Long Term Care Insurance - my experience

[NoEZmoney]

LTC - 6 to 9 months on average

Statistically most people who enter LTC facility wind up using 6 to 9 months before the big "Check Out". Reason being according to some nurses I know have told me LTC residents are usually in such health decline that they will be passing in less than a year. Of course this isn't the case for everyone but a sizeable majority don't last real long when they've reached that LTC need.

Had a aunt who paid premiums for many, many years and wound up using less than two years of benefit. Another relative, elderly uncle paid a ton over the years and spent less than 8 months. So the LTC Insurance companies made out like bandits on these two.

I've run across the odd story where someone's mom needed full-time care earlier b/c of debilitating stroke and early onset dementia but those are the lesser of what I've personally come across.

As for me and DW, we will do our best to stay healthy, have a set-aside fund for home health, and when time comes, likely will be in the 6 to 9 month program before checking out.

 

[Koolau]

Statistically most people who enter LTC facility wind up using 6 to 9 months before the big "Check Out". Had a aunt who paid premiums for many, many years and wound up using less than two years of benefit. Another relative, elderly uncle paid a ton over the years and spent less than 8 months. So the LTC Insurance companies made out like bandits on these two.

I've run across the odd story where someone's mom needed full-time care earlier b/c of debilitating stroke and early onset dementia but those are the lesser of what I've personally come across.

As for me and DW, we will do our best to stay healthy, have a set-aside fund for home health, and when time comes, likely will be in the 6 to 9 month program before checking out.

My mom and dad did it just right. Dad had no LTCi and stayed 3 months. Mom had a 2 year LTCi policy and stayed 26 months. YMMV

 

[lucky penny]

Statistically most people who enter LTC facility wind up using 6 to 9 months before the big "Check Out". Reason being according to some nurses I know have told me LTC residents are usually in such health decline that they will be passing in less than a year. Of course this isn't the case for everyone but a sizeable majority don't last real long when they've reached that LTC need.

Does LTC insurance cover people with dementia who need long-term Memory Care? That seems like a situation where having insurance could be extremely valuable.

 

[RetiredHappy]

Does LTC insurance cover people with dementia who need long-term Memory Care? That seems like a situation where having insurance could be extremely valuable.

The short answer is yes. The long answer is that someone in early stages of dementia is unlikely to qualify yet. A typical duration of Alzheimers runs about 8 years before they pass.
https://www.alzheimers.org.uk/about...for the most common types,15 or even 20 years.

 

[Koolau]

Does LTC insurance cover people with dementia who need long-term Memory Care? That seems like a situation where having insurance could be extremely valuable.

Most policies are written in terms of what specific needs a person has (do they need assistance in toileting, dressing, bathing, eating, etc.) "Simple" memory issues only qualify if they affect these daily activities of life.



My mom was admitted to memory care because she could no longer take care of herself - not memory issues per se. She died, however, from COPD in just over 2 years.

 

[harllee]

Does LTC insurance cover people with dementia who need long-term Memory Care? That seems like a situation where having insurance could be extremely valuable.

That is what I am battling my mom's LTC insurance about right now. She has dementia. Her doctor says the dementia is severe enough she needs caretakers. Insurance company says her dementia is not severe enough for them to pay because she can still go the the bathroom and lift a spoon to her mouth if food is placed in front of her.

For all you folks with LTC insurance you better plan on having someone in your family who devote many hours per week for months trying to get the insurance to pay.

 

[lucky penny]

That is what I am battling my mom's LTC insurance about right now. She has dementia. Her doctor says the dementia is severe enough she needs caretakers. Insurance company says her dementia is not severe enough for them to pay because she can still go the the bathroom and lift a spoon to her mouth if food is placed in front of her.

For all you folks with LTC insurance you better plan on having someone in your family who devote many hours per week for months trying to get the insurance to pay.

This definitely sounds like care that could or should be covered. Does your mother need 24-hour care, like making sure she doesn't wander, preparing meals, & cleaning? It makes me wonder whether other policies have different criteria that would include things like that.

 

[ncbill]

I'm buying LTCi so hopefully I can stay home (or in an ALF) as long as possible.

Home care specifically to assist my spouse...the spouse normally gets stuck providing all the care & that often trashes their health.

Like I said, my HCPOA is strict enough that I hope it's quicker for me than it was for mom.

 

[harllee]

This definitely sounds like care that could or should be covered. Does your mother need 24-hour care, like making sure she doesn't wander, preparing meals, & cleaning? It makes me wonder whether other policies have different criteria that would include things like that.

She does not need 24 hour care yet, just morning and evening. Her policy provides for reimbursement of in home caretakers but the insurance company is making it impossible to qualify for that. If mother lives long enough she will have to go to memory care and maybe the policy will pay some on that but I doubt if she lives that long, she has heart failure as well and dementia. I think the insurance company is delaying payment in the hope that she will die before they have to pay anything.

 

[harllee]

I'm buying LTCi so hopefully I can stay home (or in an ALF) as long as possible.

Home care specifically to assist my spouse...the spouse normally gets stuck providing all the care & that often trashes their health.

Like I said, my HCPOA is strict enough that I hope it's quicker for me than it was for mom.

Be sure you carefully read the policy provisions about how to qualify for home care. My mother's insurance company has denied the home care claim.

 

[ncbill]

Be sure you carefully read the policy provisions about how to qualify for home care. My mother's insurance company has denied the home care claim.

Over on bogleheads forums one of the posters who sells LTCi recommends the home health care agency handles the claim from the start.

 

[harllee]

Over on bogleheads forums one of the posters who sells LTCi recommends the home health care agency handles the claim from the start.

Mother is in a CCRC (they furnish the caregivers) and they have helped me with the claim but the LTC insurance company still rejected the claim. I am now working with a consultant. The CCRC and the consultant have told me that most claims for payment of home health care are getting turned down by the LTC insurance companies.

 

[RetiredHappy]

Over on bogleheads forums one of the posters who sells LTCi recommends the home health care agency handles the claim from the start.

We had helped our clients with LTCI with the claims and had never had a rejection in the 8 years that we were in the home care business, until we sold and retired. 40% of our clients had LTCI.