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Old 11-04-2011, 07:20 AM   #41
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it is clear to me that the companies offering this product have yet to really figure out how to price it for even the limited duration coverage. The unlimited duration variant is significantly more difficult to figure out. As more insurers realizethis, they have been exiting the market and substantially raising prices for both existing and new policies. Given all that, I fail to see how this is a product I would want to buy as it presently exists.
+1 Even the Federal provider was allowed to raise rates after a few years as data came in altering initial assumptions. We held on to the insurance but that change was unsettling.
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Old 11-04-2011, 08:02 AM   #42
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+1 Even the Federal provider was allowed to raise rates after a few years as data came in altering initial assumptions. We held on to the insurance but that change was unsettling.

It is because of the small pool and concentration of risk.

Some say that the Medicaid safety net causes many people to not purchase LTC that would do it otherwise.

We are stuck between wanting to provide a safety net and Moral hazard. The only people that purchase LTC (mainly) are people that expect to need it (anti-selection) or fear they might need it and are protecting assets.

The whole situation would be different if the person had no place to turn. If people were turned away the behavior would be different.


What should really p!ss you off is that premium increase (most of it) is due to other people gaming the system! Essentially putting all of their personal LTC risk onto Medicaid!
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Old 11-04-2011, 08:12 AM   #43
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DW and I got straight LTC policies at age 50. $100 per day with 5% escalation, no lifetime limit, etc. etc. Premiums remained unchanged for the first 12 years. This year there was a modest increase in premiums. Assuming the same rate of increases, I did the calculation that showed that if either of us needed 1.3 years of LTC after age 75 we would recoup the full cost of all the premiums paid.

For the peace of mind this seems like a bargain to me.
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Old 11-04-2011, 08:58 AM   #44
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The whole situation would be different if the person had no place to turn. If people were turned away the behavior would be different.


What should really p!ss you off is that premium increase (most of it) is due to other people gaming the system! Essentially putting all of their personal LTC risk onto Medicaid!
What do you propose if Medicaid was dropped? I like having a safety net for everyone. I don't want old folks left to die on the streets.

I don't really see falling back on Medicaid as "gaming" the system. What basically happens is that people become disabled, burn through every penny they have saved, go broke and are left with Medicaid (essentially "the poor house"). Do you think large numbers of people are faking being unable to care for themselves so they can live in a Medicaid facility?
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Old 11-04-2011, 10:14 AM   #45
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Has anybody had any experiences - good or bad when the Ins. company had to pay the benefit ?
Geriatric financial management & asset allocations

It's like any other high-volume, low-margin business: customer service sucks.

Every month I still have to fax the care facility's bill to John Hancock, because JH "doesn't do" e-mail or websites for HIPAA reasons. Every month they cut a paper check because they "don't do" electronic payments (for no apparent reason). We'll keep this up until they reach the policy limit in 3-3.5 years. You would expect that they could both automate and avoid fraud, but they don't seem willing to spend the capex on it.

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I would hope to consider my family as my LTC. Everybody in my family helped out when an elder was sick or needed help. Basically LTC is for the children of older folk. It takes the burden off of them. That being said I am in my mid 50's and still considering it. Currently I am in pretty good shape for my age and would only get it for myself. I will be there for my wife.
You're exactly right-- what you have is hope, not a plan. And by the time you've been carrying it out for a few years, you're all going to hate each other for putting yourselves in the situation.

I look at the burden my grandfather placed on my father, and the burden that my father has placed on us sons. LTC is the only way to effectively relieve us of that burden. I also believe that a group-care environment (like a care facility) is far better than the social isolation of one's home, even if it's a big loving family.

"Helping" is one thing. "Primary caregiver" is a hard time with no parole for good behavior. "Home help" and "respite care" just don't cut it.

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I'm still looking for a LTC policy which has a 2 year waiting period. We can self-insure for the typical 2 - 3 year stay but would like to have inexpensive catastrophic coverage that would kick in if one of us winds up in a nursing home for many years.
I've checked with three different agents and all say that what I'm looking for is not available.
FWIW, you may both be using different words for the same thing.

My father showed Alzheimer's symptoms for at least 18 months before he was truly no longer capable of independent living. I'm sure that at least 12 of those 18 months would have scared the heck out of us if we'd been living with him. But unless you spent literally thousands of dollars ($3670 in my Dad's case) for an in-depth assessment, you wouldn't be able to prove that he needed assistance with the criteria necessary to qualify for the insurance claim.

When many people end up in a care facility for the long term, they easily qualify for the insurance claim-- at first. With proper care & nutrition, socialization, and some medications they may actually improve in cognition to the point where the LTC insurer will suspend benefits.

So although you're still paying premiums, for Alzheimer's & dementia there may effectively be a two-year waiting period anyway.

My grandfather spend 14 years in a full care facility. That's way out past six standard deviations on the bell curve. In his case he'd used up his LTC benefits long ago, and he steadily drained his pension & assets toward Medicaid. He would've qualified about six months after he died. His spouse had died before he entered the care facility (in retrospect she was covering for him) so there was no family hardship caused by his "private pay" finances.

Same for my father-- his LTC benefits will last for ~3.5 years but his assets would last for another 15. Self-insuring worked out OK.

I admit that I don't know how the Medicaid spend-down is handled with spouses.
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Old 11-04-2011, 10:16 AM   #46
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It is because of the small pool and concentration of risk.

Some say that the Medicaid safety net causes many people to not purchase LTC that would do it otherwise.

We are stuck between wanting to provide a safety net and Moral hazard. The only people that purchase LTC (mainly) are people that expect to need it (anti-selection) or fear they might need it and are protecting assets.

The whole situation would be different if the person had no place to turn. If people were turned away the behavior would be different.

What should really p!ss you off is that premium increase (most of it) is due to other people gaming the system! Essentially putting all of their personal LTC risk onto Medicaid!
Thats a heck of a safety net. I don't know about other parts of the country, but here Medicaid only picks up long term care if the persons assets are under $2,000, and they back check five years for things like giving away large sums to others. I suppose giving up almost everything and living on SS checks alone for five years is an alternative to covering long term care, but it's not a very appealing one.

Now, I don't have LTC insurance, but I've made other arrangements that cover us without any problem, and won't be relying on Medicaid.
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Old 11-04-2011, 12:27 PM   #47
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What do you propose if Medicaid was dropped? I like having a safety net for everyone. I don't want old folks left to die on the streets.

I don't really see falling back on Medicaid as "gaming" the system. What basically happens is that people become disabled, burn through every penny they have saved, go broke and are left with Medicaid (essentially "the poor house"). Do you think large numbers of people are faking being unable to care for themselves so they can live in a Medicaid facility?
No... I like the idea of a safety net too.

My point is a little more complicated than that.

Put it like this... you took the time to accumulate the money and to fund it. You are using insurance to do it. You have taken reasonable steps to budget for it (making an effort).

There is someone else out there (actually many many people) who had the means to do it... even when they retired. But decided they would rather spend that money on something else (discretionary spending).

Bottom line is they raise the overall cost for everyone (cost shifting for LTC services because Medicaid pays very little and higher LTCi premiums in insurance pools because of lack of participation) and will jeopardize the safety net program.


There is a little more to it than that... but for the sake of brevity.
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Old 11-04-2011, 12:47 PM   #48
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There is someone else out there (actually many many people) who had the means to do it... even when they retired. But decided they would rather spend that money on something else (discretionary spending).
But that course was open to you, too, wasn't it? Do you envy those other people for having made more fortunate choices than you did? If you don't, you have nothing to complain of. If you do envy them, why is it their fault that you chose foolishly? In that case also, you have nothing to complain of.
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Old 11-04-2011, 12:57 PM   #49
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I suppose giving up almost everything and living on SS checks alone for five years is an alternative to covering long term care, but it's not a very appealing one.
Actually, Medicaid takes a big chunk of your SS check, but leaves you a small "stipend" that you can use for stuff. In my FIL's case, he got $1037 a month from SS and he got $77 a month from that check to use for what he wanted to buy.........that happened because he was a widower, it doesn't happen with married couples.........
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Old 11-04-2011, 01:16 PM   #50
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Edited because I probably shared too much here, and I'm feeling monitored by the word police.
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Old 11-04-2011, 01:36 PM   #51
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there is a limit to what any human can do for another.
I question whether that is true.
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Old 11-04-2011, 01:58 PM   #52
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I question whether that is true.
Now you are acting in a boorish manner.........
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Old 11-04-2011, 02:41 PM   #53
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I question whether that is true.
What a strange thing to say. I'm not quite sure how to respond, but will say that it must be an awesome feeling to realize that your physical and emotional capability for caring for another simply knows no bounds.
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Old 11-04-2011, 02:55 PM   #54
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Bubba...I'm inspired by your post. You and your sibling truly are your mom's guardian angels.

My friend at the moment is in an acute care hospital and will be moved (probably in a week or two) to a LTC facility. My fear is that, over at ICU, or acute care, she get's the attention and care needed, but when the move her to a LTC facility she may not.

I've seen that, years back with my mom/dad. In ICU they bounce back enough, but afterwards is when the work/other critical attention only starts.
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Old 11-04-2011, 03:07 PM   #55
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What a strange thing to say. I'm not quite sure how to respond, but will say that it must be an awesome feeling to realize that your physical and emotional capability for caring for another simply knows no bounds.
I imagine that my own capacity for this is probably limited. But recognizing that we may run up against our personal limits is a far cry from what you proposed, which was "there is a limit to what any human can do for another." I think we should recognize that some people have been able to help others without any apparent limits. So I think you should speak for yourself and not all of humanity.
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Old 11-04-2011, 03:12 PM   #56
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I imagine that my own capacity for this is probably limited. But recognizing that we may run up against our personal limits is a far cry from what you proposed, which was "there is a limit to what any human can do for another." I think we should recognize that some people have been able to help others without any apparent limits. So I think you should speak for yourself and not all of humanity.
Absolutley. Why, I myself have already donated three kidneys to sick relatives.
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Old 11-04-2011, 05:21 PM   #57
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What a strange thing to say. I'm not quite sure how to respond, but will say that it must be an awesome feeling to realize that your physical and emotional capability for caring for another simply knows no bounds.
Bubba, you don't need to respond. You've already done much more than most people will do and said out loud what other think but won't say. My closest friend cared for his mother like that for almost 4 years and his feelings were quite similar to those you expressed.

There are people that can give endlessly and selflessly to others. I know one. The choice to help theirs to give, not ours to expect. No one has the right to expect others to give like that.
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Old 11-04-2011, 05:41 PM   #58
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I imagine that my own capacity for this is probably limited. But recognizing that we may run up against our personal limits is a far cry from what you proposed, which was "there is a limit to what any human can do for another." I think we should recognize that some people have been able to help others without any apparent limits. So I think you should speak for yourself and not all of humanity.
Of course, you don't have to take every word so literally. I understood his message in a more general way, most other members here probably did as well, and it was kind of him to share it with us.
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Old 11-04-2011, 05:45 PM   #59
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But recognizing that we may run up against our personal limits is a far cry from what you proposed, which was "there is a limit to what any human can do for another."
Quotes like this should remind us all that a great deal of education does not necessarily result in a great deal of knowledge.
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Old 11-04-2011, 06:04 PM   #60
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Of course, you don't have to take every word so literally. I understood his message in a more general way, most other members here probably did as well, and it was kind of him to share it with us.
Which word did I take too literally? "Any"? "Human"? What is the general way of understanding his message that I missed?
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