To LTCI or Not to LTCI?
From the perspective of a Nursing Home Administrator, we love to welcome new residents with LTC insurance. It ensures that we have a secure payer source for and extended period of time, However, I am personally unsure whether I would purchase it for myself. Here are my considerations:
1. The cost of LTCI is high and like life insurance, it is rated based on your medical history.
2. Most short-term LTC stays for an orthopedic procedure or caridiac are of a short duration (<21 days) and are payable under Medicare or a Medicare Advantage program.
3. If my family or that of DW had a history of Alzheimer's or other dementia, I would be more likely to buy. The end game here almost always ends in a long term stay in the nursing home as the ADLs fail. It is very difficult to care safely for one with advanced dementia in the home. It is brutal on the caregiver.
4. The Centers for Medicare and Services is working diligently to provide for services in the home through programs called PACE. Nursing homes are closing across the country and those that remain will likely be non-profits. Most LTCI policies pay for in-home-care services. Yet, am I getting the full value that I paid for when buying the LTCI?? Medicare also pays for in-home-care services. The qualifications for long-term nursing home care will be more oriented to a dementia population and a limited number of other chronic illnesses that are difficult to handle in a home setting?? The chances of any of us ending up long-term in a nursing home in twenty years will be significantly less than it is today.
Anyway, that is what I am thinking about as I consider LTCI.
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