LONG TERM CARE,SCAREY STUFF

[mathjak107]

took a course last night at the local college pertaining to long term care..man is this stuff scarey,the costs on the low end here in nyc are 110,000 a year for a stay and growing ....my wife and i are still un-sure of what we want to do...my inclination is to maybe go with a 90-120 day elimination period and try to cut the costs....it also didnt seem to matter cost wise if we waited until 60 or so..the costs escalate with age so you pay in the same amount by age 85..you may as well take it younger and pay less per year and be covered..the changes in medicaid rules are also all different for anyone shifting assets or thinking a house is protected.......whats everyone else doing?

[obryanjf]

Moving to KY where the cost are not $110,000 per yr. Anyway you should validate those numbers, as it sounds like a con sells job to me.

[brewer12345]

I think LTC insurance is not a good deal by any stretch of the imagination. The companies selling the product don't really know what to charge, generally run a large duration mismatch on the product, and many have bailed out of this market in the past several years after losing a lot of money. Having said that, the worst part of the product is that you aren't really laying off the risk that LTC exenses inflate out of control. Why? Because all of these policies give the insurer the right to slap you with rate increases down the line if they find out they didn't price the policy high enough. Some policyholders have been hit with rate increases of over 50%, often after they have been paying the premiums for many years and are now unable to get coverage elsewhere.

I suggest that you save your money instead.

[Maximillion]

Are their not Government Owned /Subsidised Homes for Long Term Care or must U.S. CItizens pay when they go into Nursing Homes??

[brewer12345]

Originally Posted by Maximillion

Are their not Government Owned /Subsidised Homes for Long Term Care or must U.S. CItizens pay when they go into Nursing Homes??

For once, I will assume that you are asking agenuine question rather than indulging in cross-border baiting.

Generally speaking, nursing homes in the US are private pay: the patient is on the hook for the fees. Under US feddle gummint rules, when the patient runs out of money, the gummint picks up the tab under the Medicare program. The problem is that you have to exhast your funds first, which leaves your survivors SOL.

[Cattusbabe]

Can I chime in here? I am ERing from the long term care industry in three weeks. (Boy that sounds good.) Take a lot of time to consider LTC insurance and the need for Assisted Living (a rip) or Nursing Home placement. There are alternatives. Most people want to stay in their own homes and there are more and more opportunities to do just that.

[Craig]

Thank you, Cattusbabe ... that is exactly the kind of inside scoop I love to read on forums.* The alternative of staying in our own homes, with at-home care, looks like a viable option.

Lost my Dad a few years ago.* As his condition worsened, he stayed in his condo.* A home caregiver helped Dad day-to-day, and she was a blessing.* He finished his days in a place he felt safe and loved, looking out on a putting green.* It was so much better than those situations where I've seen elders shipped into beautiful, but sterile homes for the elderly.

Don't know the organization, but found www.hcaoa.org on the 'net.* I can believe this will be a popular option for many older retirees, and a career / business for many young people. One can find at-home medical care often in our local listings ... here in Nashville, Vanderbilt and others offer such services.

[Martha]

One development I am seeing is formation of small assisted living facilities in rural areas. A nonprofit I work with is doing this in Minnesota. They are going to small towns and buying or building facilities that will house 5 to 12 people. The residents get to stay in their community with their friends. The cost is also much lower than large urban assisted living facilities.

[modlair]

Originally Posted by Martha

One development I am seeing is formation of small assisted living facilities in rural areas. A nonprofit I work with is doing this in Minnesota. They are going to small towns and buying or building facilities that will house 5 to 12 people. The residents get to stay in their community with their friends. The cost is also much lower than large urban assisted living facilities.

Read this like the post higher in the thread. Get Out Of New York. That state is losing people to relocation faster than any other. Be one of them.

[Maximillion]

Brewer, I am just asking because in Canada if you need LTC you are put into a Nursing Home, you are cared for.

People who are Seniors and are mobile do have other options, but these you pay for.

You may opt for a Seniors Residence and you can either eat in a cafeteria style setting, or you may continue to cook your own meals in your residance.

My B in L is what is known as a PSW, a Personal Services Worker, you have access to PSW 's on a limited basis at government expense, or you may pay privatly for additional services.

Recent jobs have included staying in an elderly Gentleman's home while he died from Cancer, to living with an elderly Lady who had just been discharged from Hospital and her Children did not want her left alone.

Costs do vary, but like the US, once your personal funds are exhausted, you are provided for.

You are better off to be broke, because otherwhise your savings will be taken.

[grumpy]

My wife and I got LTC insurance at age 50. It provides for a 180 day elimination period, $100/day with automatic 5% yearly escalation, half of that for in-home health care and unlimited lifetime benefits. At that age it was very reasonable - $1600/year for both of us combined. I wanted the insurance in case one of us got hit by a truck or had a stroke at an early age and spent many years in a nursing home. My mother had early onset alzheimers so that threat is out there for me. I have had enought health problems that I feared I would be unable to get LTC insurance if I waited very long. With the insurance, the other spouse wouldn't deplete our nestegg paying for the full cost of the care. If Firecalc's projections pan out we will be in a position to self insure in the not too distant future and can then drop the LTC policies. In the meantime the LTC insurance provides for sleeping well at night.

Grumpy

[REWahoo]

Originally Posted by grumpy

My wife and I got LTC insurance at age 50. It provides for a 180 day elimination period, $100/day with automatic 5% yearly escalation, half of that for in-home health care and unlimited lifetime benefits. At that age it was very reasonable - $1600/year for both of us combined.

Grumpy, we did something similar at age 52, with a 10 year guarantee of premiums. Has your premium increased? I've heard horror stories about huge jumps and am expecting very unpleasant news three years from now when the guarantee expires.

[brewer12345]

Mostly depends on whether the company that insured you exited the LTC market. AFAIK, Genworth, John Hancock and UnumProvident did not jack rates on old blocks (yet). Most of the other companies that bailed out did jack rates up.

[REWahoo]

Originally Posted by brewer12345

Most of the other companies that bailed out did jack rates up.

CNA. They bailed and I've read of 50% rate increases. Any way of finding out what I should expect in 3 years? Or would that be an exercise in frustration and futillity.

[HFWR]

When you run out of money, I believe Medicaid takes over, not Medicare...

[brewer12345]

Originally Posted by REWahoo!

CNA.* They bailed and I've read of 50% rate increases.* Any way of finding out what I should expect in 3 years?* Or would that be an exercise in frustration and futillity.

An exercise in futility. However, if I wee you, I would either be ready to price a new policy, drop coverage and do without, or bend over and start painting a bullseye on your rear end.

[REWahoo]

Originally Posted by brewer12345

...or bend over and start painting a bullseye on your rear end.

Yeah, just what I figured... I'm wondering if I might drop the policy on one of us and use the savings to fund the increase on the policy we keep. Now, if I can just find out which one of us is more likely to suffer a long, slow, debilitating death.... :P :P :P

[SteveR]

My mother and father bought a LTC policy several years ago. They paid the full amount in cash so they had no payments. Since it was a paid policy they could not increase the rates. She is now in Assisted Living but we want to wait until she gets to full nursing care before we start using the policy since it has a limited benefit which would end up paying for about two years of care.

I don't plan on buying one. I have looked into it and believe that the rates are too high and the industry too unstable to assure the policy will still be around when I need it. We plan on self insuring since we would never be able to qualify for Medicade.

[Rich_in_Tampa]

Originally Posted by Cattusbabe

Can I chime in here? I am ERing from the long term care industry in three weeks. (Boy that sounds good.) Take a lot of time to consider LTC insurance and the need for Assisted Living (a rip) or Nursing Home placement. There are alternatives. Most people want to stay in their own homes and there are more and more opportunities to do just that.

I think this is indeed a general trend, but take it from me based on years of experience in medicine: home works only to a certain point and with certain families. Not to be pessimistic, but... 24/7 nighttime wandering takes its toll on older loved ones and caregivers; having assistants in the home means basically having a stranger in your inner sanctum a few of whom have other agendas. The costs are not as high as a NH but are not trivial. Finally, the straw that breaks the camel's back in many cases is when personal hygiene needs become intolerable.

For many, home care is the ideal alternative and should always be explored first. But most* patients currently in skilled nursing facilities are there for a reason and often could not be reasonably cared for by most families (many have tried and eventually failed).

On that cheery note, I still think LTC insurance is very dicey and have not purchased it. I hope other solutions arise by that time.