Is Long Term Care (LTC) a good idea?

[Retire2013]

Hello All,

I am not informed enough about Long Term Care to be able to even frame my question well and for that I apologize to all. However, if anyone would be so kind as to simply share your thoughts/opinion/advice on whether Long Term Care is a good idea for someone who plans to ER. Of course, I realize that I must do my own research before making the decision but since our Forum has so many knowledgeable members I would like to read in order to learn from you all first then I'll do the research. Thank you!

Retire 2014

 

[REWahoo]

You might find some good info here: http://www.early-retirement.org/for...ng-term-care-ltc-and-ltc-insurance-30860.html

 

[Rich_by_the_Bay]

The link from REW should get you started.

I have held off and am planning to self-insure, barring political changes. Factors making this risk acceptable to me include a decent nest egg, an average LTC stay of something like 3 years or less before death, cost (esp with COLA), and uncontrollable premium hikes which you are almost forced to accept unless you want to render all your prior premiums meaningless.

I might change my mind, but that's my story now.

Tough call

 

[ziggy29]

I have held off and am planning to self-insure, barring political changes.

Same here. Plus, chances are I'm at least 20 years away from needing LTC (as it's quite rare to need it under age 65) and there's a pretty good chance that just about everything related to how health services -- standard medical, dental, vision, nursing home or assisted living arrangements -- are delivered and paid for will change considerably.

For example, if I enrolled now to "lock in" low payments at 44 (which is a joke of a claim) and if some sort of public, low cost or tax-funded long term care system arose in 15 years -- long before I'd be likely to need it -- would that have just been 15 years of premiums down a rat hole?

 

[Purron]

For example, if I enrolled now to "lock in" low payments at 44 (which is a joke of a claim) and if some sort of public, low cost or tax-funded long term care system arose in 15 years -- long before I'd be likely to need it -- would that have just been 15 years of premiums down a rat hole?

I have LTC insurance and am concerned about this, especially since my premiums just went up.

 

[FinallyRetired]

DW have had it for about 10 years. We got it when we were young enough to qualify for a reasonable rate. We got 5 years of coverage, which is a lot more than the average 3 year stay.

Where we live, average nursing homes are running $75,000 a year, so a long stay in nursing homes would run through our nest egg pretty fast. And, having gone through the medicaid experience with MIL, it's really not a good option.

It's one of those things that if it turns out you don't need it, it will look like a foolish purchase. But, then, all insurance is like that.

 

[Stevewc]

I'm planning/hoping the Doc's and people on this board are going to take care of me. You folks do care don't you?
Steve

More seriously, where I'm from, family do their best to keep you cared for and comfortable, until you meet your maker. !!!

If not, I live in a card board box (which my son tells me I will) and die.

 

[BigNick]

An immediate needs annuity for LTC costs about 3-4x a year's care costs, at age 85. So if you can be sure that your portfolio will have that amount of cash available, it might be a better bet to ensure that someone you trust has POA and is well briefed on what to do.

 

[Stevewc]

It's one of those things that if it turns out you don't need it, it will look like a foolish purchase. But, then, all insurance is like that.

I hate insurance, they are betting you will live and you are betting you will die.

 

[easysurfer]

Insurance is one of those things that feels like a ripoff paying the premiums but when you need it, you surely are thankful that you have it. I have LTC coverage, so the jury is still out whether I'm a dummy or a genius

Seriously, if you do get LTC coverage, the best bet is to choose the option that is indexed for inflation. It's more expensive, but otherwise in 20 years or so when you need it, you'd get little in return.

 

[REWahoo]

I have LTC coverage, so the jury is still out whether I'm a dummy or a genius.

Me too, and I'm hoping I'm a dummy and every penny I spend on it is a total waste.

 

[easysurfer]

Me too, and I'm hoping I'm a dummy and every penny I spend on it is a total waste.

There's really no good way to look at it. I don't want to picture myself at a time needing LTC. Yet the alternative is have a quick exit. Pick your posion

 

[Rich_by_the_Bay]

Consumer Reports article here.

 

[zinger1457]

There's really no good way to look at it. I don't want to picture myself at a time needing LTC. Yet the alternative is have a quick exit. Pick your posion

I'm going with the quick exit, just hope I'm mentally and physically sound enough to take action when the time comes. I'd rather go out on my own terms, the last thing I want is to spend my final days in a LTC facility.

 

[Orchidflower]

I'm going with the quick exit, just hope I'm mentally and physically sound enough to take action when the time comes. I'd rather go out on my own terms, the last thing I want is to spend my final days in a LTC facility.

If I'm healthy like both my parents until my 90's, feeling good and just using a walker, let me live. If I am sick, in bed, feeling lousy every day...taaa, taaa, Toots! What's the point of hanging around then?

 

[Alan]

+1 for self insuring. For the last ~6 years we've been paying into a MF with VG that is outside of our retirement savings, not used for withdrawals now that we are ER'ed, and that we continue to pay into monthly. Hopefully we won't need it before age 75 which will mean over 25 years of saving for that event should it happen.

Of course, many things can happen so it is just our gamble and I completely understand why folks buy LTC insurance.

 

[Rich_by_the_Bay]

If I'm healthy like both my parents until my 90's, feeling good and just using a walker, let me live. If I am sick, in bed, feeling lousy every day...taaa, taaa, Toots! What's the point of hanging around then?

Wish it were that simple. When the rubber meets the road, it is very hard to stop "hanging around." If you are judged incompetent others can see to it that you are medically cared for. You can make your wishes known in advance when you are healthy, but there are all kinds of gray areas. It is not always the case of a suffering, demented, patient with cooperative family and a living will.

Most of us would accept short-term treatment for a reversible disease (e.g. antibiotics for pneumonia) but during that illness you may require a ventilator to keep you going until the drugs can work. Yay or nay? You may never get off the ventilator if things take a turn for the worse, and that can last months. Pull the plug? Maybe, but in comes the prodigal grandkid who throws a fit, and says you are not to stop the ventilator under any circumstances, I won't sit by and kill grandma.

You can't really even refuse medical care since nursing homes are required to have medical care for every patient.

I guess my point is that however much we feel clear about our wishes for health care and dying, it is usually very complex and fails to turn out the way we had hoped.

But get that living will and health care POA filled out, talk to all possible stakeholders calmly and well in advance with yearly reminders. Talk to your doctors regularly about your wishes. If a doctor seems to resist your wishes unreasonably, find another one (but be open-minded -- the doc may see a side to things that you are missing).

 

[Retire2013]

Thank you EVERYONE for all your thoughts, advice, and opinions. I am thoroughly confused now. Just kidding. Wishing ALL a wonderful day while we are still healthy and none of us needs LTC yet

 

[Amethyst]

On the subject of LTC, I am wondering how people who dislike office life as much as we forum members do, are going to tolerate assisted-living facilities. It seems to me that the ultimate irony would be to LBYM, and all the rest of it, in order to ER, only to find oneself back in the same sort of environment one sought to escape.

Even if we're sick and feeble, we're still the same people with the same independent streak. How are we going to deal with being in a situation that resembles the one we worked so hard to retire out of? Do you suppose we will spend the last few years of our lives, grumbling and rebelling in small ways against the institution that we (just as with employment) filled out an application and were selected to join?

*You are obliged to keep company you didn't choose, and probably wouldn't have picked if you'd had the choice. (This, as far as I'm concerned, is the worst feature).

*Mealtime and meals are decided by those in charge.

*Residents gossip about each other, and you will be gossiped about too, and expected to join in the gossip or else be thought a snob.

*Recreation is common-denominator, and entirely indoors.

*You can't make a mess with your personal belongings (I need the freedom to spread out and be messy when I wanna be).

*Can't comfort yourself with a retirement countdown.

Have given this quite a lot of thought. It seems the only way to deal with LTC is the way our stoic elders do: Remind yourself that you were lucky to get a place, and there's no sense in grumbling. Tell everyone that it's "lovely here," and try to believe it yourself. But if we were capable of that line of thinking, wouldn't we already be applying it in the workplace?

Amethyst

 

[Purron]

I guess my point is that however much we feel clear about our wishes for health care and dying, it is usually very complex and fails to turn out the way we had hoped.

This was the case for my MIL. Strong, independent woman who never wanted to spend the last 15 years of her life disabled and dependent on others for all of the daily activities of living. As much as she hated what happened to her, she still had a strong will to live. She was an amazing woman and she taught us so much about life and death.

 

[MBAustin]

Many LTC plans provide for in-home assistance (non-medical - bathing, feeding, etc.) and care (nursing / medical), so don't assume having LTC means going into a care facility if that is not what you want.

 

[F4mandolin]

Just can't help thinking it is a rip-off. Things just don't seem right and the prices just keep jumping more than they should. I can't help thinking they are preying on the "what if" crowd. hmmm, don't really want to say want I want to say......

 

[chinaco]

It is expensive. There are many concerns about the insurance companies and rising rates.

We have it because we go it at a very low cost through a group plan at work. However, as we age, the inflation option (cost) rises.

Insurance (when properly applied) is used to mitigate the risk of a financial loss.

It is a complicated topic.

IMO - the overall issue is as much about protecting the joint assets for the surviving spouse as providing money for the care of the insured.

 

[Purron]

IMO - the overall issue is as much about protecting the joint assets for the surviving spouse as providing money for the care of the insured.

I agree. If DH and I decide to cancel our LTC insurance, we would look for other ways to protect our assets from Medicade.

 

[Rich_by_the_Bay]

I agree. If DH and I decide to cancel our LTC insurance, we would look for other ways to protect our assets from Medicade.

Just curious if anyone has investigated whether a SPIA (bought early enough to pass the look-back rules of your state) can play a role here in that regard. While it might be diverted to Medicaid during the owner's life, would the surviving spouse (assuming it was set up this way) resume collecting distributions after the other's death?