Anyone have long term care insurance?

Anonymous

My employer is having an open enrollment period for Prudential long term care insurance that, if needed, will cover a stay in a skilled nursing facility, a custodial facility or home care, plus several other care options. It includes paying for hospice, either at home or in an institution. As much as I hate thinking about this stuff and am truly hoping never to need it, getting this insurance has begun to make sense to me. I'm no longer married and have a daughter who I don't want to burden with my care or figuring out how to pay for it. Does anyone else have this type of insurance or any experience with it?

~Marin

everyminute

My father has it - got it years ago and is just starting to use it now at 84 (so they got their moneys worth out of him~)  It pays for his stay at assisted living 100% which is about $4400 mo for a small one bedroom apartment and all meals, phone, elec, heat, etc.  He also no longer has to make the monthly payment now that he is using it.

It will also cover home health care if we decide to move him back home as well as nursing home if he progresses.  Not sure the exact amounts on those but it seems as though it is a good plan and he chose to cost of living increases (which increased his payments ) over the years which was a good plan!

The claim process hasnt been awful but not easy either - didnt expect it to be though.

abbadoodles

Marin, this insurance is quite expensive.  Rates go up with age at sign-up, of course, and probably with medical history.  I looked into it years ago and decided against it.

Actually, it makes most sense if you have lots of assets and a family to provide for or leave your fortune to.  It is true that without it you will have to pay for long term care yourself, but once you've blown through your assets (house proceeds, etc.) Medicaid picks up the tab in most cases.  So, unless you fit the profile, I wouldn't bother with it.

NanaOfTen

Marin, Sept. 2002 I landed the job of my dreams with a major law firm in my state. The benefits were unbelievable! One of them was for long term disability benifits - it paid 60% of your income if you became unable to do your job or ANY job where you could earn an equal pay. I thought, why would I need this??? The human resourse person said, it is only this much and one never knows ... (can't remember exactly how much, but was very little premium).

Anyway . . . 

May 2003 - just eight months later - I had an auto accident, knocked out, and had many many body injuries. When I went back to work, I discovered I could no longer understand what I read - and as the months went by, many more cognitive problems came to be known, and eventually I grew to even have seizures. By august 2003 I had to leave my job as I could no longer do it. 

I have been on the long term disability since then (in addition to SSD - what happens, is the LTD subtracts the SSD and pays you the difference in their money payment) and am so glad I chose to subscribe to it. One never knows what life will throw at us ... I prayed I would never get breast cancer, either. 

abbadoodles

Nana, long term disability insurance is different from long term care.  I believe Marin is talking about insurance that pays for your nursing home care or similar care.   Long term disability insurance is a salary replacement policy.  Two different things.

miamimama

My employer offered it the year before I retired so I did purchase it.  It's expensive - about $1500 a year because I was 61 when I started.  Every time the bill comes in I question the need for it - but then I think of my mother who blew through almost $400,000 and then died the day medicaid would have kicked in.  I don't have a lot of money but what I do have I would like to go to my kids, so I continue to pay. 

It also shows that I intend to live to a ripe old age.  My mother was a 36 year BC survivor who died at 89.

Anonymous

It is expensive, but TOTALLY worth it if you can afford it. Marin, since you are younger than some of us, it won't be as expensive for you. Also, large employer rates are much less than the rates for individuals. If you have no assets, it's not as big a deal; however, we all are getting older and will probably all need care of this type some day. If I could afford it, I would DEFINITELY have it.

mzmiller99

Will anyone cover us cancer folks?  I have friends with Aflack and they say the coverage is great.  I don't even dare to enquire now.

Anonymous

Thanks for your input everyone. This "open enrollment" is advantageous to me because for this period only, there are no health questions, exams, etc. ANYONE, regardless of medical history, can sign up. After Feb. 23rd, though, anyone wanting the insurance through my employer will have to answer medical background questions and can be turned down on the basis of their responses.

The insurance is a bit pricey, but for $56/month I am guaranteed $150 per day for hospice or nursing home care. I'm thinking that knowing I have that assurance will give me greater peace of mind. Even though I know that Medicaid, once I am eligible, would foot the bill, I'd then have no choice of facility or pretty much anything else. I'd rather have some modicum of choice if I can, ya know?

I think I'm going to sign up for it...

~Marin

iodine

Keep in mind that at 65, your Medicare covers 60 days of skilled nursing home(and to qualify for this level of care involves a great deal of medical need), it will also cover home health, up to a set # of days.

Hospice bills your insurance, usually Medicare and costs you nothing.  They also take on cases with out ins, or with Medicaid.

Pls. ck with local nursing homes for costs per day for long term nursing homes.  You will get a lot of GOOD information, that is accurate, from the social services dept. at local hospitals---they are the ones who set up transfers to the different level of nursing homes. 

Ck. the policy to see what the limits are---some of these sound great, but I spent years in social services and can assure you that not all policies are presented to fully inform you of the pitfalls=---just like a lot of things, buyer beware!!!

Anonymous

My understanding is that Medicare covers the SNF (skilled nursing facility) care ONLY if you have a hospitalization of a certain # of days first (I think 3?). Many times we will "fade" into SNF care without an episode requiring hospitalization...

Anonymous

Thanks for all of the great info and warnings! Actually, my first career in medical social work involved doing a lot of discharge planning and coordinating efforts with Medicare and, especially, Medicaid. Coverage under Medicare was always extremely difficult unless a physician certified a skilled need such as tube feedings or dressing care. If "merely" custodial or basic "nursing" care was all that was needed, we would have to get very creative and, ultimately, advise the patient or family to use their private resources until Medicaid eligibility was satisfied. Even that has become a huge challenge now and it takes months and tons of documentation to prove that someone has "validly" depleted her/his resources.

So my understanding is if Medicare is going to be of much value, one should always purchase the supplemental policy. Apparently, the basic plan will pay 100% of a hospital or skilled care cost for only the first 20 days and then requires a substantial co-pay (more than 50%) for the rest of those 100 days. And then, after that, you could be screwed.

I'm still awaiting some communication with Prudential because I've asked for more details regarding the specific types of care that will be covered, but it still is looking good to me. (And a "typical" skilled facility in NC is about $180-200/day. In places like MA and CT, I understand, it is up to about $300!).

~Marin

desdemona222b

My company is offering this, too.  I don't understand how you ever become eligible for this type of insurance (and for LTD, for that matter) if you are getting it through your company.  My LTD requires that I be disable for at least 90 days before I can make a claim, but if my companie terminates me prior to the 90 day waiting period, I can't continue it through Cobra.  I think the long-term care insurance is limited in the same way. 

Does anyone have any information to impart about this?  It has been bothering me for years - maybe there's something you gals know that I don't? 

ps - still have the LTD 

C130sunshine

Hello

I have long term care insurance.  I got it on my own several years ago, when my grandparents had to go into a skilled facility and Medicare was a "bear" to work with.  My parents are still fighting with Medicare when one of my grandmothers was placed in a skilled facility after she fell and broke her hip...that was over two years a ago.  My Grandmother was in NC.  You also have to take in account everything that goes a long with being in a skill facility which will raise the price......any treatments, will you need a nurse or just a helper, how often will you need actually skilled care, etc

One of the things to look at is how long does the insurance cover.  You can get insurance that covers for all the time you are in a long term care facility or just a certain amount of time (example for 5 years).  Dedemona222b has a point.  What happens if you leave your employer....can you still keep the long term care insurance. 

I am glad that you requested more information.  What ever you do make sure you do your home work and ask alot of questions.

iodine

Excellent to ask more questions.  It's the small print that gets ya!

  And yes, for Medicare (and other ins. usually follows their lead) you need to be in the hospital for 3 days to step down to skilled (SNF)  and you need more skilled nursing care than a feeding tube==== more like a knee replacement with daily intensive PT- or burns with major dressing changes--and yes you have to prove it to the Medicare people---and KEEP qualifying===but this is the same with all ins. for skilled level.  SNF is a bear. 

As a friend who sells ins once told me: you never know how good the ins. is till you have to use it.  Dang that's true!

Marin is correct (great to see another discharge planner in the group!---I then went into private consulting for catastrophic case management)

rferraris

Marin,

I am a LIfe Specialist with State Farm in Georgia and we offer Long Term Care Policies.  With our plans you can pick your number of "elimination" days  which we usually do 90 because of Medicare.  I would check with a local agent about buying your own policy than through a group.  If you ever leave that job you've lost that coverage.   

When it comes to Life Policies so many times I hear "I've got coverage at work".  It is recommended that for LIfe Policies that you have 8-10 years of annual income for your families needs.  Having only group coverage is very risky.  If I had not bought private insurance when I did (at age 34) I would be uninsurable until 2021 because of my breast cancer.

anianiau

Overall, group policies tend to be less expensive than individual policies. The point about what happens when you leave the group is well taken. So, ASK! and ask to see their answer in writing. See what it says in the booklet you got from your HR dept. Don't believe things just because they tell you.

My husband has LTC. (I don't, because I had a heart attack in my 50s. As is the case with health insurance, a company can refuse to insure you, even though you continue to work full-time. That sucks!)

Policies differ. Good LTC can offer you some important options that Medicaid doesn't. Look for a provision that they can't raise your premium just because you make use of the policy; instead, they have to raise the premium of all members of your age & class.

Companies differ in how good they are, too. Insurance companies are rated by various groups, though after what we've seen on Wall St. recently, who knows how good those ratings are?

anianiau

PS: Wow! $56/mo is a great price. My husband pays a LOT more.

Anonymous

rferraris, are you saying your company won't insure anyone who has had breast cancer until 15 years after diagnosis????  I had hoped that it was just a 5 year cancer free period.  Wow!

LisaAlissa

There is another thread here:

http://community.breastcancer.org/forum/89/topic/725757?page=1#idx_7  

titled "Getting life insurance after diagnoses?" that might be helpful for those concerned w/ life insurance (instead of LTC insurance). There are some companies that don't exclude for those who have had an "early" diagnosis and have completed treatment "sucessfully."  For others(I understand from that thread), there is a "years" wait.

HTH,

LisaAlissa 

abbadoodles

Marin, you are right about the cost of nursing home care in MA/NewEngland/New York.  If paying privately, expect at least $80,000 per year.

Remember, insurance companies sell policies to make money, not to help you in your old age.

And, again, you have to consider your individual situation while making any of these decisions.  As my husband and I have no kids and would spend what we had before worrying about anyone inheriting anything from us anyway, we figure we will run through all we have and then let Medicaid take up the slack if it ever comes to that. 

Another thing to think about if you own your own home is whether or not putting it under the homestead act, if available in your state, would protect that against being taken for expenses.  This is only important for a surviving spouse, the one NOT in the nursing home, so they would always have a place to live.

Also, you can look into a reverse mortgage.  Once you have gone through all the value in your home, I believe some institutions allow you to stay there until your death or whenever you decide to leave.

I'm not trying to be flip or morbid but there is also the possibility that you will not require nursing home care; you may just drop dead someday.  My father did.  And my mother was admitted to the hospital with previously undiagnosed terminal cancer and died there a couple of months later.

None of this is easy.

rferraris

Sorry to confuse you.  You have to be 5 years from no treatment and they consider my Tamoxifan treatment.  I will be to be on it for at least 5 years and I only have 2 down.

CharlieFoster

My wife and I both have it, and our folks do too. My wife is a Gerontologist and has developed the product for several companies and is employed by an insurer who is getting into the business.  So, we are biased.  However, her Mom used it for home care and it paid for itself.

A couple of things to look for. Make sure the plan is underwritten by a respected company, you want them to still be around years form now if you trigger coverage. If you want to stay at home make sure home care is covered, most do but check what is covered. Inflation can really get you, so consider a plan where you can adjust for that. Ask what the waiting period is from the time of a trigger event to when you start getting the benifit and make sure you can cover your own expenses during that time. Ask about underwriting, as a BC survivor some plans may exclude you. Usually group plans have less underwriting.

Understand your other options, if you don't have assets to protect and you and your kids would be okay with you going on Medicade, that is an option. Remember, it is your tax dollors that support Medicade. Some states are nursing home only and the state will take your home and other assets (even if you hide them by putting them in your kids name in the last 5 years or so), however, the surviving spouse is allowed to live in the house for the rest of their life. Know that Medicare does not cover long-term-care (LTC).

One way to decide is to take the annual premium cost and multiply it times the number of years you might pay before you would trigger claims.  Then find out the cost of daily care in a nursing home in your area. Most people don't last over 2 years. So, figure out that cost for 2 years. Now, only 50% of us will ever need LTC; so that is how the insurers profit, not everyone needs it and the few of us that do need it won't for very long periods. If you think knowing your covered is worth it then look into it, otherwise consider other alternatives.