# Do You Have A Long Term Care POlicy?



## Lon

Because I have two different medical conditions that may require me to have ASSISTED LIVING in the near future I checked my files for the Long Term care policy that I bought when I retired at age 58. I called the company and was pleased to find out that even though the term ASSISTED LIVING  had not come into being at that time that the company had updated the terminology of all their older contracts to include, and more importantly cover LTC. That is a relief to find out, Hopefully my monthly income and assets along with the LTC policy will be sufficient to take care of any eventuality.


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## Don M.

We took out a LTC policy many years ago.  I've seen so many elders who have to move back in with their children, or wind up in some marginal State home, that we figured that it would be money well spent..especially since longevity runs in our families.  At the bare minimum, it should allow us to hire help in later years, should normal housekeeping/cooking, etc., become a chore.  

Besides, the way my luck runs, if I have extra parts and plans, on hand, I never need them...but the first time I don't have a backup plan, that is usually what breaks down.  I'm hoping that we stay active and healthy right up to the end, and all the LTC money goes down the drain.


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## Underock1

Good for you guys. We thought about it, but it was way too expensive. We decided to roll the dice. It became a very close run thing with my wife. She died within a week of having Medicare coverage run out. A year or two of her needing a nursing home would have wiped us out. I have idiopathic peripheral neuropathy in both legs and am unstable walking. Other than that am in pretty good health at 83. Hoping for a quick death. I think the odds of me needing LTC at this point are in my favor. 
:fingerscrossed:


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## Ruthanne

I guess I will probably be put in one I can afford.  I don't have any type of plan.  I only have medicaid presently.


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## Buckeye

My LTC policy is my son.  But I'm most likely not to need it - already had 1 heart attack and quad bypass, so I should go quickly....


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## Grumpy Ol' Man

Wife and I were "talked into" long term care insurance quite a few years ago.  Now, you can't even buy the policy we have because it's "too good".  Covers most all costs in a facility upon admittance for as long as you are there.  Cost wasn't that much per month and we have kept it in force.  
Our kids have always said we need to be kind to them because they will choose the nursing home we go to.  :>)  At least they should be able to choose one of reasonable competence since it will be paid for.


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## Myquest55

Grumpy Ol' Man said:


> Wife and I were "talked into" long term care insurance quite a few years ago.  Now, you can't even buy the policy we have because it's "too good".


Grumpy - did you, by chance purchase a policy from Prudential?  We compared a couple of them and ended up with theirs and yes, it is not sold any more because it was too "good."  My father encouraged us to purchase policies if we could afford it-in our mid-50s.  We had recently inherited some money from my husband's mother so we took some of that and purchased an annuity which pays us once a year to almost cover the premium payments.  My one regret is that we were supposed to have the chance to lower our premiums if we had a better physical 2 years after we purchased.  I lost weight and came off the statins and they told us we couldn't decrease our premiums because they no longer sell the policy.  I was NOT happy but there wasn't anything I could do about it.  The premium prices have risen once and I have recently read that LTC policy premiums are due to increase yet again across the board.  Kind of scary.

Now, my husband has Parkinsons and I feel better that we purchased the policy when we did and I fully intend to, ultimately, put it to use. 

In the same vein - we purchased life insurance policies when our children were born.  They were $25,000 policies so they would cover a funeral if - God forbid, we needed it.  They would also have something in place, should they be injured or develop a condition that would prevent them from being insured as they got older.   There were also bump-ups built in and they all have something now, just in case.  I think they originally cost about $35/year.  My father purchased one for me, when I was born and I have been able to increase the value along the way.  We tried to plan ahead.


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## Grumpy Ol' Man

Myquest55 said:


> Grumpy - did you, by chance purchase a policy from Prudential?  We compared a couple of them and ended up with theirs and yes, it is not sold any more because it was too "good."  My father encouraged us to purchase policies if we could afford it-in our mid-50s.  We had recently inherited some money from my husband's mother so we took some of that and purchased an annuity which pays us once a year to almost cover the premium payments.  My one regret is that we were supposed to have the chance to lower our premiums if we had a better physical 2 years after we purchased.  I lost weight and came off the statins and they told us we couldn't decrease our premiums because they no longer sell the policy.  I was NOT happy but there wasn't anything I could do about it.  The premium prices have risen once and I have recently read that LTC policy premiums are due to increase yet again across the board.  Kind of scary.
> 
> Now, my husband has Parkinsons and I feel better that we purchased the policy when we did and I fully intend to, ultimately, put it to use.
> 
> In the same vein - we purchased life insurance policies when our children were born.  They were $25,000 policies so they would cover a funeral if - God forbid, we needed it.  They would also have something in place, should they be injured or develop a condition that would prevent them from being insured as they got older.   There were also bump-ups built in and they all have something now, just in case.  I think they originally cost about $35/year.  My father purchased one for me, when I was born and I have been able to increase the value along the way.  We tried to plan ahead.



Ours are with Thrivent Financial.  They were purchased when that was AAL (Aid Association for Lutherans).  The Lutheran Church had two insurance/benevolent groups, AAL and Lutheran Brotherhood.  Some years ago, the were merged into Thrivent.  We have an old, old annuity with them that is gaining, and has been, much faster than most other investments due to how it was written.  They guaranteed a certain percent return when interest rates were 11% or greater.  I think it's guaranteed to return something on the order of 7%, which sure beats a lot of stuff out there that won't get you 1%.


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## bodumene

Both my in-laws have been in a nursing home for a couple of months now.   The cost was over $20,000 per month -- that's almost a quarter of a million per year -- until my father-in-law died suddenly.  Of course, the money is running out very quickly, and my MIL will probably have to go on Medicaid.

My wife and I were lucky in that we bought LTC insurance when we got married, because we can't afford that kind of expense.  Yes, the insurance is expensive (it wasn't then, but they keep raising the rates), but they do provide inflation adjustments each year to somewhat compensate for the higher rates.

It is said that if you are poor, or if you are rich, you don't need LTC insurance.  It's the middle income and asset people who benefit most from it.  If you are poor, you can go on Medicaid right away, and if you are rich, you can afford nursing home care yourself.

The only thing about Medicaid is that you really don't have all the choices of where you go that you do if you have private pay.  Many nursing homes, especially those run by for-profit companies, I have heard are not very good.  And many of the good ones will not take Medicaid clients, or take only a small number each year.  We were lucky in that the nursing home my in-laws are in is non-profit.  (You wouldn't guess that by looking at the cost!)  But the care is excellent there, and remains the same whether you are private pay or Medicaid.


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## Lethe200

Yes, we've had them since I was 48 and my DH was 46. 

Four years after we bought them, DH suffered a severe stroke. Recovered quite well, but now has a much higher than average risk for: death by heart trouble, another hypertensive stroke, or risk of developing dementia.

We've had four rate increases over the 17 years as class-wide increases for existing policyholders were approved. But we, too, have policies that are not sold any longer, because the coverage is so comprehensive. We planned for rate increases as I knew the actuarial assumptions that LTCi carriers were using were probably too rosy and unfortunately I was correct!

When my MIL needed an Asst. Lvg facility we investigated eight full-care facilities within 15 min of our home. She had sufficient funds for care no matter how long she lived. 

But FYI for those reading this thread: None took Medicaid patients. Only three would allow an elderly resident to stay even if their money ran out; the facility applies for Medicaid in their name and makes up the deficit through general fund-raising. All the others kicked indigent residents out if their funds were used up. They could stay only as long as it took to find them a bed in a Medicaid facility - which admittedly can take months, sometimes.

We bought our LTCi policies on the advice of an insurance agent running a seminar on retirement planning; the state pension fund had a full day of seminars on different subjects and this was one of them. His presentation helped us realize that the disability of one would impoverish the other spouse, whether it happened while we were working or after we retired.

Over a period of five years we took a number of retirement planning seminars the fund offered, but that one tip on LTCi was the single best thing we ever learned. Our policies have compound inflation protection so they now cover the full cost of skilled care. In our area that runs $8,000+/monthly - and we learned in our research that every July, all the facilities raise their rates 3-4% without fail. 

Scary stuff, to be without the fallback protection of our LTCi policies, these days.


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## bodumene

What we are worried about is what happens when the money runs out and Medicaid is applied for.  Medicaid looks back five years to see if there were any gifts.  What about all those Christmas and birthday presents, and gifts to charities?  My MIL was very generous.  Medicaid will not pay right away, subtracting an amount of nursing home care equivalent to the amount of the gifts.  You can buy yourself a yacht for $200,000, but you can't give your kid $100 as a birthday present.


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## NancyNGA

It's on a state by state basis, but I believe in our state, at least a few years ago, you were allowed $12,000 in gifts per year.  Above that, they started counting.  It may be up to $15K now, not sure.


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## Ruthanne

That's why it's better to deal with things in cash than in checks.


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## Butterfly

Ruthanne said:


> That's why it's better to deal with things in cash than in checks.



They can look at your bank statements and ask you to prove where where large withdrawals went, at least in most states.


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## Butterfly

bodumene said:


> What we are worried about is what happens when the money runs out and Medicaid is applied for.  Medicaid looks back five years to see if there were any gifts.  What about all those Christmas and birthday presents, and gifts to charities?  My MIL was very generous.  Medicaid will not pay right away, subtracting an amount of nursing home care equivalent to the amount of the gifts.  You can buy yourself a yacht for $200,000, but you can't give your kid $100 as a birthday present.



As Nancy NGA says, it's all state by state, but in most states there is a limit.  I don't think they are concerned about birthday presents, etc., but they won't let you give large sums of money away in order to qualify for Medicaid.  Check your State's rules and regulations.  If you can't find them yourself online, call up your Medicaid administrators and ask them where to find them.  OR, if you have a local Senior Citizens' Law Office, they can probably tell you.


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## bodumene

Butterfly,  Excellent idea.  Thank you.


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## mathjak107

we do , for many reasons .

we were going to self insure but  most folks who say they will do that  make no plan for doing so.

anyone with some money left can self insure and pay for things . Key word is money left. Depending where you are a snf can run 120k a year. It does where we live.

How long would most folks be able to sustain that from the pile of money allocated to producing income without choking off the income stream to the stay at home spouse.

How about if you needed care in 2009 and your portfolio was 30% less and we didn't recover so fast.

 most folks fail at having a plan to self insure. To really do it right you need to set that money a side where it is not counted as part of the income money where it can be spend down if you have poor sequencing and returns..

It needs to be a seperate fund isolated on its own in a CONSERVATIVE INVESTMENT where it can be counted on to be there.
Our estate attorney is one of the biggest in nyc. He was telling us how a good part of the business is folks who planned to self insure. 

Now that their spouse went in to a facility they are realizing that their expenses depended on that portfolio being in place and with the 100k plus a year to pay they are realizing that if this extends out their own income will have to take a nasty hit and they can't afford that hit.

They made the classic mistake of making their insurance money part of the goose laying the golden eggs of their income stream not realizing now they have to kill a bunch of those geese.

So how they want help as the stay at home spouse goes in to survival mode.

So i am saying , if you are going to self insure then do it. Get that money out of the main stream investments where it can be greatly reduced in times of poor markets and Don't count on it for generating part of you income since it may not be there.

My feeling is if i had to take a big chunk of money and set it a side invested conservatively , i was better off leaving it more aggressively invested and with a piece of the higher return pay the policy premium.

The idea behind a safe withdrawal rate is that it counts on spending down principal if need be to even zero if it has to is something folks either forget or don't know .

You can't really self insure when that money is part of the income stream unless you need so little of it for living that for all purposes you really are not spending it down.

Folks with good pensions may be in that position.

You may want to make sure that money is just about guaranteed to be there as well for staying out of a snf facility and being able to modify your home if needed. So it can cost a pile of money to stay out of an snf too modifying that home and having in home care


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## mathjak107

just wondering how many here actually  did any long term care planning , as opposed to rolling the dice , calling it self insuring and taking your chances .


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## Don M.

mathjak107 said:


> just wondering how many here actually  did any long term care planning , as opposed to rolling the dice , calling it self insuring and taking your chances .



We took out a LTC policy over 20 years ago....and have paid thousands in premiums.  We saw our parents having to jokey their finances in order to receive the care they needed in their later years, and decided that we needed a "cushion" if we lived as long as they did.  With a little luck, we may not need to draw much on this policy, but if we do, it will be good to have.


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## mathjak107

like all insurance I will gladly pay it and not need it


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## Aunt Bea

No long term care insurance here.

I have read and it has been my observation that if you live on your own as long as possible the need for assisted living/long term care should not exceed 3-5 years, I can handle that.  If I miscalculate then I will have to rely on medicaid and stumble the last mile up the hill to the cemetery on my own.


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## Dudewho

Regarding long-term care they're only two ways to pay for it. LTC Insurance or your assets. Medicaid spend down will make you dissolve your assets before Medicaid starts to pay. If use are lucky enough to have assets you would like to leave as a legacy to another generation you may not be able to without one time Karen cha if use are lucky enough to have and said she would like to leave as a legacy to another generation you may not be able to without LTC  Insurance. Once on Medicaid your access to care is limited.  If the first Medicaid bed opens up on the other side of the state your family may have to spend hours in a car to come visit you. 

 A little known fact about LTC insurance is that many states have Filial Support laws on the books to make adult children responsible for mom and dad's LTC costs.  Here's a list of the states and statutes, although the list is a little dated I believe it goes back to 2012.

Keep in mind that usage in other states has been infrequent, though long-term-care providers could look to the Pennsylvania precendents as sources of payment become more constricted.

STATESTATUTEAlaskaAlaska Stat. § 25.20.030 (Duty of parent & child when poor); Stat. § 47.25.230 (Persons liable for support and burial) Alaska Stat. §  11.51.210 (Crime)ArkansasArk. Code Ann. § 20-47-106 (Duty limited to mental health services)CaliforniaCal. Fam. Code 4400-4405 (Duty to support parents); Cal. Fam. Code 4410-4414 (Relief from Duty to Support Parents); Cal. Welf. & Inst. Code §& 12350  & 12351 (Including Releases of Obligation to Reimburse State) Cal. Penal Code § 270(c) (Crime)ConnecticutConn. Gen. Stat. Ann. § 53-304 (Crime, for refusing reasonable necessary support to parent under age 65)DelawareDel. Code Ann. Tit. 13 § 503 (Duty to support poor person includes spouse, parents & children); Del. Code Ann. Tit. 13 § 506 (Just cause defense to failure to support)GeorgiaGA. Code Ann. § 36-12-3 (Children of full age shall support paupers)IndianaInd. Code Ann. §§ 31-16 -17-1 thru 7 (Liability of children for support of parents & contribute to burials) Ind. Code Ann. § 35-46-1-7 (Crime)IowaIowa Code Ann. § 252.1 (Defining “poor person”) Iowa Code Ann. § 252.2(Liability) Iowa Code Ann. § 252.5 (Remote relatives – Grandparents)KentuckyKY. Rev. Stat. Ann. § 530.050 (crime)LouisianaLa. C.C. Art. 229 (Reciprocal duties; parents & children); La. C.C. Art. 239 (Reciprocal duties; illegitimate children); La. R.S. 13: 4731 (Alimony from children or grandchildren)MarylandMD. Code Ann. Fam. Law §§ 13-101 thru 13-109 (Support claims by destitute parent or adult children)MassachusettsMass. Gen. Laws Ann. ch. 273, § 20 (Crime)MississippiMiss. Code Ann. § 43-31-25 (Liability of parents, grandparents, brothers & sisters)MontanaMontana Code Ann. § 40-6-214 (Reciprocal duties of parents & children); Montana Code Ann. § 40-6-301 (Duty to support indigent parents)NevadaNev. Rev. Stat. Ann. § 428.070 (Child’s duty to reimburse for county hospitalization of indigent parents, where child promised to support parent in writing); Nev. Rev. Stat. Ann. §439B.310 (Defining indigent)New HampshireN.H. Rev. Stat. Ann. § 167:2 (Reimbursement to state or county for public assistance to parent) N.H. Rev. Stat. Ann. § 546-A:2 (Liability of spouses, parent, child for reasonable subsistence)New JerseyN.J. Stat. Ann. §§ 44:4-100 thru 44:4-103 (Liability of parents, spouses and children of poor persons); N.J. Stat. Ann. §§ 44:1-139 thru 44:1-142 (Compelling assistance from relatives including children)North CarolinaN.C. Gen. Stat. § 14-326.1 (Crime)North DakotaN.D. Cent. Code § 14-09-10 (Reciprocal duties of parents and child; promise of adult child to pay for necessaries furnished to parent is binding)OhioOhio Rev. Code Ann. §  2919.21 (Crime)OregonOR. Rev. Stat § 109.010 (Duty of support for children and parents) Or. Rev. Stat. § 163.205 (Crime)Pennsylvania23 Pa. C.S.A. §§ 4601 thru 4606 (Duty of parents to indigent child and child to indigent parents)Rhode IslandR.I. Gen. Laws §§ 15-10-1 thru 15-10-7 (Penalty for unreasonable neglect of destitute parents); R.I. Gen. Laws §§  40-5-13 thru 40-5-21 (Obligation of kindred for support)South DakotaS.D. Codified Law § 25-7-27 (Adult child’s duty to support parent); S.D. Codified Law § 25-7-28 (Right of contribution from brothers and sisters); S.D. Codified Laws § 28-13-1.1(Defining “indigent or poor person”)TennesseeTenn. Code Ann. § 71-5-103 (Definition of responsible parties includes children); Tenn. Code Ann. § 71-5-115 (Welfare Department may require reimbursement from responsible parties)UtahUtah Code Ann. § 17-14-2 (Support of Poor by Relatives: children; parents, brothers and sisters, grandchildren, grandparents)VermontVT. Stat. Ann. Tit. 15, §§ 202 & 203 (Penalties for nonsupport)VirginiaVA. Code Ann. § 20-88 (Support of parents by children)West VirginiaW. VA. Code § 9-5-9 (Liability of relatives for support, including children, parents, brothers & sisters)


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## mathjak107

So far the few cases that have had medicaid going after the kids have all been unique situations and not just normal events


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## Dudewho

mathjak107 said:


> So far the few cases that have had medicaid going after the kids have all been unique situations and not just normal events




Yes, Thankfully. But the states are out of $$$. I fear, they may start doing it more often.


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## OneEyedDiva

Hopefully Lon. I was declined by my state retiree benefits group plan due to certain ailments. I investigated further and found that other LTC carriers also reject applicants for those reasons. So I'm saving and investing a little more than my entire SS benefit so that I will have the funds, at least to get me into a decent facility and hopefully not for a long stay.  My Medicare policy will reimburse for 120 days a year, so that's a big help.  I was torn anyway about getting a LTC policy because of the caveats and the real possibility of major increases in premiums over time.


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## mathjak107

they are pretty strict who they take. our agent is over weight and the company he represents will not take him . i got surcharged an extra 1k a year for being prediabetic .got our renewal yesterday-no increase over last year


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## Butterfly

OneEyedDiva said:


> Hopefully Lon. I was declined by my state retiree benefits group plan due to certain ailments. I investigated further and found that other LTC carriers also reject applicants for those reasons. So I'm saving and investing a little more than my entire SS benefit so that I will have the funds, at least to get me into a decent facility and hopefully not for a long stay.  My Medicare policy will reimburse for 120 days a year, so that's a big help.  I was torn anyway about getting a LTC policy because of the caveats and the real possibility of major increases in premiums over time.



 I guess I'm rolling the dice, so to speak, but I don't have a LTC policy, either.


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## Fyrefox

I was talked into a LTC plan in middle age.  Both my parents wound up in nursing homes, because of which it was calculated that I have a one in three chance of the same fate.  Three years in assisted living and then comprehensive care diminished my mother's estate significantly.  While LTC insurance is wickedly expensive, it provides a hedge against you and your heirs being placed into a spend-down situation until almost nothing is left and the state assumes your care, at a place of their choosing.


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## mathjak107

Aunt Bea said:


> No long term care insurance here.
> 
> I have read and it has been my observation that if you live on your own as long as possible the need for assisted living/long term care should not exceed 3-5 years, I can handle that.  If I miscalculate then I will have to rely on medicaid and stumble the last mile up the hill to the cemetery on my own.




statistics mean nothing to us humans  , only to insurers . if it meant something to us humans we would never have life insurance at a young age , fire insurance or auto insurance . those odds are far less than needing any kind of long term care too . as humans we have only two outcomes .  things work out or they don't . someone has to be on the wrong side of the statistic and face  the consequences ,. to an insurer they really don't care who it is , but if it is us we sure care  and so many times we have to assume it will be us on the wrong side since someone has to . my dad spent 6 long expensive years in a snf impoverishing his wife  .

we are living longer now and facing different issues then the generations of old that statistics are based on . one of the reasons insurers can't get a handle on costs when pricing premiums is  when you have insurance far more is spent on care and far greater numbers are needing and getting care .


when medicaid cut their snf budget in half in 2000 they started sending folks needing lower levels of care to facility's that are not considered snf . the statistics failed to consider those folks who being healthier tended to live a lot longer in the facility and did not count in being in a snf .


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## OneEyedDiva

I found out since my first reply that my insurance will reimburse for 120 days  in a skilled nursing facility (SNF) per BENEFIT PERIOD, not per year. A benefit period starts after 60 days of being out of a SNF. So if I go in on Jan 1st, stay until Sept 15th, come home and have to go back in on December 15th, that's a new benefit period.


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