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Old 01-26-2021, 06:10 PM   #21
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I got it in my 40s. Premiums, despite major increases along the way, remained comparatively low. However, after a divorce and the latest premium increase, I opted to let it go. I did a lot of research and decided that it was unlikely the policy would end up being all that helpful to me.

Let's face it: Few got this coverage when it was more widely available and affordable, so the problem has not been addressed for society as a whole. I think the government will have to provide a solution of some sort in the future.
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Old 01-26-2021, 06:26 PM   #22
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got it when i turned 60. why? the purpose of insurance is to transfer risk.
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Old 01-26-2021, 06:52 PM   #23
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Let's face it: Few got this coverage when it was more widely available and affordable, so the problem has not been addressed for society as a whole. I think the government will have to provide a solution of some sort in the future.
There is already. It's called Medicaid. Depending on the quality and availability of Medicaid beds in your area, it may not be pretty.

I'm self-insuring. Monte Carlo simulations by my advisor confirm that this is realistic. It's an easier decision as a single person- no scary scenario of one person in the house, the other in LTC. My son, my only heir, knows that my top priority is not outliving my savings.
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Old 01-26-2021, 07:10 PM   #24
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There is already. It's called Medicaid. Depending on the quality and availability of Medicaid beds in your area, it may not be pretty..
several years ago my late mom-in-law had to spend about a month in a nursing home recovering from a fall. my wife and i inspected about a dozen. one, which seemed to cater to medicaid patients, was a hellhole. we never went past the front desk. my late father-in-law set up a substantial trust for MIL so she was able to pay-out-of-pocket.
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Old 01-26-2021, 08:18 PM   #25
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Self insured. It's only me so if it happens after I'm 70, between SS and selling the house I get 3 years or so in a decent nursing home or 8 years in an assisted living apartment.
The better nursing home in my county takes you if you can give 2 years cost up front and will keep you if you end up on Medicaid. Not sure if you go to a double room at that point though.
That's assuming I went through the whole IRA before having to go into the system.
DD2 worked at the most expensive assisted living apartments in the area at the same time an acquaintance was living at another place that was slightly more than 1/2 the cost. The food and common area furniture was a bit better at the expensive one but the assistance was no better.
You could have a small dog at both places so it's something I could make work.
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Old 01-26-2021, 10:17 PM   #26
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There is a podcast called the Retirement and IRA Show that is run by 2 FPs from Colorado. It’s available from all the usual podcast providers. Lately, they have been talking a lot about LTC in their bi-weekly shows and there has been some good info. The only caveat is that they (or at least one of them) is quite the talker and you have to listen longer than you might like to get to the nuggets.

You can also get to the podcast at jimhelps.com.
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Old 01-27-2021, 12:38 AM   #27
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As part of our retirement benefits, we purchased LTC group policy for each of us. It has simple inflation protection. We got it to protect the spouse who didn’t need LTC.
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Old 01-27-2021, 01:14 AM   #28
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Don't see anyone who mentioned the "Hybrid Life Insurance/LTC" policies available. We purchased one from One America/State Life in 2016. Either or both spouses can avail themselves in just one policy of the LTC benefits if needed. And if the LTC benefits are never used (or not all used up), the policy pays death benefit to heirs (our three kids). We paid upfront a lump sum of $121000 to get a monthly LTC benefit (usable by either or both spouses) of $7000 a month for up to 33 months. If we only tapped say $4000 a month, the benefits would last longer than 33 months. If LTC never used, the policy pays out $233000 death benefit to heirs. We also added a rider that increase benefits by 3% annually. We pay $3140 a year for inflation rider, and LTC monthly benefit if needed would now be about $8300 a month. We can quit paying for the inflation rider at any time and LTC policy is still in effect at last attained benefit amount. One could also choose to pay annually for the LTC/Life policy instead of lump sum upfront. I figured for the piece of mind of knowing we could cover LTC costs for "likely average" length of time needed, and knowing if LTC never needed the money was not wasted but death benefit go to heirs, it was worth it. I figured I was basically giving the insurance company the time value of investing that $121000 for "probable" length of time before we both died---and that trade was worth it to give us LTC peace of mind as well as still giving our kids almost double the money back if LTC never used. . So, I would recommend people interested in LTC look into the "hybrid LTC/life insurance" model. Of course, since 2016, State Life has also increased "effective" prices in its models.
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Old 01-27-2021, 01:22 AM   #29
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One additional comment on hybrid LTC/Life insurance I mentioned above: Since our kids get back almost double the policy's upfront cost to us at our death, I look at it as my wife and I will have gotten LTC peace of mind for free during our lives. Not a bad deal, in my book. BTW, I was 69 and wife was 62 when we purchased, and they rated policy on an actuarial "combined" age of 64.
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Old 01-27-2021, 05:01 AM   #30
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At this point, we are self insuring. Might make use of an irrevocable trust in the future, but have enough monies outside the trust to get into a non medicaid place at the start.
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Old 01-27-2021, 05:29 AM   #31
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LTC

Had a close relative who retired young and was in the application process for LTC when they were paralyzed for life suddenly in an accident. Of course this disqualified them.. This LTC policy also provided a option for live at home nursing & care. This relative could have benefited greatly from that. I have a group policy for myself and spouse that runs about $4500 a year....thatís still expensive but nursing homes in my area run 72k a year or more for decent ones and I own some family land I want to pass on and not sell to fund a nursing home stay. So for me I think itís ok. I do expect a bureaucratic hassle with the insurance company if I ever need it but it seems like everything is a bureaucratic hassle these days so Iím getting good at dealing with those.
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Old 01-27-2021, 05:53 AM   #32
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We're playing the odds: the average stay is a couple of years. So, we're self insuring.
Here's a link to estimated care costs by state from Genworth: https://tinyurl.com/y39j2b67
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Old 01-27-2021, 07:25 AM   #33
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Originally Posted by friar1610 View Post
There is a podcast called the Retirement and IRA Show that is run by 2 FPs from Colorado. Itís available from all the usual podcast providers. Lately, they have been talking a lot about LTC in their bi-weekly shows and there has been some good info. The only caveat is that they (or at least one of them) is quite the talker and you have to listen longer than you might like to get to the nuggets.

You can also get to the podcast at jimhelps.com.
I listen to their podcasts, and I really like them. Their recent podcasts on LTC, have made rethink the possibility of some form of LTC insurance. I had always thought of the house as a backup plan, but that will do little good if either I or the wife needs LTC first.

One important point he has made is that you should not really call it "self insuring". Many on this thread have said the are "self insuring", but instead it should be said you are planning to "self fund". I know you may think it is a matter of semantics, but i think it is a very valid point. Insurance implies risk pooling, which you are not doing when you self fund. I am not saying that there is anything wrong with self funding if you have the means, you are just not self insuring. The risk pooling of LTC would protect against the rare but catastrophic case of a very extended time in a LTC facility due to something like a major stroke.
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No/Yes
Old 01-27-2021, 07:39 AM   #34
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No/Yes

My wife has it, i don't. The theory is I'm older than her and have more health issues so chances are I'll go before she does. She'll be left alone with no one to care for her. Unless the world goes to hell, we have enough money to keep us going for a long time.
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Old 01-27-2021, 07:52 AM   #35
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Self insured. It's only me so if it happens after I'm 70, between SS and selling the house I get 3 years or so in a decent nursing home or 8 years in an assisted living apartment.

The better nursing home in my county takes you if you can give 2 years cost up front and will keep you if you end up on Medicaid. Not sure if you go to a double room at that point though.
Here's how it worked with my Uncle in Ohio: he was IMMEDIATELY placed into a "Medicaid bed" (had a roommate, curtain down the middle) because, you know, there might not be one available when he qualified for Medicaid. So, they paid the full rate from Day One, but for lesser accommodations. Just about the time he was about to qualify for Medicaid (and my poor Aunt was losing sleep over spending down to that level), they jacked the rates up to something crazy so she moved him. What a racket. He died shortly after that.

Still, it's a good middle ground for people who have enough to fund a couple of years since you get a better choice of facilities.

The calculator cited earlier was spot-on for the facility my Dad is in right now in SC. I'm planning to move near DS and DDIL when I can no longer live independently and the cost of full LTC is a bit less than what I spend in a year right now- and of course nearly all my other expenses will go to zero (car, home maintenance, travel, etc.) and I'll have sold the house, which could fund 3 years right there. (Mortgage balance right now is only $67K and it's due to be paid off when I'm 77.)
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Old 01-27-2021, 08:30 AM   #36
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Very helpful comparison discussion. I guess from this we are looking at a hybrid of relying on our LTC policies, which we bought in our 30s when it was offered at a major university I worked for. DW had already had cancer once at 38 so the topic seemed real. We are now in our mid 50s and pay less than $50 each/month for a $175/day benefit with CNA. If the SHTF and we needed more, I guess weíd turn to our portfolio and home equity.
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Old 01-27-2021, 08:45 AM   #37
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I have been wrestling with this question lately. DW has an LTC policy however I do not. After running through a couple of models, I have basically determined I will self fund for myself. I was able to build in enough expense to cover 3-4 years of nursing home care with some cushion left. We have the flexibility to use these funds for my care or for whatever the wifeís policy does not cover. Beyond this, if care extends multiple years, sale of the home is the backstop.

I found this article (if accurate) to be interesting and helpful in the decision.

https://eggstack.com/blog/2019-07-28...aste-of-Money/
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Old 01-27-2021, 09:01 AM   #38
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DH took advantage of a group policy with John Hancock at age 52 when he was still working. He's now 68 and retired. Our premiums have gone up due to inflation, but we're still only paying an annual premium of $2,352 for both of us, with lifetime maximum benefits of $425,000 each.

As someone said above, when one of us kicks, we'll drop it. We could probably self insure, but looking back at how much our premiums have been over the years, I still feel like it was a good deal for us. I have no doubt DH will be the first to need it and that will be a load off my mind when it happens.
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Old 01-27-2021, 09:40 AM   #39
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Don't see anyone who mentioned the "Hybrid Life Insurance/LTC" policies available. We purchased one from One America/State Life in 2016. Either or both spouses can avail themselves in just one policy of the LTC benefits if needed. And if the LTC benefits are never used (or not all used up), the policy pays death benefit to heirs (our three kids). We paid upfront a lump sum of $121000 to get a monthly LTC benefit (usable by either or both spouses) of $7000 a month for up to 33 months. If we only tapped say $4000 a month, the benefits would last longer than 33 months. If LTC never used, the policy pays out $233000 death benefit to heirs. We also added a rider that increase benefits by 3% annually. We pay $3140 a year for inflation rider, and LTC monthly benefit if needed would now be about $8300 a month. We can quit paying for the inflation rider at any time and LTC policy is still in effect at last attained benefit amount. One could also choose to pay annually for the LTC/Life policy instead of lump sum upfront. I figured for the piece of mind of knowing we could cover LTC costs for "likely average" length of time needed, and knowing if LTC never needed the money was not wasted but death benefit go to heirs, it was worth it. I figured I was basically giving the insurance company the time value of investing that $121000 for "probable" length of time before we both died---and that trade was worth it to give us LTC peace of mind as well as still giving our kids almost double the money back if LTC never used. . So, I would recommend people interested in LTC look into the "hybrid LTC/life insurance" model. Of course, since 2016, State Life has also increased "effective" prices in its models.

Thanks for sharing your approach. Iím interested in thoughts about this option from others much smarter than me. Iíve always heard to avoid combining investment and insurance policies. That makes sense to me intuitively. But everything you state sounds pretty good, except the initial $121K payment of course. Just trying to understand some pros/cons of this approach.
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Old 01-27-2021, 12:48 PM   #40
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Don't see anyone who mentioned the "Hybrid Life Insurance/LTC" policies available. We purchased one from One America/State Life in 2016. Either or both spouses can avail themselves in just one policy of the LTC benefits if needed. And if the LTC benefits are never used (or not all used up), the policy pays death benefit to heirs (our three kids). We paid upfront a lump sum of $121000 to get a monthly LTC benefit (usable by either or both spouses) of $7000 a month for up to 33 months. If we only tapped say $4000 a month, the benefits would last longer than 33 months. If LTC never used, the policy pays out $233000 death benefit to heirs. We also added a rider that increase benefits by 3% annually. We pay $3140 a year for inflation rider, and LTC monthly benefit if needed would now be about $8300 a month. We can quit paying for the inflation rider at any time and LTC policy is still in effect at last attained benefit amount. One could also choose to pay annually for the LTC/Life policy instead of lump sum upfront. I figured for the piece of mind of knowing we could cover LTC costs for "likely average" length of time needed, and knowing if LTC never needed the money was not wasted but death benefit go to heirs, it was worth it. I figured I was basically giving the insurance company the time value of investing that $121000 for "probable" length of time before we both died---and that trade was worth it to give us LTC peace of mind as well as still giving our kids almost double the money back if LTC never used. . So, I would recommend people interested in LTC look into the "hybrid LTC/life insurance" model. Of course, since 2016, State Life has also increased "effective" prices in its models.
One of the posters over on bogleheads forums who sells LTC insurance points out these hybrid policies end up costing roughly 3x the cost of a LTC policy alone...but are easier to get if you have pre-existing medical conditions that would disqualify you from a regular LTC policy.

And you have to make sure there really are no costs down the road...I had an insurance salesman try to sell me one ($10k/year for 10 years) but the underlying policy was universal life, not whole life, so under the guarantee my policy would have blown up around age 70.
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