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OP, you might want to do some research now on what care would look like without LTC insurance. Tour facilities you could see yourself being willing to use, set up an appointment with the admissions and financial person and ask them to be straight with you.
When my mother went into a facility, she was already on community medicaid. Because she had medicaid already in place, and not "pending" as a private pay person would, she jumped to the head of the line. They just wanted to guarantee payment. A person on Medicaid is more of a guarantee than a private pay person whose funds have run out. Just a different way of looking at things.
As for the type of facility she got into, it is nicer than 90% of the facilities in our area (Long Island, NY). She has a private room since the dementia unit is all private rooms. It is not by any means the best of the best. The staff to patient ratio is just average. The cream of the crop facilities would not even look at us once I mentioned Medicaid (I think there were 3 of those) but by and large, there were a handful of very decent facilities that accepted a Medicaid person without a private pay period.
It's worth mentioning that there are relatively few outstanding facilities, period. I contacted about 26, almost every facility in my county and a number of facilities in neighboring counties. I did a LOT of tours, some twice. There were only 3 that I would consider a dream facility, and they weren't that big, so even if you have the money, what are the chances of getting into one of those?
I applied to 5 facilities. The others I don't think I would send a dog there. (There are a LOT of bad facilities.) One accepted her, and it's quite nice, comparatively. It doesn't hurt that it's in one of the most expensive neighborhoods in NY. I've heard "the nicer the neighborhood, the nicer the nursing home," but you'd have to test that in your own state.
When you talk about nursing homes, you're talking about quality of care. We have some outstanding aides, who I wish I could clone, and also some lousy ones we have to complain about and get removed from my mom's care. Mom is fortunate to have me, her "helicopter daughter" right on top of things. That's how we make this work. We MAKE it work.
But what about those of us who have no kids? We NEED to be in those top notch facilities, and we need a strategy to get there, which may or may not include LTC insurance. Do lots of research. Ask questions. Talk to people who've been there, and plan for yourself.
Great question!
It sometimes seems like there's just no good solution. Healthcare is expensive. Unjustifiably expensive. Prohibitively expensive.
My facility is $14,000 a month. The other day, I saw an aide sleeping in the dining room when she was supposed to be making sure people didn't choke to death. I can't imagine anywhere how a share room (in most cases), 15-20 minutes of a CNA's time per day (who makes $16 an hour), 3 cafeteria style meals plus snacks, and the *presence of an LPN ( a friend who's an LPN told me that means "low-paid nurse") merits $14,000 a month!
But when you add to the mix the fact that many of these people have no other option, it becomes supply and demand and the price skyrockets. The same reason some cancer drugs cost so much. Certainly, the ingredients and production are not much more expensive than many other reasonably priced drugs (I used to work in the pharmaceutical industry), but when you factor people's desperation to live to the equation, you get away with murder!
And sure, the facility needs to keep the lights on and pay the social workers and the financial people and buy supplies, etc, etc, but, for a 30-resident unit, they are pulling in (and this is assuming everyone is on Medicaid paying $8000 a month instead of $14,000) $240,000 A MONTH. And most of these places smell like urine. Are ya kidding me?
Our advisor pitches one to us about every year. Actually, they seem to be more attractive than what was available 2 or 3 years ago; and we almost applied this year, then backed out.
I think you just need to do some comparison shopping for available plans, considering your own personal plans. If you think you will have a family member care for you at home, obviously, make sure the policy you buy will pay for that.
Another consideration: There will probably be a physical required, and you will have to be in good health to be accepted.
My policy is with Allianz.
My relative's policy is underwritten by John Hancock.
I'm not sure why you would say that good companies don't offer long-term care insurance anymore. Some of the biggest and strongest insurance companies in the country sell long-term care insurance: Massachusetts Mutual, Mutual of Omaha, New York Life, Northwestern Mutual, State Farm, Thrivent, Transamerica, all sell long-term care insurance and they are all very large and very strong companies.
Once a company sells a policy they can't cancel your policy (unless you don't pay your premium on time.) If a company stops selling new policies, they still have to honor all of the policies they've already sold. My relative's policy is with John Hancock. They've stopped selling new policies, but they have to honor all claims of all the policies they've sold previously.
The National Association of Insurance Commissioners publishes a Shopper’s Guide that outlines what to look for in a LTC Insurance policy. Compare policy offerings and consider:
What are the policy's limitations on home care? Are Home Care Costs Covered at all? How may days per week? What Services are Covered?
Does the policy pay family members for care giving?
Does the policy pay for 24 hour a day home care? (most do not)
What level of physical and mental impairment does it take to get the policy to pay benefits? Eligibility for coverage is based on whether or not a person can perform Activities of Daily Living. Make sure you understand the policy’s definition of ADL's. People who are unable to perform these Activities of Daily Living, and who can't obtain adequate nutrition, usually require a caregiver to support them from 12 to 24 hours each day. ADL's include: Dressing
Bathing
Toileting
Eating
Walking
Shoppers Guide is at:
https://www.ltcfeds.com/epAssets/documents/NAIC_Shoppers_Guide.pdf
(Don't confuse ADL's with Independent ADL's, which are the activities that enable a person to live independently in a house or apartment, such as: preparing meals, performing housework, taking medication, going on errands, managing finances, and using a telephone.)
My state, Massachusetts, is unique because it has a Long Term Care Insurance incentive program that exempts an elder’s home from Medicaid liens, and protects the home from estate recovery. No other state in the union has this protection. three important features that must be found in the policy: 1) coverage for at least two years of long term care, and 2) a daily benefit dollar amount of $125 and 3) elimination period (days on which services are provided to an insured before the policy begins to pay benefits) not longer than 365 days in a nursing facility or a deductible of no more than $54,750.
Because the Massachusetts law measures these requirements at the time the policy is purchased, elders can use the qualifying insurance policy to pay for community-based home care before they enter a nursing home, without fear of being disqualified by the two year requirement. The purpose of the law is to protect elders who use their long term care insurance for community-based care, so they can remain in their homes as long as possible.
More and more companies are raising premiums and " re-interpreting contracts " to lower their claim exposure, thus raising profits. Meaning people who planned on those benefits for retirement care, are not getting them. It's a constantly changing dynamic.
Litigation against Long Term care companies
Have double since 2012, as more people attempt to start claims and get denied.
Sorry if my earlier post seemed to imply that no good companies offered LTC. As you say, that's not the case.
I was just opining that the offerings change so often that it is hard to make comparisons; and you can't base your own decision on the experience of someone else, because the coverage they collected on probably is not available today, not from another company or even the same one.
My relative's experience with John Hancock is an example--good company, paid as promised--but, as you said, they don't offer LTC now.
Mr. Roberts, Indiana also has an asset-protection approved plan similar to what you described. I'm going to check out the Shoppers Guide you mentioned.
Thank you both for your informative posts.
Here's a link to the chart
twitter.com/LTCShop/status/942606001768873984
Here's a link to the entire study published by Dept. of HHS:
ltcfacts.org/wp-content/uploads/2015/04/ltci-claims-audit
Last year 254,910 people received benefits from their LTC insurance policies. In that same year, there were 50 lawsuits filed against LTC insurance companies. For every 5,000 claims paid there was just 1 lawsuit filed.
The LTC policies that have had disputes over claims have mostly been policies that did not meet the federal guidelines for LTC insurance.
The most important policy terms (e.g. how to know if you qualify for benefits) have been standardized by the federal gov’t. The policies that meet those guidelines are very clear in terms of when you qualify for benefits.
You're 100% correct that LTC insurance offerings have changed from what was sold 15 years ago. However, the changes have not been for the worse, but for the better.
15 years ago, most states did not have LTC Partnership Programs. If your policy ran out of benefits you were out of luck. Today, 44 states have these programs. Consumer can protect most, if not all, of their assets if they buy a policy that has an amount of benefits equal to (or near) their net worth.
Badandy's concerns about rate increases would be correct if long-term care insurance companies were allowed to price their new policies, available for sale today, the same way they priced their policies 15 years ago.
Fortunately, insurance regulators do NOT allow any policy purchased today to use the old pricing assumptions. Also, 41 states have passed very strict pricing regulations for any policy purchased today. These new regulations have removed any profit incentive from rate increases.
Now that’s good news and that’s bad news. The bad news is that a policy purchased today costs more than a similar policy that was purchased 15 years ago.
The good news is that because of the new regulations and because today’s policies are priced more conservatively, any policy purchased today has a very low chance of having a large premium increase.
Reference the Class Action Lawsuit of
Gwen B Daluge vs
CNA Financial Corporation.
My husband had LTC through my work five years ago, and that was three years before his Alz diagnosis. On the one hand, he was lucky that he got in just in time, because now he would not be qualified to enroll. On the other hand, we didn't know he would get sick so soon, so he only signed up for a 3-yr policy. We now wish he had signed up for the "indefinite" policy with the highest daily benefit amount ($450/day). We would have been financially stable if he had done so, even having to pay a much higher monthly premium. Here's why:
Several months ago, my husband had a crisis that caught me off-guard. That was the first time I had first-hand experience what delusions looked like. Wow, it was scary and heart-breaking. I put him in memory care while I worked out a better care option for him. The monthly cost in memory care was $9,000 a month! He stayed there for two months and we were $18,000 poorer. His LTC policy only paid half, which helped a bit. But if he had purchased the "indefinite" policy with the maximum DBA, we would not have to pay a dime. And once you have been approved for claims, LTC stops collecting your premium and anything you paid after the approved date would be refunded to you. So, even if my husband had paid $1500/mon in premium, it would still have been cheaper than $9000 a month.
I do not know what I will do after the 3-yr policy is gone. Right now, I can only focus on one day at a time.
I think if you are super rich like Trump, Gates, and other billionaires, there is no reason to by an LTC policy - for obvious reasons. But if you are a normal person like most of us, an LTC policy is a good idea, because the cost of caregiving is VERY expensive, and it gets more expensive as more care is needed later.
Not sure if my post helps, but everyone's situation if different.
Long-term care insurance premiums are based upon your age (and health) at the time that you apply. The older you are when you apply for a policy, the higher the premium.
Can you share some specifics about the suit? I couldn't find anything about it online.
According to the annual reports published by the NAIC, in 2015, CNA incurred $824,492,319 in claims. In 2014, CNA incurred $694,455,842 in claims. In 2013 CNA incurred $650,624,104 in claims.