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Old 11-16-2012, 09:47 AM   #121
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So if you start buying in your 50s, you can pay premiums for what 15-20 years before you might actually collect?

How do they determine what's a valid claim?

You decide to go to a facility and they have to start paying? Or is there some medical threshold that you have to reach and it's determined you need care?
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Old 11-16-2012, 10:01 AM   #122
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Interesting discussion on LTCI. I have not bought LTCI insurance .I looked closely at my family history & except for my grandfather who spent about a year in a VA nursing home no one else has. We have no history of Alzheimer's or strokes . I have decided to self insure . Hopefully it is a wise decision.
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Old 11-16-2012, 10:02 AM   #123
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Originally Posted by explanade View Post
So if you start buying in your 50s, you can pay premiums for what 15-20 years before you might actually collect?

How do they determine what's a valid claim?

You decide to go to a facility and they have to start paying? Or is there some medical threshold that you have to reach and it's determined you need care?
the ltci insurnce is much more involed than that. since i am enrolled-havent't used i'll tell you what i know.

when ltci provider informed you get assigned one of their facilitators.they work with you and md to decide course of action. there are several guidlines. my policy also does home health care. it depends on how bad you are as to whether you go into a home. there are many government rules and regulations overseeing this. I would not worry about the insurance service and worry how to afforrd the premiums. as to when they start paying it depends on what kind of policy you buy. most have number of days after entry dpending on how much you want to pay in premiums. mine starts after 50 days-however medicare usually picks up to one month then you are on your own.

the ltci book is like a contract-it has pages and pages about every step.

i bought mine 10 years ago. somethings may have changed
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Old 11-16-2012, 10:13 AM   #124
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Originally Posted by explanade View Post
So if you start buying in your 50s, you can pay premiums for what 15-20 years before you might actually collect?

How do they determine what's a valid claim?

You decide to go to a facility and they have to start paying? Or is there some medical threshold that you have to reach and it's determined you need care?
Search Nords posts on LTCI. He is the conservator for his dad and has posted extensively about working with the LTCI insurer to pay for his dad's care.
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Old 11-16-2012, 10:46 AM   #125
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My wife and I are investigating LTCi as well. We have quotes from Genworth and from Northwestern Mutual Life(NML). We are 56 (me) and DW is 54. Right now we are leaning towards NML. The premium is $3k/yr, but there are unique variations on this e.g. inflation adjusted at 3%, I think it is ~$4k/yr and then they have a option to increase 5% a year but then stop at any point an just pay that premium going forward. The other item I like about NML is they seem to pay a dividend (not guaranteed) which can offset some of the premium.

It actually seems pretty complicated and we are scheduled to talk through this in greater detail in a couple of weeks. Hopefully I'll have a better idea after the meeting.

Has anyone used NML?
A comparable policy from NWM should be 30-60% more expensive than Genworth. Are you sure the policies you are comparing have similar benefits?
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Old 11-16-2012, 10:49 AM   #126
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Originally Posted by explanade View Post
So if you start buying in your 50s, you can pay premiums for what 15-20 years before you might actually collect?

How do they determine what's a valid claim?

You decide to go to a facility and they have to start paying? Or is there some medical threshold that you have to reach and it's determined you need care?
A licensed physician must certify that you have lost two of the six activities of daily living (ADL): eating, bathing, dressing, toileting, transferring (walking) and continence. After that's done, benefits kick in immediately subject to any waiting periods specified in the policy.
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Old 11-16-2012, 10:53 AM   #127
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A comparable policy from NWM should be 30-60% more expensive than Genworth. Are you sure the policies you are comparing have similar benefits?

when i originally purchased 10 years ago for me and the wife the agent we went to represented both. at the time 10 years ago he felt GE gave the best value and financially was as strong as Northwestern Mutual.

10 years later GEenwoth is still the leader and seems financialy sound
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Old 11-16-2012, 11:08 AM   #128
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A comparable policy from NWM should be 30-60% more expensive than Genworth. Are you sure the policies you are comparing have similar benefits?
No, the benefits are different. In fact, to try and compare 2 LTCi from any companies seems impossible as they all seem to have some differences. Like in NML the elimination period is in weeks. But all you need is to use a in home assistance for an hour one day during that week and it counts as a week. The elimination period is 12 weeks. They also don't have the spousal sharing option. There are definitely some differences.

As I mentioned we are meeting with the NML rep after the T-day holiday. I hope to have a much clearer picture then.

I also agree they may be a bit higher in costs, but agree with pb4uski that the based on my searches NML seems like they rarely raise a premium and have a solid financial rating.
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Old 11-16-2012, 11:28 AM   #129
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No, the benefits are different. In fact, to try and compare 2 LTCi from any companies seems impossible as they all seem to have some differences. Like in NML the elimination period is in weeks. But all you need is to use a in home assistance for an hour one day during that week and it counts as a week. The elimination period is 12 weeks. They also don't have the spousal sharing option. There are definitely some differences.

As I mentioned we are meeting with the NML rep after the T-day holiday. I hope to have a much clearer picture then.

I also agree they may be a bit higher in costs, but agree with pb4uski that the based on my searches NML seems like they rarely raise a premium and have a solid financial rating.
A good agent should be able to show you a side-by-side comparison of the differences between the two policies. Most LTC benefits are actually fairly standardized in their comparisons. Having a policy without shared benefits at a higher price doesn't seem like a good deal IMO....those shared benefits can be pretty important if you aren't going for a 6+ year benefit period for each person. NWM may be less likely to raise premiums in the future, but you are essentially paying for a built-in rate increase already by choosing a more expensive policy.
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Old 11-16-2012, 11:42 AM   #130
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SoReady, if you haven't already done this, be sure to take a look at the actual expenses you'd face in various scenarios. When I did that, I found that we really only needed LTCi for one of us (but there's no telling which one). The most "draining" situation (in our case) is one person in a NH and the other outside. If only one of us is alive, the savings, sale of the home, plus SS and a pension would be enough to pay for NH care for that person. Even with both folks checked into a NH, the house could be sold to buy some time. If your situation is like this, then the "shared benefits" option is worth quite a bit to you: Buy a lesser amount of coverage on both of you and just pile them together if needed for the first to need LTC.
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Old 11-16-2012, 12:35 PM   #131
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A licensed physician must certify that you have lost two of the six activities of daily living (ADL): eating, bathing, dressing, toileting, transferring (walking) and continence. After that's done, benefits kick in immediately subject to any waiting periods specified in the policy.
Right. That's the way my policy reads too.

I got my policy a few years ago, before the stuff hit the fan in the economy and insurance industry. In any case, the premium won't change, but my benefit won't change either. I have an optional "inflation kicker" I can employ every 5 years. My option.

We're still pretty young so the premium is fairly reasonable. Just hope it is worth something if we ever need it.
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Old 11-16-2012, 01:49 PM   #132
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Originally Posted by explanade View Post
So if you start buying in your 50s, you can pay premiums for what 15-20 years before you might actually collect?
How do they determine what's a valid claim?
You decide to go to a facility and they have to start paying? Or is there some medical threshold that you have to reach and it's determined you need care?
Quote:
Originally Posted by dgoldenz View Post
A licensed physician must certify that you have lost two of the six activities of daily living (ADL): eating, bathing, dressing, toileting, transferring (walking) and continence. After that's done, benefits kick in immediately subject to any waiting periods specified in the policy.
My Dad probably first started showing symptoms of cognitive impairment in 2008 (age 74), and in March 2011 he could no longer live independently. He's been receiving benefits from his John Hancock LTC policy since the 100-day exclusion period ended that July. By then he'd been paying the policy premiums for just over 18 years. Many policy premiums ramp sharply upward if you purchase them after age 60. Of course today many of them also ramp sharply upward after you turn age 60, even if you bought them before age 60.

Most policies specify partial or total loss of at least two of the activities of daily living, and the policy fine print is extremely detailed in exactly what that means. (Which is a good thing.) Unfortunately it's quite possible for someone with Alzheimer's to be totally unsafe for independent living, yet still be able to pass a mini-mental state exam and appear to be handling the ADLs. When John Hancock rejected the documentation provided by Dad's care facility, we hired a neuropsychologist ($3670) to interview Dad for several hours on well-known tests like drawing a clock, spelling words backwards, dialing 911, and handling home emergencies. JH then quickly approved the claim.

It's not always necessary to be living in a facility before the policy starts paying. Early LTC policies used to specify "nursing home" care, but now most of them will include benefits payments for home care or assisted living facilities.

You could start at this post in this thread: Geriatric financial management & asset allocations

I'm a tad jaundiced on the subject. I think a lot of the insurance industry's issues would be resolved if the execs and sales staffs had an immediate family member in a care facility (and had to file the claim) or if they interned alongside a CNA in a care facility for a month.

John Hancock, come walk a mile in my fax machine slippers the next time I have to send you the monthly bill from my Dad's care facility...

Here's another thread that I just posted about seeking interview questions for a long-term care exec who I'll be talking to in a few days:
Seeking questions for an interview on long-term care insurance
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Old 11-16-2012, 03:10 PM   #133
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Thanks for the postings of questions and experiences. I have had a revelation reading the comments from those caring for a loved one in LTC facility. It isn't about me, it is about those who would have to deal with the expense and hassle if I end up needing such care. Has me rethinking my aversion to such insurance.
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Old 11-16-2012, 04:49 PM   #134
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A comparable policy from NWM should be 30-60% more expensive than Genworth. Are you sure the policies you are comparing have similar benefits?
Agree. NWM' s quote for the same policy for us was $7550 which is 70% higher than Genworth and 86% higher than Mutual of Omaha. Their quote was the 3rd highest after NY life and John Hancock.
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Old 11-16-2012, 05:32 PM   #135
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So would you or have you purchased LTCI for yourself after going through the experience with John Hancock?
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Old 11-16-2012, 08:59 PM   #136
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So would you or have you purchased LTCI for yourself after going through the experience with John Hancock?
Hell no, and I should probably short their stock too.

It's like buying your office supplies from Steve Carrell at Dunder-Mifflin.

Dad's leaving each of us about $67K in life insurance. That'll go into a brokerage account under my name, and I'll probably invest it in a small-cap fund and a value dividend fund.

Spouse and I are keeping an eye on the premiums of the Federal Long-Term Care Insurance Program. When the jump in the premiums approaches (probably around age 59, in seven years) then we'll reassess the situation. But since we each have our own pensions, I suspect that I'll be able to self-insure.

If spouse ends up being my caregiver, she might have plans of her own...
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Old 11-19-2012, 05:09 AM   #137
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I was just reading this report from Metlife. The average nationwide cost of a nursing home per year (private room) now exceeds $90,000. I feel I have made the right choice by getting LTCI this year.

https://www.metlife.com/assets/cao/m...care-costs.pdf
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Old 11-19-2012, 08:57 AM   #138
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I have to ask how are people paying for such care.

Population at large isn't amassing big retirement savings and even among the ER set, it doesn't sound like LTCI is that common.

And who knows how many claims the insurers are paying on average. So how many of these facilities are actually collecting so much?

Is it like inflated hospital bills which overcharge those without insurance but often remain uncollected? So the insurers are quoting retail charges to uninsured while they end up paying much lower negotiated rates, like health insurers pay to network providers?
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Old 11-19-2012, 09:15 AM   #139
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I have to ask how are people paying for such care.

Population at large isn't amassing big retirement savings and even among the ER set, it doesn't sound like LTCI is that common.

And who knows how many claims the insurers are paying on average. So how many of these facilities are actually collecting so much?

Is it like inflated hospital bills which overcharge those without insurance but often remain uncollected? So the insurers are quoting retail charges to uninsured while they end up paying much lower negotiated rates, like health insurers pay to network providers?

most of this is being paid by MEDICAID. however you do have to impoverish yourself to get on it. I looked into this before buying our policies.

it looks easy tricking the government beofre you do it -but it is not so easy once you actually have to do it.
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Old 11-19-2012, 09:39 AM   #140
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DW and I bought our LTCI policies from John Hancock through my MegaCorp at age 60 for both of us. No employee or spouse could be rejected for health reasons. Neither DW nor I would have been able to get policies if our health was considered.

My mother's LTCI policy was with Conseco (now defunct). IMHO Conseco was absolutely the worst outfit I have ever had to deal with.

The worst part was that after I had finally jumped through all their hoops and they were paying for her stay in an assisted care facility, she had to go to the hospital and then to a nursing home. Medicare paid for a while. This broke her LTCI coverage. I had to start all over and jump through all the same hoops again.

I am proud to say that we did finally use every penny of the benefits provided by my mother's 48 month Conseco LTCI policy. After that she went on the Pay-Through-The-Nose plan (self-insured?) until she died.
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