I'm not altogether sure that Long Term Care includes what to me would be quality of life, just quantity of life.

But then I could be wrong.

quote:

quantity of life.

As in less quantity. It is amazing how fast Seniors bite the dust in these places.

I have it. After seeing my mother's LTC come through I became more of a believer in it. Especially, when I had to move her into a private residential care home. Those homes aren't cheap and it really paid off so-to -speak. Her LTC was excellent with no lifetime maximum and paid out about $7,500/monthly.

In my case, I converted an employer LTC policy to my own private policy when I left that employer years ago. I pay Prudential quarterly. My premiums have increased over the years but so have the costs to the insurance companies. Not sure how they can afford to sell these policies but they do.

I don't have the Riders that against premium increases or spousal discounts etc. My policy with Prudential has a lifetime benefit of $326,675 with a 90 day elimination period, daily nursing home maximum of $179/day or a Home & community based daily care max of $90/day until I hit the $326k max. I'm paying about $500/quarter for this coverage and I'm almost 69 years old now.

My personal opinion is that most folks who enter a nursing facility don't make it over two years. There are a lot of exceptions to that rule including my Uncle and my grandparents. In my case, I wanted something good for 2 years and it's difficult to find policies that are unlimited (until you pass) while still being affordable. My .02..

Thanks 2Pak - always good to consider first hand experiences in these kinds of decisions. And your information is great for establishing some baseline against which to weigh the coverage / premium in front me.

My mother had and used it for 8 years. It did not cover all her costs but did cover over half.

My oldest BIL does not. He is on Medicare but with no supplement. His costs were covered for 90 days. After that, his cost would have been $10,000 a month to stay where he was.

He is living with his oldest sister now and she and the other sisters are taking care of him. (A 68 yr old caring for a 69 yr old).

His three children, not so much.

This $10000/month number that keeps coming up is really worrisome. For 1 or 2 years, okay. But for the rest of one's life seems troubling.

Need to find some stats - if one has two or more of the LTC ADL's triggers, what is the life expectancy at that point.

The median length of stay for nursing home residents is 5 months, and 53% of residents die within 6 months of admission. ... ... The median length of stay for nursing home residents is 5 months, and 53% of residents die within 6 months of admission. The median stay is longer for women (8 months vs.Jul 5, 2022
ADLs are relative

Thanks. That's a good start.

Interesting then, that the LTC insurance will cover, say $200/day or $6K/month while the full coverage amount is perhaps much more than that (say, $300K lifetime). LTC should pay $10K/mo and they would still not pay out their full obligation; but at least they would cover the monthly costs of the insured (vs as it is, seems like the insured needs to cover $4K/month out of pocket somehow).

quote:

Originally posted by ZSMICHAEL:

quote:

quantity of life.

As in less quantity. It is amazing how fast Seniors bite the dust in these places.

Probably discover that they don't care to live that way and just let go. Can't say I blame them.

I strongly double I'll ever be inside of one of those places.

IMO, there is a big difference between 'homes' and facilities. Private homes (Adult Family Homes) vs an Assisted Living facility vs Nursing Homes. Monthly costs vary and choices on which place you might be able to live at can vary upon your condition as well.

After seeing the spectrum, if I couldn't live at home, I'd prefer a Adult Family Home until I wasn't able to live there anymore and had to move into a facility. In my Uncle's and Mothers case, they passed at an Adult Family Home and didnt have to make a transition into a more assisted living or nursing facility.

If a person is in a dementia stage, your cost is going to go much higher.

Yep. Sounds like you have it.

If you’re very rich and have lots of money, buying an LTC is a strategy to minimize your LTC costs and keep more of your money that you’ll leave behind.

If you don’t have much money anyway, you can rely on Medicaid after you’ve used up most of what you have to take care of your long term care.

If you’re somewhere in between where buying LTC insurance is a significant cost compared to your assets but still want to preserve what you can of your assets, then instead of buying LTC insurance, you can spend money on an estate planning attorney who can set up an irrevocable trust into which you can transfer your assets. This will make you look poor on paper legally and thus qualify you for Medicaid without the Government coming after what was once your assets. This assumes 5 years have passed from the time you transferred your assets into the trust until the time you start needing Medicaid support.

In the meantime, the irrevocable trust will be controlled by somebody else for your benefit while you are still living. So you need to be sure the person is someone you can trust with your assets. They are in control of the assets within the trust and you can’t ever get control of the trust back - hence “irrevocable” trust. Usually, this would be children of the person who will get the assets anyway upon the person’s death.

You fit into one of these three scenarios. The first two are straightforward strategies. The third is more complicated especially with selecting the controllers or trustees of the trust.

Good luck.

How about option number 4, where you have a comfortable amount of money (I have no good personal definition of very rich) and have plenty to pay for LTC yourself without any insurance or worries about running out of money before running out of lifetime?

quote:

Originally posted by Flash-LB:
How about option number 4, where you have a comfortable amount of money (I have no good personal definition of very rich) and have plenty to pay for LTC yourself without any insurance or worries about running out of money before running out of lifetime?

That's called being "self-insured" and is a perfectly valid option if you've got the scratch.

quote:

Originally posted by Flash-LB:
How about option number 4, where you have a comfortable amount of money (I have no good personal definition of very rich) and have plenty to pay for LTC yourself without any insurance or worries about running out of money before running out of lifetime?

For most people, whether poor or rich or somewhere in between, money is a concern as in they want to keep more of it under their ownership. In your case, it's obvious you have enough money to be indifferent about maximizing the value of your estate that you will leave behind. You're not like John D. Rockefeller who, when asked how much money is enough money, answered, "just a little bit more." So you're rich and indifferent with regards to your wealth. Congratulations.

If you think you need it, you won't be able to afford it.

If you can afford it, you won't need it.

More or less a scam.

15-20 years ago it would of been a good thing to invest in. Now, nope.

My take anyways.

I take the Dave Ramsey approach to it. Until age 60 the stats don't back up the need for LTC insurance. After age 60 is when the gamble starts.
The average nursing home stay is 2.25-2.5 years. The average cost is 6-10000 dollars a month for a rough average cost of 200-300000 dollars for the average length of stay.
If you have no assets,and can not afford LTC, the govt will provide your care through medicare. At an appropriately cost effective establishment. If you have 10 million dollars, you can go into a nice facility, spend 300k and when you die your wife will still be left 9.7 million, enough that she will be fine the rest of her life, if managed correctly. In this case you don't really "need" LTC, you will be fine without it.
If you have 300k in assets when you go into LTC, you will burn that up in the facility and leave your wife nothing. You absolutely need LTC to save your assets to pass onto your wife. Between 300k and 10 million is the gray area that you have to run your own numbers on. How much money do you want to leave your spouse VS how much in premiums you are going to pay between now and the time you enter LTC and then pass. If you knew when you were going to go into LTC it would be an easy calculation.
Unless you can afford a 300k hit to the estate you plan to pass on, and you are over the age of 60, I would get LTC.

[quote]the govt will provide your care through medicare.
^^^^^^^^^^^^
MEDICAID. Medicare does not pay for long term nursing home care. You get 90 days after a hospital stay.

I'll admit it been a while since I saw the stats, but the average stay at a nursing home was 2-1/2 years.

That was pretty much spot on for both my parents. We were private pay for about 1 year for each and after that it was Medicaid.

My mother-in-law was a different matter. She was in a nursing home for about 8 years, and she had great LTC policies, so her estate was left intact. If she didn't have LTC coverage, the private pay would have been $768,000.

Underwriting to get a LTC policy is very tough. It's harder to get than life insurance. The key is buying it when your younger and healthy. If you wait, not only does it get more expensive to buy, but your health status may have changed and now you can't get LTC insurance at all.

Like all insurance, it is a transfer of risk with many unknowns for which you can't plan ahead.

As to Medicaid, you must have depleted your assets before you qualify for LTC using Medicaid. Most nursing homes won't take a patient without starting with direct pay because Medicaids reimbursements to them are so low.

Hence if a nursing home accepts Medicaid patients they usually strive for the majority of patients to be private pay (cash or LTC insurance) and a small percentage of Medicaid patients.

Usually the nursing homes that have a higher percentage of Medicaid patients, and yes I realize this is a broad brush stroke, have a much lower quality of care. I've toured many such homes and I would not want to stay there.

Another component of LTC insurance, is "at home" care. For example on my policy I can have it pay a family member or professional care giver take care of me at my OWN house. That is HUGE because who really wants to move out and go into a nursing home unless you absolutely must do so.

Lets say you are 50 years old. Buy some kind of policy. Pay the premiums till you are 77 (27 years) How much did you pay? Move into a ltc facility for the 2-1/2 years. If you invested the money you spent paying the premiums for 27 years how would that of panned out?

Most folks (heirs) who say their parents estates were used up for the care that did not have ltc insurance do not take that into account.

I do not think it pans out nowadays.

Thanks guys for the benefit of experience and the perspectives. Good food for thought. Need to make a decision this week....