ltc insurance

[harllee]

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Originally Posted by RetireeRobert Can you share some more information about what is involved with CCRC's financially? And what parameters determine when one "moves into" a CCRC? Just curious, this is an area totally off my radar, and my ignorance on CCRC's is huge.

There are several threads on this Forum which discuss CCRC. There are all sorts of CCRC models but the CCRC we plan to move into is a nonprofit "Life Care" community. You pay a fairly hefty move in fee (exact amount depends on the size of the villa or apartment you chose) and then a monthly fee that does not increase if you have to move into assisted living, skilled nursing or memory care. Hence there is no need for long term care insurance. The monthly fee covers all maintenance, utilities, a certain number of meals per month and health care. Our CCRC also has a wonderful fitness center that is included in the monthly fee. You must be able to live independently when you move in--you have to pass a physical and a mental test so you don't want to wait too long. You also have to have adequate assets to cover your fees for your life expectancy. Our CCRC has a trust fund to pay monthly fess for anyone who runs out of money (for example there are 2 ladies over 100 in the memory care who have run out of assets and whose monthly fees are being paid by the trust). We are on the waiting list (the waiting list is about 10 years long but we have been on it a long time so we are near the top) and most people at our CCRC move in while they are in the 70s.

[Huston55]

Quote:

Originally Posted by RetireeRobert Can you share some more information about what is involved with CCRC's financially? And what parameters determine when one "moves into" a CCRC? Just curious, this is an area totally off my radar, and my ignorance on CCRC's is huge.

Check out this thread in the FAQ.

https://www.early-retirement.org/for...ml#post1860388

[RetireeRobert]

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Originally Posted by harllee There are several threads on this Forum which discuss CCRC. There are all sorts of CCRC models but the CCRC we plan to move into is a nonprofit "Life Care" community. You pay a fairly hefty move in fee (exact amount depends on the size of the villa or apartment you chose) and then a monthly fee that does not increase if you have to move into assisted living, skilled nursing or memory care. Hence there is no need for long term care insurance. The monthly fee covers all maintenance, utilities, a certain number of meals per month and health care. Our CCRC also has a wonderful fitness center that is included in the monthly fee. You must be able to live independently when you move in--you have to pass a physical and a mental test so you don't want to wait too long. You also have to have adequate assets to cover your fees for your life expectancy. Our CCRC has a trust fund to pay monthly fess for anyone who runs out of money (for example there are 2 ladies over 100 in the memory care who have run out of assets and whose monthly fees are being paid by the trust). We are on the waiting list (the waiting list is about 10 years long but we have been on it a long time so we are near the top) and most people at our CCRC move in while they are in the 70s.

OK, thanks for the brief rundown on CCRC's. Very informative. I'll search the threads you mention too. Seems like the crux on any CCRC decision then, is you have to decide if you want "institutional" living accommodations while you are still "independent", as opposed to single family home ownership most (but not all!) of us are used to while we are independent.

Things would be so much easier if we did not get old!

[RetireeRobert]

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Originally Posted by Huston55 Check out this thread in the FAQ. https://www.early-retirement.org/for...ml#post1860388

Thank you Huston55, saved me a search.

[Huston55]

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Originally Posted by RetireeRobert OK, thanks for the brief rundown on CCRC's. Very informative. I'll search the threads you mention too. Seems like the crux on any CCRC decision then, is you have to decide if you want "institutional" living accommodations while you are still "independent", as opposed to single family home ownership most (but not all!) of us are used to while we are independent. Things would be so much easier if we did not get old!

This seems to be a pejorative comment. I can assure you that in many CCRCs, especially those in high end areas and offering "Life Care" (Type A) contracts, are anything but "institutional". Country Club or Waterless Cruise would be a better description for CCRCs on the high end of the scale.

[harllee]

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Originally Posted by Huston55 This seems to be a pejorative comment. I can assure you that in many CCRCs, especially those in high end areas and offering "Life Care" (Type A) contracts, are anything but "institutional". Country Club or Waterless Cruise would be a better description for CCRCs on the high end of the scale.

Yes and in the CCRC we are moving to you can have a single family home (called a Villa) but you are not responsible for any upkeep--the best of all worlds. Of course it's not cheap. During the pandemic many of the things that we are interested in at the CCRC--events, organized travel, dances, music, etc are on hold for now. On the other hand, during the pandemic the CCRC provided meals and groceries delivered to each home and the folks in the CCRC were one of the first to get the vaccine.

[REWahoo]

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Originally Posted by RetireeRobert May I ask what LTCi insurer are you with?

We purchased from CNA in 2000. They stopped issuing new LTCi policies a few years later.

[RetireeRobert]

Quote:

Originally Posted by Huston55 This seems to be a pejorative comment. I can assure you that in many CCRCs, especially those in high end areas and offering "Life Care" (Type A) contracts, are anything but "institutional". Country Club or Waterless Cruise would be a better description for CCRCs on the high end of the scale.

Not meant to be "perjorative" at all. My bad, sorry you took it that way.
As I said, I know nothing about CCRC's. I stand corrected about what I assumed they might be.

[RetireeRobert]

Quote:

Originally Posted by harllee Yes and in the CCRC we are moving to you can have a single family home (called a Villa) but you are not responsible for any upkeep--the best of all worlds. Of course it's not cheap. During the pandemic many of the things that we are interested in at the CCRC--events, organized travel, dances, music, etc are on hold for now. On the other hand, during the pandemic the CCRC provided meals and groceries delivered to each home and the folks in the CCRC were one of the first to get the vaccine.

Thanks for the description. Nice to know this type of living is available, including the option of single family dwelling.

No maintenance or upkeep responsibilities---now you have got my attention!

[RetireeRobert]

So, now on CCRC's let me pose this thought:

"Hybrid's" are a melding of life insurance and long term care insurance to solve the problem of handling long term care needs financially.

It occurs to me that CCRC's are a melding of housing "leasing" and long term care services to handle long term care needs financially.

Any comments on that idea? I guess a question I have implicit in that thought is: when one enters into a CCRC contract, one is guaranteed a "lease" on a housing unit (of some type, and that type may change over time), and also guaranteed LTC care services as needed? Does one have incidents of ownership in CCRC contracts?

Just trying to get a handle on the nature of the beast.

[Huston55]

Quote:

Originally Posted by RetireeRobert So, now on CCRC's let me pose this thought: "Hybrid's" are a melding of life insurance and long term care insurance to solve the problem of handling long term care needs financially. It occurs to me that CCRC's are a melding of housing "leasing" and long term care services to handle long term care needs financially. Any comments on that idea? I guess a question I have implicit in that thought is: when one enters into a CCRC contract, one is guaranteed a "lease" on a housing unit (of some type, and that type may change over time), and also guaranteed LTC care services as needed? Does one have incidents of ownership in CCRC contracts? Just trying to get a handle on the nature of the beast.

The vast majority of the CCRCs in the SF Bay Area are analogous to leasing. I believe this is true throughout the US. However, there are some that include (require) unit ownership. While that might sound like a good thing to some, I view it as a disadvantage because one (or one’s heirs) typically continues to pay the monthly fee until the unit is sold. And, there is a limited buyer population for such units so, it can take a while.

[ChrisC]

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Originally Posted by Huston55 The vast majority of the CCRCs in the SF Bay Area are analogous to leasing. I believe this is true throughout the US. However, there are some that include (require) unit ownership. While that might sound like a good thing to some, I view it as a disadvantage because one (or one’s heirs) typically continues to pay the monthly fee until the unit is sold. And, there is a limited buyer population for such units so, it can take a while.

I'm on the wait list for a CCRC in my neck of the woods. It's a Type C business model with equity ownership -- you own the unit and pay-as-you go for home care or skilled nursing care if you can no longer independently care for yourself. The wait list is 4 plus years long and there's never been a shortage or timing issue with new residents taking over units once they become available. Typically, new residents customize their units, which might take up to 4 months. I'm not aware of this CCRC charging heirs any monthly maintenance fees once the owner has left the campus -- and even if they did, this would be a very minor expense given the speed in which these units are sold and the appreciation in value these units have had over the 22 years this CCRC has been in existence.

I also have LTCi, 5 year coverage, with a daily benefit of $303. My LTCi coverage would dovetail nicely with the coverage provided with this CCRC. With the CCRC, care in the SNF is free for the first 90 days, afterwards you pay a per-diem cost for care, currently $270 a day (which the CCRC says is a discounted rate). This CCRC is well versed with LTCi and would handle claims processing and advocacy for the resident. My LTCi has a 90 days elimination period and then daily benefits coverage would apply.

We're very risk adverse to LTC with parents and siblings who have had long goodbyes in skilled nursing and assisted living facilities. Our Plan A is to stay at home and receive home care if necessary. Plan B is the CCRC

Covid 19 has caused us to rethink our preferences for CCRC units. Our CCRC campus has single family homes (cottages they call them) and condos in multi-unit buildings (villas they call them). In light of Covid 19 and potential pandemics, we will try to avoid all congregate living in multi-unit housing. Covid 19 has spread like wildfire in the congregate components of virtually every CCRC, nursing home or asssited living facility in our area.

[CRLLS]

For those not aware of coverage, DMIL is starting the benefit stage of her LTCi. She needs a lot of care but wants to stay at home as long as she can. She is getting 12 hr per day care. Her cost for home care is considerably more than if she was in a facility. In addition, the LTCi pays less per day for in home care than it would for 24 hr care in a facility.

[latexman]

Dad and Mom's LTCi was my sister. Sis and her hubby lived on Dad and Mom's 40 acre farm. Dad and Mom's house was just down the hill from Sis's house, about 150 yards away. Sis paid the taxes on her tract, but no rent, for years. I thought it was a sweet deal for her for the longest time, but when Sis stepped up to help Mom and Dad and eventually quit her job for 2-3 years when they needed even more care, I realised it wasn't so sweet a deal then, and Sis was paying for the investment Mom and Dad made in her. Mom and Dad passed 4 and 3 years ago, repectively. Sis is my hero!

[Trooper]

Timely thread for DW and I. We, just last month, decided to cancel our LTC policies that we've had since 2005 (we were in our late 40s at the time).

Reasons were the same as many have indicated:
- 3rd straight annual increase of 20% or more
- Skepticism regarding insurer's willingness to pay claims should they arise
- Ability to self-insure. I'm taking my employer's moderate pension offering as a lump sum. We'll invest that and earmark it for LTC. This, plus equity in our home should be sufficient.

One item of note: We chose the "Contingent Benefit Upon Lapse" option, which allows us to stop making payments, but entitles us to a benefit equal to what we've paid in premiums thus far. If you considering canceling, ask about this.

[nwsteve]

We are in a Type A (Life Care) CCRC and moved in when we were 72 (about 2 years ago). Earlier than planned but the timing fit other desires to be closer to grandkids and being closer to an aging (95) parent.
Our property was a new build by an established Life Care Community org. so there was no wait list. One other benefit is that demographics are much younger than with established properties. Our average age is currently 78 versus the 82 at our 20 year old sister property which has a long waiting list.
Selecting a CCRC requires you to parse which type of CCRC you want. Type C is closer to rental model with moves to higher level care coming at rates closer to market driven by level of care. Only Type A (Life Care) provides no cost moves to higher level of care. Type B is more a blended model with moves from Independent Living to Assisted/Skilled Nursing/Memory at a discount to market but definitely not no cost. For example, we had a resident here who suffered a stroke and moved to Memory Care ($10000/mon market price) while his spouse remained in their IL apt. Only increment in cost was the additional cost meals served which our state mandate advance care providers deliver. He was there for about six months and was able to move back to his IL apt with his spouse due the care and medication bringing him to a manageable condition for his spouse.
Also, you find some properties are for-profit while most are non-profit. Just learn which ones are which as your long-term costs will likely to be much different.
Your upfront entry cost is greatly impacted by not only how elaborate of a property is but also how much you want to have refund (usually to your heirs). Our CCRC offered a limited refund period (5 years) and then none but also up 95%. Our heir is unlikely to need to inherit to have a good life so we chose the no refund option cut our entry cost by 40%.
CCRC are complex and offer a lot of choices of life style. Life care properties fully replace a traditional LTC policy and add so much more including immediate benefit vs waiting until you are too impaired to enjoy. It also liberates your children from the decision of where to put Mom & Dad. We preferred to make our own choice ;-)

[Koolau]

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Originally Posted by harllee Plus if your homeowners or auto policy goes up 100% (which happened to my mother's LTC policy) you can usually find another insurer at a cheaper rate--not so with a LTC policy. If you are age 80 and your LTC policy goes up 100% you cannot find another policy, there is no way to shop around, you are stuck.

Very true. In fact when our premiums for LTC almost doubled, I looked around to find another policy. All policies which even approached our coverage cost MUCH more than we were paying - even with the doubled premiums. YMMV

[RetireeRobert]

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Originally Posted by nwsteve We are in a Type A (Life Care) CCRC and moved in when we were 72 (about 2 years ago). Earlier than planned but the timing fit other desires to be closer to grandkids and being closer to an aging (95) parent. Our property was a new build by an established Life Care Community org. so there was no wait list. One other benefit is that demographics are much younger than with established properties. Our average age is currently 78 versus the 82 at our 20 year old sister property which has a long waiting list. Selecting a CCRC requires you to parse which type of CCRC you want. Type C is closer to rental model with moves to higher level care coming at rates closer to market driven by level of care. Only Type A (Life Care) provides no cost moves to higher level of care. Type B is more a blended model with moves from Independent Living to Assisted/Skilled Nursing/Memory at a discount to market but definitely not no cost. For example, we had a resident here who suffered a stroke and moved to Memory Care ($10000/mon market price) while his spouse remained in their IL apt. Only increment in cost was the additional cost meals served which our state mandate advance care providers deliver. He was there for about six months and was able to move back to his IL apt with his spouse due the care and medication bringing him to a manageable condition for his spouse. Also, you find some properties are for-profit while most are non-profit. Just learn which ones are which as your long-term costs will likely to be much different. Your upfront entry cost is greatly impacted by not only how elaborate of a property is but also how much you want to have refund (usually to your heirs). Our CCRC offered a limited refund period (5 years) and then none but also up 95%. Our heir is unlikely to need to inherit to have a good life so we chose the no refund option cut our entry cost by 40%. CCRC are complex and offer a lot of choices of life style. Life care properties fully replace a traditional LTC policy and add so much more including immediate benefit vs waiting until you are too impaired to enjoy. It also liberates your children from the decision of where to put Mom & Dad. We preferred to make our own choice ;-)

Wow! Very informative post. I see I will have to research what models CCRC's even exist here in my neck of the woods where my three kids are. Thank you for taking the time to post!

[bolt]

I always recognize the solvency of all INSURANCE providers considering so many numerous LTC/and similar insurance providers will no longer offer LTC and many have gone into bankruptcy.

LTC.....no, I do not have or believe in LTC insurance being viable.

YMMV

[ncbill]

All I can say for those buying into CCRCs is I wish them luck getting a SNF bed that's actually at the CCRC.

Over the ~25 years my grandparents lived at the local top-rated (church-run) CCRC it demolished the existing SNF and rebuilt a much smaller one...private rooms only, but maybe 1/3 the capacity of the original...grandfather never needed it but grandmother barely got into a bed there (otherwise G_d only knows where they would have put her)