I know there aren't as many options for good Long Term Health care Insurance anymore. What are the good options left?

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I know there aren't as many options for good Long Term Health care Insurance anymore. What are the good options left?

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I think I need to get Long Term health care for my husband. His health seems to be declining and he is a smoker. I need to be prepared to take care of him in the future. I need to have enough money saved to pay for his health care, and find good affordable insurance.
Before anyone says it, I know it would be better if he quit smoking, but I can't force him to do it. He tried to do it for me once, but he wasn't able to do it.
He is also a veteran, are there any veteran program for paying for nursing home care.

Financial Planning Long Term Care Long Term Care Insurance

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Long Term Care Insurance is best bought into when you are "younger" and in excellent health. Like all insurance, these companies depend upon making their money by your paying in for a good long time before you need the care. If you get my meaning?

There is this to consider with long term care insurance, also, other than its high monthly cost.
It can SOMETIMES not be a good thing when you are in need of going onto governmental assistance. Take this sort of made up example:
John is 40 years old.
He just can't save much: to many obligations. BUT he works for a great company, his job is safe, and he will retire with a pension to add to social security.
So John decides he will now invest in a long term care insurance policy.
Now comes the sad news that John, at 65, has early onset Alzheimer's Disease. He is retired and he has his good social security. And he has the wonderful long term care insurance. But he just doesn't have much else. A car and an apartment. And John needs memory care.
So the family looks around and find care at a nearby facility.
But John has 2,500 for SS, 2,000 from pension, and 2,000 from LTC policy.
So John makes way too much to qualify for any Medicaid help.
BUT
John doens't make enough for the 15,000 a month LTC facility.

John's family now has to go to see about Miller Trusts and QIT because John is monthly asset rich, but real assets poor. Has no home to sell. No million dollars sitting in accounts.

These questions, what to do about aging, about savings, about anything in the realm are so complicated. It is good if you can get a financial advisor or an hour of time with an elder law care attorney with some basic questions. You sit down with your spouse if you have one and go through your assets, your pensions, your SS at retirement, and you make decisions.

For LTC insurance, waiting until age is creeping in, is already too late to consider some things. Do research online "Long Term Care Insurance: Pros and Cons." You will come up with more questions than answers, likely, but that's the way of things.
Good luck.
I am glad to hear of the VA access. Another good thing to begin to research now in terms of benefits.

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Reply to AlvaDeer

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If John qualifies for Miller Trusts and QIT he ought to be spending his own money for his care.

Amazing how many people deny their elders the care they need and have worked their whole lives for, so that they can keep the elder's money for themselves. Utterly despicable.

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My parents bought expensive long term care insurance for my mom. They couldn’t afford it for both of them and decided based on the agent’s recommendation that women were more likely to need care. She went into the best nursing home in their city post stroke and began using the policy. It completely ran out in just over a year. She went private pay briefly and then onto Medicaid, remaining in the same room, same bed, same care no matter who was paying. There was no “Medicaid facility” The terribly expensive policy merely delayed the time before Medicaid happened, we think of it as a complete waste of money. Consider carefully if one of these pricey policies is worth bothering with

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Reply to Daughterof1930

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I have to wonder if your mom would have gotten into the best facility if you had not started out with the LTC policy. Without it, you may have had to show how long you could private pay and once they discovered "briefly" they may not have accepted her knowing she would soon be a Medicaid patient. I bought LTC policy hoping to have more options should I need care and not have to accept whatever facility has a Medicaid bed available. I have heard some better nursing homes have NO Medicaid beds except for someone like your Mom who has been there for a while and no longer able to pay. A facility that depends on filling Medicaid beds often does no provide quality care. If what I understand is really true, what you spent on the policy was not a waste.

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I am only speaking my opinion. Personally I never want to be in a long term care situation. I would rather be dead so I choose to live my life with that in mind. Living in long term care is not for the individuals but for the family. I saw my mother in-law with dementia suffer for years because one of her daughters kept reviving her when she would die. My wife was very upset to see her mother go that way. I have seen death it doesn’t frighten me. So let me go

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Reply to Sample

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It is something that bears talking about. Hubby and I plan to go to Pegasos in Switzerland for medically assisted suicide when the time comes. My grandmother spent 6 years in AL and 6 years in NH. I'm doing what I can to keep my Mom in her own home, but for myself, I want to walk out on my own power.

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Unless hubs is in his 40’s, LTC insurance premiums will be very expensive and will increase as over time. If you are somehow tied to wanting to get one, look at Cigna to see what policy options they have with a 90 sequential custodial care day waiting / clearance period of being in a LTC / SNF facility. Assume the premium for year 1&2 stay the same but afterwards it increases by 25%. Is it affordable?

LTC insurance landscape for underwriters is not profitable. The big insurers (MetLife 2010 and Genworth this year) stopped writing new policies but still service existing ones. What has taken their place is a hybrid life insurance policy which has LTC coverage & a life insurance benefit. Often hybrids require single lump sum premium paid. Like 200K range. Often when a company downsize, they offer hybrids as part of the exit package and contribute a %.

If there simply isn’t the $ to afford LTC, imho, you are best off looking into how Medicaid program for health insurance and for LTC programs runs for your State and what options exist for custodial care in a facility. Then you as the community spouse do whatever to show that you as a community spouse need your hubs mo income so he does not have all his income go as the copay or Share of Cost to the NH. Doing stuff like this is not ever a DIY. It’s all State dependent on it’s very intricate regulations. You need an elder law attorney who is experienced in Medciaid and not just all about estate planning.

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Reply to igloo572

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If it is too late, I recommend you see an elder attorney. Get informed on how each spouse protects their assets. If you do it wrong, you might become impoverished rather than protecting yourself

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Reply to MACinCT

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I actually started buying long term insurance when i was in my 50s … now early 80s … and it cost my husband and me a little less than $200 a month for both.

company stopped carrying it so i changed companies and in 2006 went to another company and it’s now costing about $1500 a month for both with forever coverage as long we pay till in a facility.

there is no way we could afford facility care without it but i worry about how long we can do it.

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Reply to Betsysue2002

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Wow, that is to me shockingly expensive if you haven’t used it yet

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LTC insurance is gotten years before you need it. You can't start paying once your a Senior because the premiums are outrageous. I think, too, that you have to pay premiums for a certain length of time before you can take advantage of the policy. Its not like health insurance where as soon as you pay the premium, your covered.

If you have no assets, there is always Medicaid.

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Reply to JoAnn29

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Definitely check with your state Dept of Veterans Services. And, if he has not been receiving care from the VA, reach out to the DAV to help you secure his access to benefits. Some of his illnesses may be on the list of presumed service-connected illnesses, especially for Vietnam and Persian Gulf veterans. I recommend you do not try to navigate the VA system without assistance. It’s complex and the DAV has Veteran Service Officers who exist to help Veterans secure benefits they earned through their service. Good luck.

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Reply to LADeGo

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If a veteran has not been receiving care from the VA, the first step would be get enrolled. Being enrolled opens the door to all kinds of benefits. We were very late in learning that you don't have to give up private providers. You only have to have an annual check-up to stay in the system and things do get easier. A lot of services they provide are learned by word-of-mouth, so ask every veteran you know if they use the VA and what services/supplies they receive. Most VA staff only know about their small area and quite often seem surprised when when I share what my husband gets. For example, just for staying active in the system with his annual checkup my husband has received incontinence supplies, DME such as wheelchair, U-step walker for Parkinson's, special bedside commode, Ensure, Caregiver Hours. An appointment with a VA PCP is where you start and often a message through their portal is all that is needed to start the process to get the prescription based on their records that show his need. We have gotten glasses and hearing aids by asking for an appointment. Yes, the DAV can help with the pensions and financial benefits but even they are not always aware of the all the small things that can save out-of-pocket expenses. Don't buy into the myth that a vet has to be 100% service connection to receive benefits like we did for so many years... there are some benefits for 0% service connection. The savings we have because of what the VA has provided (especially the caregiver hours) helps make our savings last a bit longer while trying to keep my husband home longer.

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I’m sure it’s already too late for you to get this and have it affordable.

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Reply to southernwave

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Unfortunately, I think you're 100% correct. Our LTC policies, purchased about 25 years ago, have become (almost) prohibitively expensive.

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If he is older than 59 I'm not sure it will be affordable. The premiums can be very steep the older one gets. In personally asking around it seems that policies purchased in the 70s and 80s were good but nowadays the policies don't cover nearly as much. That being said, never "invest" in something you don't understand. If you are considering a policy I would have an expert explain it to you in plain English...

I chose to not buy one.

https://www.nerdwallet.com/article/insurance/long-term-care-insurance

Also check out this financial forum:

www.bogleheads.org

I know there aren't as many options for good Long Term Health care Insurance anymore. What are the good options left?

14 Answers

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