven or eight in assisted living. Probably more than adequate.

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I hope u have a policy, because its too late now to get one. They are bought years in advance. At your age the premiums would be outrageous.

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Exactly! I looked into buying a policy last yr at age 59. I’m as healthy as a horse and hopefully won’t need it and it was $1200 a month for a max payout of $250k. What a joke considering at home care can run 100k a yr for 10 hrs a day. A live in is bout 250k a yr! These companies are con artists. The only way this ins is beneficial is if you buy a policy when you’re 20. Ha

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A down side is if the policyholder gets dementia and forgets to pay the premiums and loses the coverage

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When I took over paying my father’s bills I found many unpaid bills. His property taxes for all his rental properties and his primary home were months late, and I found a life insurance policy that was 2 days into it’s grace period for payment that he had been paying on for decades. Luckily I got that paid and have kept it paid. Not so lucky on another one he had that I found out he stopped paying the year before.

ANYONE who has an elder should start doing forensics on their finances as soon as they can while the elder is healthy. Having copies of all of the bills and monitoring them to make sure payments are being made will save time and money later. You can also submit a form to insurance companies that give them permission to notify you if a payment has not been made so you have time to pay it.

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All of the policies are different. You're going to have to read the details of the one you purchased. One thing to pay attention to is the CAP. A coworker of mine had long term care insurance but it capped out at $400,000. Which I am sure seemed like a lot of money 20 years ago when they purchased it, but memory care units can be $10,000 to $15,000 per month. At that rate you would run out of coverage in 2-3 years. So she retired and kept her husband at home as long as she could. When it became dangerous (he was an escape artist) she had to place him and the clock started ticking on that $400,000 policy. Luckily he did not outlive the policy and she did not have to move him to another facility and apply for Medicaid. I don't mean that to sound cruel...he would not have wanted to live that way for a long period of time.

So I guess what I am saying is if your policy does cover at home care, what it does pay for will be nipping away at the cap, so watch your spend.

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Really depends on the policy that you have. Most policies have some kind of limitation as to the number of hours or the number of days or the number of years that will be covered.. It is not indefinite. In my experience most policies will give coverage for about 3 years worth of care. You need to work with your long-term care provider. They will pick out the agency you work with; they will be billed directly for services rendered to you or your loved one. You need to read the fine print about what is covered. Generally speaking long-term care in the home or in a setting is only given to those who cannot complete tasks of daily living, i e. get dressed, feed themselves, take a shower etc etc If they can do these things then they won't qualify for long-term care. I know many people are frustrated by the coverage available through these policies because their loved one never qualifies. Most people end up paying something out of pocket for care in the home. And it ain't cheap! Many insurance companies have gotten out of the long-term care business because it is not profitable to them. I would look for a non-profit company that provides long-term coverage in your area. They are not so focused on making a dime! Also the The younger you are when you sign up for a policy, the less expensive it will be. My husband and I signed up for long-term care insurance when we were in our middle fifties, and paid for it for about 15 years before it was needed. But then it sure was needed and was worth every cent we had invested. That's the thing. You need to think of long-term care insurance as an investment. And be willing and able to pay for it for a long time before it's needed. If you wait until you're in your '70s to sign up for it it will be very expensive. I could go on and on about long-term care insurance! But I'll stop now.

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I will check my policy, but in general will it help me out if I need a hip replacement and am incapable for a week.

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Mom had LTC with Fortis which sold to John Hancock. She had put in a claim at 82 and it paid for licensed caregivers at her home. She received $80 a day for their salary and we paid the rest. When she went into Memory Care, the insurance paid $80 a day towards her $9600 monthly bill. She stopped paying premiums at age 80.
Hope this helps.

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Are you saying you have a LTC policy?

If you do, then read it, and you will see what is provided. There will be a number on your policy to discuss what provisions it will make for care, as well.

If you do not already have a LTC policy then it may be too late to get one. They vary a lot. Will wish you happy reading.

How does private long-term care insurance work if you’re retired, living at home and need in-home care?

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