long term health care plans


P

P.Schuman

as us baby boomers age....

Where do we begin to investigate Long Term Health Care plans
that will come into effect when we may have to migrate into a retirement home ?

I did some browsing, but there doesn't really seem to be a structure
of benefits, timelines, thresholds, waiting periods, coverages, etc....
Not the same like other "insurance" policies.

Just wondering what others have decided,
and where they have looked for information, comparisons, etc
 
Ad

Advertisements

A

Avrum Lapin

P.Schuman said:
as us baby boomers age....

Where do we begin to investigate Long Term Health Care plans
that will come into effect when we may have to migrate into a retirement home
?

I did some browsing, but there doesn't really seem to be a structure
of benefits, timelines, thresholds, waiting periods, coverages, etc....
Not the same like other "insurance" policies.

Just wondering what others have decided,
and where they have looked for information, comparisons, etc
I looked when I was in my early 60's (approximately 2000) - my bottom
line was
a) my late wife was uninsurable at the time
b) the articles that I read at the time suggested that it wasn't for me.

At that time nursing homes cost about $100 a day

I summarized my findings and will present them here

Whether to purchase LTC insurance becomes a question of your net
worth, your estimate of your personal probability of entering a nursing
home and whether there is a spouse or other dependent still at home.

The consensus of articles that I have seen in Business Week, WSJ,
Forbes etc is that you should not buy LTC Insurance if your assets are <
$100K or > $1M

The recommended time to buy is about age 60 - you will still have
your health and should have an idea if you will be able to afford the
care

Nothing could be worse than to pay LTC premiums for 15 years and then
have to give up the policy because you can no longer afford the premiums

Spend down rules vary from state to state - especially the amount
that can be set aside for a spouse still at home. Elder Law attorneys
in CA claim that they can usually arrange for a larger amount/portion of
the income to be set aside for the spouse still at home than might be
inferred from the spend down rules.

If you think that you will never return home, I can make a case for
going to the Waldorf Nursing Home during the spend down period and then
going on MedicAid.

Here are some statistics that I have gleaned:

"Taking Care of Tomorrow" by CA Dept of Aging (which would prefer that
you have LTC Insurance and not become dependent on Medi-Cal*) quoting a
study by Kemper and Murtaugh called Lifetime Use of Nursing Home Care
and the 1986 National Mortality Followback Survey:

Age at Death % who used a Nursing Home
65-74 17
74-84 36
85-94 60

Projected lifetime use of Nursing Homes for persons who reached age 65
in 1990
Never 57%
Under 3 mo 11
3-12 Mo 8
1-5 yr 15%

*MediCal is what MedicAid is called in California

"Business Week" 3/29/99 pg 182 > 1 yr in a Nursing Home
Men aged 65 14%
Women aged 65 30% (probably influenced by mortality and survivorship)

Business Week 7/19/99
Average stay is 30 months
76% out within 36 months
86% out within 5 yrs (not a normal distribution)

Wall Street Journal 4/23/90
70% of all couples have at least one partner go into a nursing home
after age 65

Study by Health Insurance Association of America 1992 (I haven't
actually seen this but I think it is the source of most of the
statistics) and the Journal of Taxation of Estates and Trusts - Winter
1992: Nearly half of all persons aged 65....

Quote attributed to the 1991 Annual Report of Long Term Care Facilities
of the CA Health and Welfare Agency (another outfit which would prefer
that you have LTC Insurance and not become dependent on Medi-Cal)

Under 2 weeks 23% 1 yr 7%
2-3 week 20% 2 yr 4%
1-2 mo 21% 3-4 yrs 4%
2-6 mo 12% 5-6 yrs 2%
7-12 mo 8% 7-10 yrs 1%
which is consistent with the previous table
 
P

PeterL

as us baby boomers age....

Where do we begin to investigate Long Term Health Care plans
that will come into effect when we may have to migrate into a retirement home ?

I did some browsing, but there doesn't really seem to be a structure
of benefits, timelines, thresholds, waiting periods, coverages, etc....
Not the same like other "insurance" policies.

Just wondering what others have decided,
and where they have looked for information, comparisons, etc

Employees of the State of California gets to buy a very good long term
care plan at a great price. I can afford to buy the top line of the
plan.
 
R

rick++

I heard a fair number were exercising their clauses to increase
premium rates.

Uncertain whether I not forget a or be unable to make a premium
payment
for each of 30-some years, I decided on the self-insurance option.
I'll probably always have three-plus years of nursing home costs in my
retirement savings.
 
E

Elizabeth Richardson

Where do we begin to investigate Long Term Health Care plans
that will come into effect when we may have to migrate into a retirement home ?


Just wondering what others have decided,
and where they have looked for information, comparisons, etc
If you decide you should be purchasing LTC insurance, the rates are better
the younger you are when you purchase. I believe I will live well into my
90s, and feel confident that I will need some sort of assistance in the end
years.

I googled and found an agent in Washington state who specializes in LTC
insurance and is licensed to sell in all 50 states. He helped me find a
policy that covers either or both my husband and me. It is not a policy with
unlimited benefits - I bought what I could afford, which is approximately 4
years coverage, but does cover for home health care if we need it. This
policy has a clause so that benefits increase with inflation, 5% compounded.
Since I believe health care costs will increase at a greater rate than the
cost of other goods, this was a very attractive clause. I also purchased a
slightly higher monthly benefit amount than is the current cost in Alaska,
about $4500 per person per month where I live, to further help with
inflation.

I recommend you find an agent who specializes in LTC insurance and explore
your various options. My agent was easily able to find a policy that beats
the group rates offered through my husband's pension, and my coverage is
better. But in the end, you will have educated yourself, even if you choose
not to buy.

Elizabeth Richardson
 
P

P.Schuman

my wife's mother and father created a LTC policy with John Hancock...
Not sure if both were worth the same, or there was some rollover.
Her dad never used it - was vibrant and active running a business at 80,
until he developed a blood situation, (same as Carl Sagan),
and basically died within a year.... that was a couple years ago.

Her 80yr old mom recently had surgery for colon cancer,
and went into a facility for recovery... as there were some other medical
issues,
and she needed help getting around - but is still very active & mentally all
there :)
It became a challenge for the kids to keep running over to the house
every time she needed something,
or if she fell in the middle of the night or during the day.
So - had a daytime care giver, but then got into the cancer/surgery issues.

Her LTC policy had a 90 day waiting period,
and just now has kicked into direct pay.
There is about $400k in the John Hancock LTC policy,
and the retirement home is about $3k a month.

SO - that got me to thinking about our own future situation....
Could develop something and go quickly.... never using the policy,
or have some condition - that requires living assistance.
 
Ad

Advertisements

C

Cal

P.Schuman said:
as us baby boomers age....

Where do we begin to investigate Long Term Health Care plans
that will come into effect when we may have to migrate into a retirement
home ?

I did some browsing, but there doesn't really seem to be a structure
of benefits, timelines, thresholds, waiting periods, coverages, etc....
Not the same like other "insurance" policies.

Just wondering what others have decided,
and where they have looked for information, comparisons, etc
I would suggest that there are a number of items that you would
look for IN the contract.

a) cost of living increase (usually 5% per year, COMPOUNDED)
b) A Bucket of Money Concept ! ! ! !
you purchase what ever benefit that you can afford. It amounts to
a Total DOLLAR amount benefit (say 4K total). That money can be
utilized for what ever NEED you have: drugs, home care, assisted
living,
Home heath care, day care, or one of many other legitimate expenses.
Last of which would be Nursing Home care.

c) guaranteed premium period. Or if that is NOT available, look into the
possibility of a "10 Pay Contract". It will cost a few dollars more,
BUT
you are Guaranteed that NO PREMIUMS WILL BE DUE AFTER 10 Yr..

Kalman J. Lester CLU
 
T

Thumper

my wife's mother and father created a LTC policy with John Hancock...
Not sure if both were worth the same, or there was some rollover.
Her dad never used it - was vibrant and active running a business at 80,
until he developed a blood situation, (same as Carl Sagan),
and basically died within a year.... that was a couple years ago.

Her 80yr old mom recently had surgery for colon cancer,
and went into a facility for recovery... as there were some other medical
issues,
and she needed help getting around - but is still very active & mentally all
there :)
It became a challenge for the kids to keep running over to the house
every time she needed something,
or if she fell in the middle of the night or during the day.
So - had a daytime care giver, but then got into the cancer/surgery issues.

Her LTC policy had a 90 day waiting period,
and just now has kicked into direct pay.
There is about $400k in the John Hancock LTC policy,
and the retirement home is about $3k a month.

SO - that got me to thinking about our own future situation....
Could develop something and go quickly.... never using the policy,
or have some condition - that requires living assistance.

My mother was in a nursing home for 7 years after a stroke in her
early 60's. While visiting her I was continually struck by the number
of young people who appeared to have head injuries that were there for
years.
Thumper
 
E

Elizabeth Richardson

P.Schuman said:
my wife's mother and father created a LTC policy with John Hancock...
Not sure if both were worth the same, or there was some rollover.
John Hancock is the company we chose. This feature for either or both was
very attractive to us, what you're thinking as a rollover. There is a fixed
amount per month that it will pay, but it can go towards us both at the same
time if necessary, then when one of us dies, the other has whatever is left
of the policy benefit.

Elizabeth Richardson
 
S

sandybeth

as us baby boomers age....

Just wondering what others have decided,
and where they have looked for information, comparisons, etc
We bought John Hancock LTC policies in 2001--we were age 55. Our
benefit period is 6 yrs & spouses can transfer their care over to each
other if needed. $150/day, 328,500 maximum. Inflation option is 5%
simple, so at age 61 today, we would each get $198 daily benefit. The
cost is $2474 a year combined total--this has stayed the same. Yes,
it's expensive.
I didn't do a great deal of price comparison research, but read up a
lot of LTC policies in general before buying. The John Hancock had
the aspects that we desired at the time. Prices of other policies
that I read about were somewhat comparable.
LTC insurance, like all other types, will change a great deal as the
years pass. Our policies may end up being a good deal, and may not.
Maybe policies today are better? Worse? Of course, we hope we are
healthy until we die, but you can never count on that. We presently
have a huge dilemma with mother-in-law who is age 91 and needing LTC.
6 of us so are currently sharing her caretaking. Live-in help costs
anywhere from $400/week to $2000 a week here in lower Michigan, so we
are trying to decide what to do. Mother-in-law has enough money to
pay for 2 years at $1000/week. Her SS money is pretty much used up by
house bills & medical co-pays.
LTC policies are great if you end up needing them, but wastefully
expensive if you don't.
SandyBeth
 
D

Don

LTC policies are great if you end up needing them, but wastefully
expensive if you don't.
SandyBeth
I am surprised that, In all this discussion, no one is looking at the
possibility that government health insurance will come about in the not too
distant future. I would not be surprised if something is put in place after
the next presidential election. And from that point , I cannot see anything
but increasingly more government coverage in years to come. We all know that
the USA lags behind other industrialized nations in health care, that the
Canadians are ahead, and that American politicians and people generally are
gradually coming to the conclusion that the situation is bad. So it would
seem to be a sensible prediction that the USA is not going to remain at the
bottom of the heap forever more. Something surely will be done eventually.

I am wondering how people with the better private health plans will fare when
they become eligible along with everyone else for government assistance. And
will private plans survive when public ones are available?
I should imagine that advice from financial planners to pre-retirement
seniors about what coverage to buy would prudently take these matters into
consideration.
 
Ad

Advertisements

E

Elizabeth Richardson

I am surprised that, In all this discussion, no one is looking at the
possibility that government health insurance will come about in the not too
distant future.
Long Term Care Insurance isn't health insurance. If you need doctor's care
or a prescription, you need other insurance. LTC is strictly for your
physical care and well-being and covers you if you are unable to perform
(usually) 2 or more of the activities of daily living (dressing, feeding,
toileting, transferring, bathing, there is another one I always forget) or
you are cognitively impaired. State governments do have programs now to care
for you in these circumstances, but you must be impoverished. Most of us
here are trying to avoid being impoverished.

Elizabeth Richardson
 
E

Elizabeth Richardson

We all know that
the USA lags behind other industrialized nations in health care, that the
Canadians are ahead,
Is that why Canadians are coming across the border daily to get health care
here? They have a hard time getting a lot of routine stuff. We may have a
very expensive system here, and surely there are ways to address that, but
don't be too sure that we don't have really fine health care in the US.

Elizabeth Richardson
 
D

Don

Long Term Care Insurance isn't health insurance. If you need doctor's care
or a prescription, you need other insurance. LTC is strictly for your
physical care and well-being and covers you if you are unable to perform
(usually) 2 or more of the activities of daily living (dressing, feeding,
toileting, transferring, bathing, there is another one I always forget) or
you are cognitively impaired. State governments do have programs now to care
for you in these circumstances, but you must be impoverished. Most of us
here are trying to avoid being impoverished.
Although LTC is separate from health insurance, I would imagine that sensible
financial planning should look at how the two work together. One of main
reasons that seniors become impoverished is that they become sick and do not
have enough health insurance. I suspect that eventually government plans
will cover both doctor's care and long term care, as plans in various
nations, including, for example, Canada, already do.

I wonder if it might be a good idea to put just half as much into LTC
insurance, in hopes that government assistance will pick up in years to come,
and invest the other half into financial products with growth potential.
 
D

Don

Is that why Canadians are coming across the border daily to get health care
here? They have a hard time getting a lot of routine stuff. We may have a
very expensive system here, and surely there are ways to address that, but
don't be too sure that we don't have really fine health care in the US.
Many affluent Canadians cross the border to consult US doctors in order to
avoid long waiting lists. Actually, these waiting lists are mainly for
non-life-threatening conditions, where the wait is not all that important.
For serious conditions Canadians get quick attention. Other (highly) affluent
Canadians go to renowned specialists in the US in hopes of getting superior
high-tech care for more serious conditions. On the other hand, many US
citizens flock to Canada in order to fill prescriptions at far less cost.

All these matters are a small part of the total problem. The real failing of
the US system is the vast number of disadvantaged citizens who have no health
insurance at all or whose limited insurance stops after a major illness, and
are financially ruined by sickness. No one in Canada (nor England, France,
etc.) faces that problem. Relax during the holiday season by going to see
Michael Moore's movie "Sicko" in your neighborhood theater.
 
A

Avrum Lapin

Don said:
I am surprised that, In all this discussion, no one is looking at the
possibility that government health insurance will come about in the not too
distant future. I would not be surprised if something is put in place after
the next presidential election. And from that point , I cannot see anything
but increasingly more government coverage in years to come. We all know that
the USA lags behind other industrialized nations in health care, that the
Canadians are ahead, and that American politicians and people generally are
gradually coming to the conclusion that the situation is bad. So it would
seem to be a sensible prediction that the USA is not going to remain at the
bottom of the heap forever more. Something surely will be done eventually.

I am wondering how people with the better private health plans will fare when
they become eligible along with everyone else for government assistance. And
will private plans survive when public ones are available?
I should imagine that advice from financial planners to pre-retirement
seniors about what coverage to buy would prudently take these matters into
consideration.
Your domain name suggests that you are a Canadian. I was and my father
lived in Montreal until he died in 2006 at the age of 98.

Quebec (a Canadian province) does not pay for LTC unless you exhaust
your funds. In the US, Medicare does not pay either, if you exhaust
your funds Medicaid will pay.

The 80 plus percent of Americans with health insurance worry that any
national health plan will leave them with lousier medical care. My
observation of Quebec was that what you had was the equivalent of a
government HMO with care being rationed by the fact that facilities were
not available.
 
Ad

Advertisements

E

Elle

Avrum Lapin said:
Your domain name suggests that you are a Canadian. I was
and my father
lived in Montreal until he died in 2006 at the age of 98.

Quebec (a Canadian province) does not pay for LTC unless
you exhaust
your funds. In the US, Medicare does not pay either, if
you exhaust
your funds Medicaid will pay.

The 80 plus percent of Americans with health insurance
worry that any
national health plan will leave them with lousier medical
care. My
observation of Quebec was that what you had was the
equivalent of a
government HMO with care being rationed by the fact that
facilities were
not available.
Wait times are atrocious in many U.S. cities, regardless of
whether one has insurance.

Just the other day a friend of mine, with excellent health
insurance through her employer, a state, tried to get in to
see an Ob/Gyn for a routine physical. The first appointment
available is in July. Preventive care is important for
cancer prevention, and many cannot get it, again, regardless
of the possession of insurance.

Last spring I broke my arm. Several weeks after the cast was
on, I was worried the bone was not setting right. I read as
much as I could as is available, but ended up concluding I
needed someone with profound experience to look at it. I
struggled mightily to get a five-minute consultation with an
orthopedic doctor. I was ready to pay a thousand dollars,
well above the usual cost of a visit. I called every
orthopedic doctor in my city and the next nearest large
city. Most flat out refused to see me. A few would see me,
but a month or more later. Ultimately I learned my arm was
setting just fine, but for over a week I was terribly
worried.

If you have any doubts that access has now become a problem
in this country, search the New York Times for {"primary
care physicians" shortage}. In the U.S. a recent letter to
the editor noted that 30% of MDs are primary care
physicians, and 70% are specialists. The ratio is reversed
in other developed countries, with better access and care
resulting.

Why so many specialists? Economics rule 1 kicks in: Medical
specialties pay more, so med students yada go where the
money is. Economics rule 2 then takes over: When a service
appears to be free, supply of the service creates its own
demand. In cities with more specialists, more people see
specialists, and hence the cost per capita is higher (even
adjusting for differences in costs between geographical
regions). Yet the healthiness of those who see more
specialists is no different than those who do not. Doctors,
their clinics, and hospitals churn.

Your survey figures are not accurate. People in the U.S. are
really down about health care lack of access and costs. My
understanding is that most people want major health care
reform but say they also do not want a single payer system.
Medical doctors routinely testify in the media that they too
are fed up.

Through all this, I think it's important to remember that no
reform (in Canada, the United Kingdom, France, or the U.S.)
is going to be perfect. But improvements are possible. It's
mostly a question of a nation's will. I do not have hope
that meaningful change in the U.S. will occur before some 20
years pass, because I think both changes to the medical
school system (have the government mostly finance medical
education; require more primary care physicians) and a
cultural attitude shift (more is not better) will be
necessary.

How to financially plan for lack of access (regardless of
changes made to medical care in the U.S.)? In my opinion
(and as one other here routinely notes), invest in
established products known to improve your health, such as
stop smoking kits; exercise materials; stress reducers; etc.
Then use them.
 
E

Elizabeth Richardson

One of main
reasons that seniors become impoverished is that they become sick and do not
have enough health insurance.
One of the main reasons seniors become impoverished is because they didn't
do sufficient financial planning when they were younger. As to your health
reasoning, many younger people in the US have a difficult time today with
medical costs because they do not try to live a healthy life. This has a
ripple effect.

Elizabeth Richardson
 
T

Thumper

I do not have hope
that meaningful change in the U.S. will occur before some 20
years pass, because I think both changes to the medical
school system (have the government mostly finance medical
education; require more primary care physicians) and a
cultural attitude shift (more is not better) will be
necessary.
This is one of the major reasons for a shortage of doctors. Until
around the early eighties you could look over your doctor's shoulder
and see a whole set of US ARMY medical books. Most doctors received
their medical training through the US. Army in exchange for some
service. This has all changed now and has been "privatized."
Thumper


======================================= MODERATOR'S COMMENT:
Posters to this thread should relate comments to general financial planning.
 
Ad

Advertisements

T

Thumper

Long Term Care Insurance isn't health insurance. If you need doctor's care
or a prescription, you need other insurance. LTC is strictly for your
physical care and well-being and covers you if you are unable to perform
(usually) 2 or more of the activities of daily living (dressing, feeding,
toileting, transferring, bathing, there is another one I always forget) or
you are cognitively impaired. State governments do have programs now to care
for you in these circumstances, but you must be impoverished. Most of us
here are trying to avoid being impoverished.

Elizabeth Richardson

Correct. In my case my wife is 17 years younger than I and I don't
wish to use all our assets on nursing home care. One important thing
to me is though, the possibility of avoiding a nursing home altogether
using the home health care provisions of my plan.
Thumper
 

Ask a Question

Want to reply to this thread or ask your own question?

You'll need to choose a username for the site, which only take a couple of moments. After that, you can post your question and our members will help you out.

Ask a Question

Similar Threads


Top