LTC coverage, one real life example

The problem I have is that you can pay the lower premiums for 20+ years and then the insurance company starts raising them higher and higher as you get into your 70's. Then what do you do?

As the odds increase of needing the insurance, the price can get significantly more expensive. Getting the insurance early does not guarantee significantly cheaper premiums for as long as you live. :(

This is why I favor paid up life insurance as alternative to LTC. You know the cost at outset. You can borrow against it as needed. It remains in force-and pays off.

No surprises.
 
The problem I have is that you can pay the lower premiums for 20+ years and then the insurance company starts raising them higher and higher as you get into your 70's. Then what do you do?

As the odds increase of needing the insurance, the price can get significantly more expensive. Getting the insurance early does not guarantee significantly cheaper premiums for as long as you live. :(

This is why wife and I got hybrid single premium LTC/whole life policy that covered us both under one policy: (1) "Never" any premium increase or chance for increase; (2) never any feeling of paying for decades and "wasting" all those premium dollars---either we use the LTC benefits, or the kids get a multiple of our single premium as life insurance death benefit. Either way, the hybrid pays off.
 
This is why wife and I got hybrid single premium LTC/whole life policy that covered us both under one policy: (1) "Never" any premium increase or chance for increase; (2) never any feeling of paying for decades and "wasting" all those premium dollars---either we use the LTC benefits, or the kids get a multiple of our single premium as life insurance death benefit. Either way, the hybrid pays off.

Where is the insurance company making its profits?
 
Where is the insurance company making its profits?

Time value of money invested over some decades. "Some" of the time value of investing that upfront single premium goes to insurer. In return, we get a multiple of the single premium as either LTC benefits or kids get a multiple as death benefit. And we get the peace of mind. We cede to the insurer "some" of the time value return of investing those funds over long period.

As to self-insure, we could invest that single premium ourselves and "probably" have a larger lump after those decades. But, "probably" leaves out the chance of big market downturn(s) at just the wrong time for us. "Probably" leaves out the chance our investing skills aren't all that great over that long of a period. "Probably" leaves out the certainty a pot of money will be there for its intended purpose just when we might need it. "Probably" does not give us any peace of mind.

Insurer is also able to fairly consistently project what its claims demands will be over extended periods based on mortality tables, and what its investment returns will be over an extended period, and can average its risks over a huge pool of individual insureds to achieve that consistency. We as individuals, however, do not know if we will be here healthy for thirty more years. Or if we will need LTC care tomorrow or kick the bucket next week. Which realities makes those immediate insurance "multiples" of our single premiums, and the peace of mind, very attractive.

If you want to self insure and deny the evil insurance company some profits, so be it.
 
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This is why wife and I got hybrid single premium LTC/whole life policy that covered us both under one policy: (1) "Never" any premium increase or chance for increase; (2) never any feeling of paying for decades and "wasting" all those premium dollars---either we use the LTC benefits, or the kids get a multiple of our single premium as life insurance death benefit. Either way, the hybrid pays off.

I would assume this is more expensive than paid up life insurance. Aren't they really just repackaging a while life policy?

Apologies if I am missing something here.
 
I would assume this is more expensive than paid up life insurance. Aren't they really just repackaging a while life policy?

Apologies if I am missing something here.

Don't know there is any definitive one answer for everyone. You would have to shop the hybrid LTC/whole life policy markets and shop the paid up whole life policy markets, with your particular ages and health conditions, and desires as to amounts of longterm care coverage and life benefits, to attempt to answer whether one policy type is more expensive than the other policy type--for "you".

The particular hybrid my wife and I have I consider "not" just a repackaged whole life policy. There are lots of LTC features and attributes specifically designed into the policy. And it is a joint policy covering both wife and I, LTC benefits available to either or both of us all in one policy. And as to life, it is a second to die policy that pays out to kids (or named beneficiaries) only after demise of both wife and I. (State Life/One America is the insurer. More info/explanation here: https://www.longtermcareinsurancepa...term-care-policy-with-life-insurance-benefits )
 
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My mom became unsafe to live on her own, even living next door to my brother. She then spent almost 3 years in a nursing home. We got over 2.5 yrs of "most" of her expenses covered by the LTCI. And I think we also got some premiums refunded after she died. Dad went quicker and never drew on the policy. I think Mom got a refund on his premiums too.

In 2019 (age 62) I was talking to a LTCI agent to select a policy. Before we got the paperwork finalized, I got a prostate-cancer diagnosis. "That makes it harder," my agent said, "but not impossible. Get it treated, and 2? 3? yrs later they will consider you coverable."

5 months later I got a lymphoma diagnosis -- same stuff that killed my dad. LTCI agent said "OK, they won't touch you now."

So my LTC will have to be funded out of my estate (unless anyone knows of a better option). Hopefully I wouldn't need much. I've told my sons I do NOT want to be stuck in a nursing home if I'm unable to care for myself. (I need to set up a Living Will &etc...) In her last year or two my mom was miserable, in pain, and losing it physically & mentally. It took "two orderlies and an engine host" for her to go to the bathroom. No thanks. I'd rather check out on my own terms. Colorado has a Death with Dignity law, but it only applies within 6 months of projected death. On the other hand I could just quit taking my cancer meds, and I probably wouldn't last long after that.
 
For a single person living in a given area, what do you think the ratio of "LTC monthly budget" to "ER monthly spending" is ?

1.5 to 2.0 ?

That is, a person spending $5,000/month rent, trans, food, entertain, etc would probably be in a nursing home costing $7,500 ?

If these numbers are close, is the "nursing home risk" equivalent to ramping up SWR from 4% to 6% at end of life ?

For someone ER'ing in 50's, likely not needing nursing home for 20-30 years - I would think this is a very manageable risk.
 
OP, did her premiums she paid in through the years, was those premiums recovered from
pay out for the care she used?

So, how much did she pay and what amount did she get for care?
 
I'm interested to see the numbers, so thanks for this thread.

When you read information online, the numbers rarely reflect cost at home vs. cost in a facility, or what type of policy you have.

I was fortunate that I bought two policies, a few years apart, 10-12 years ago. I got a Hancock policy with 5% compounded, which as of 2019 was $306/day. I made sure it included home care, as that is the most important thing for me. The broker who sold it was about to have me sign a NY Life policy, when I said, "I assume this would be valid in foreign countries, right?" Whereupon he took that policy away and brought me the Hancock. Much later I read the fine print and saw that while the Hancock does give support overseas, it's about half the amount and runs out over a few years. Used in the US, my policy is open-ended. I bought it as a 10-pay, at about $10,000/year for 10 years. It is now fully paid up.

Because home care is important, I looked at costs again a couple of years later and bought a second policy. Genworth was the only place still offering 10-pays, so I got a policy that currently covers $140/day. Open-ended, but no overseas coverage at all. I have one more payment to make on it, in about a month. (It used to be $6,000+ per year, and now is $9,000+.)

Both have 90-day delays, though the Genworth agent told me the delay does not apply to at-home care.

I was feeling pretty good about this ("I'm over-insured! Go me! I'll never have to worry about this"). Then about three years ago I reviewed my coverage and realized that both policies together would only cover about 14 hours a day in my home, leaving ten hours for me to scramble to fill as I burnt through money at a fast clip. I then went on a deep dive, looking at various hybrid vehicles, with particular attention to those that operate globally. I also learned from an expert that there are two main types of LTC policies: one is called "reimbursement" (the sort I had with Hancock and Genworth, in which you have to hire qualified (according to the company) help and have them submit hours for repayment; this can lead to all sorts of paperwork delays). There's another type of policy where, if you qualify for LTC, you're given the money and spend it however you need to. Hire whomever you like. (I believe these are referred to as "indemnity only.")

This is useful for a number of reasons, one being that as we get older it may become harder to find help that qualifies, especially if you don't live in a major city. (Too many boomers, too few qualified caregivers.) This way you can hire someone who lives down the street, if you don't need very specialized care all the time.

And there were indemnity-only hybrid policies that were good overseas, so it left options open.

I dithered for quite a while over the possibilities, too busy with my job to finalize anything. Along the way, an agent pointed out a couple of things: first, I had 5% compounding, so my care might cover more hours 20 years from now. Second, there are unofficial things people do to stretch into the hours LTC does not cover. For instance, you could offer a room in your house to someone who agrees to act as a caregiver, and they could cover the night hours when you might not need as much assistance.

So for the moment I've left it at the two policies. And when I relocate, I want a house that I can share with at least one roommate and still have a room for a caregiver.
 
My husband I bought a policy through JC Penny's in1993 with a 5 % inflation rider. It saved our finances when my late husband had to go in a nursing home. Since
1993 the policy has been sold several times, currently Transamerica Life Insurance Co. and the premiums have increased several times to $155/month. Apparently this is too good of a policy and I have 5 lbs. of confusing papers . It's for a REHABILATION PLAN (SHIP)."Rehabilitation is a court supervised process intended to remedy the company's financial deterioration for the benefit of policyholders and creditors ....etc." From trying to understand all the papers which talk about different policies -eventually the options will be higher premiums with less benefits. In the meantime they want you to continue making your monthly payments. Does anyone know about this?
 
I'm interested to see the numbers, so thanks for this thread.

When you read information online, the numbers rarely reflect cost at home vs. cost in a facility, or what type of policy you have.

I was fortunate that I bought two policies, a few years apart, 10-12 years ago. I got a Hancock policy with 5% compounded, which as of 2019 was $306/day. I made sure it included home care, as that is the most important thing for me. The broker who sold it was about to have me sign a NY Life policy, when I said, "I assume this would be valid in foreign countries, right?" Whereupon he took that policy away and brought me the Hancock. Much later I read the fine print and saw that while the Hancock does give support overseas, it's about half the amount and runs out over a few years. Used in the US, my policy is open-ended. I bought it as a 10-pay, at about $10,000/year for 10 years. It is now fully paid up.

Because home care is important, I looked at costs again a couple of years later and bought a second policy. Genworth was the only place still offering 10-pays, so I got a policy that currently covers $140/day. Open-ended, but no overseas coverage at all. I have one more payment to make on it, in about a month. (It used to be $6,000+ per year, and now is $9,000+.)

Both have 90-day delays, though the Genworth agent told me the delay does not apply to at-home care.

I was feeling pretty good about this ("I'm over-insured! Go me! I'll never have to worry about this"). Then about three years ago I reviewed my coverage and realized that both policies together would only cover about 14 hours a day in my home, leaving ten hours for me to scramble to fill as I burnt through money at a fast clip. I then went on a deep dive, looking at various hybrid vehicles, with particular attention to those that operate globally. I also learned from an expert that there are two main types of LTC policies: one is called "reimbursement" (the sort I had with Hancock and Genworth, in which you have to hire qualified (according to the company) help and have them submit hours for repayment; this can lead to all sorts of paperwork delays). There's another type of policy where, if you qualify for LTC, you're given the money and spend it however you need to. Hire whomever you like. (I believe these are referred to as "indemnity only.")

This is useful for a number of reasons, one being that as we get older it may become harder to find help that qualifies, especially if you don't live in a major city. (Too many boomers, too few qualified caregivers.) This way you can hire someone who lives down the street, if you don't need very specialized care all the time.

And there were indemnity-only hybrid policies that were good overseas, so it left options open.

I dithered for quite a while over the possibilities, too busy with my job to finalize anything. Along the way, an agent pointed out a couple of things: first, I had 5% compounding, so my care might cover more hours 20 years from now. Second, there are unofficial things people do to stretch into the hours LTC does not cover. For instance, you could offer a room in your house to someone who agrees to act as a caregiver, and they could cover the night hours when you might not need as much assistance.

So for the moment I've left it at the two policies. And when I relocate, I want a house that I can share with at least one roommate and still have a room for a caregiver.

With your 2 policies, you are in good shape. As long as you have some room in your investments to fund the difference between 24x7 home care and what these 2 policies pay, you really don't need a 3rd policy. I wouldn't hire someone down the street as if you hire the wrong person, you end up being responsible for when they get hurt and IRS comes after you for not having paid employment taxes and workers compensation.

My Genworth policy does pay 75% benefits when approved and is not based on reimbursement if claiming / living overseas. I have no intention of living outside of the US but it is a good policy for people who contemplate retiring in another country.
 
...you lose if you die without fully utilizing what you have paid into. For those who manage to use it for far more that have been paid into win big. Oh, that is also called insurance.
I win if I die without entering a care facility. In 2018 and 2020, I visited my mother in a memory care unit and spent a few days living in a high-end assisted living community with a friend.

The assisted living community was nice, but by the time you get there, you probably can't drive, don't have any freedom, and end up eating in most of the time. My friend was in early stage dementia. I felt really bad for her when they locked the place down when COVID hit, as the only thing that made it tolerable for her was interacting with other residents and playing cards. After they locked it down, she couldn't see her friends there, eat with her friends, enjoy the theater, rec room, pool, bar or gym.

My mom paid into LTC insurance until she finally realized that she couldn't afford to make the payments, after paying probably $20K into the system. She entered the memory care unit after breaking her pelvis, going to the hospital, and then going to rehab. She was there about 6 weeks, and it cost around $8K. If she had kept the LTC, she wouldn't have outlived the waiting period. While she planned to have LTC insurance, when the time to go to the facility came, with her dementia, she didn't see the need, and resisted until she ended up breaking her pelvis and had no choice. I had hired in-home care for her, but she fired those folks.
 
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I had hired in-home care for her, but she fired those folks.

We saw that all the time. Most of the time they didn't want the aides because they cost money. Having LTCI does help with that mindset. With dementia, some don't respond well to having other people around.
 
With dementia, some don't respond well to having other people around.
Yes. She had a friend who was helping her go to doctor's appointments, with bill paying, and grocery shopping. My mom thought she was bossy and trying to control her life. My mom became hostile to people trying to help, or 'interfere' in her life. In her mind, she was fully self-sufficient. She wasn't, and was such a hazard to herself that a care worker removed the stove knobs so she wouldn't burn the house down. My mom didn't realize that without her friend's help, she would have ended up in a care facility at least a year earlier. I kept reiterating that point, but it was pointless, as she'd forget within minutes.
 
I opted for group LTCi through our state PERS plan. Daily benefits started at $200/day for nursing home care, with simple 5% inflation. Currently, our daily benefit is at $270/day. There is a 90 day deductible. Benefits will last for around 4 years, assuming payout at the maximum. Premiums for both of us are about $300 and have not increased over the past 7 years. Our reason for getting coverage was that LTC would leave the surviving spouse destitute.
 
I will have to look up our details. As Federal employees, we bought a level premium with inflation protection - the only wrinkle is that the contact gets re- negotiated every seven years and it has been hard to find an underwriter . Since we bought our policies when we were 40- they will probably be up again many times. Each time we have been offered either same premium with a slight reduction in benefits or same benefits with an increase. If neither of us ever has to use it, I will say we won.
 
OP, did her premiums she paid in through the years, was those premiums recovered from
pay out for the care she used?

So, how much did she pay and what amount did she get for care?

Street, sorry, I don't have those numbers and don't know how long she had been paying. I think her husband also had a LTCI policy. He did not collect as he never needed care beyond what MIL provided at that time. He lasted less than 24 hrs once he was put into hospice care.

This thread has moved a bit from my original intention. I had read a lot of threads over the years of the existence of LTCI as if it were just one entity with one set of conditions. With this recent situation with MIL, I thought I would share actual numbers as they applied to her plan, her choices and the alternate options she had. That is about all. It has now moved on to whether LTCI is was win or lose financial decision and other EOL stories. That is fine as all discussion is healthy, generally.
 
I've been thinking about LTCI lately and wanted to ask the group when the right time to buy is.

DW and I are 49 and 44, respectively. Is that too young, meaning the reduced premiums will not make up for the longer time I'd be paying? Do I need to buy before I FIRE; does employment matter?


DW and I got our LTCI before either one of us was 50. Good thing for me, as I had a major heart attack at 51. Since then, as everyone knows, the LTCI market have been in mild convulsions. We have hung on the to plans through all the adjustments, because we viewed them as insurance for things like a permanent and disabling injury from severe car crashes. There are so many terrible injuries from car crashes. So the old plans, before the cutbacks, were just fine for catastrophic insurance as we were younger. As we get older now (both in mid 60's) we hopefully don't need the extensive plans that we used to have, before the cutbacks by the companies. We plan on going with the home care options as long as we are both alive. If one of us dies, the other will be off to assisted living, if they still have that then.
 
FYI, we have recently jumped into an LTC policy ( pure "traditional" ins, not a "hybrid" life ins combo ) with a company that allows options like:
* 180 day elimination period
* single premium/one-and-done
* 10 yr premium/done paying after 10 yrs
Wanted to let folks know that those kind of options still exist to reduce premiums and potential increases.
 
FYI, we have recently jumped into an LTC policy ( pure "traditional" ins, not a "hybrid" life ins combo ) with a company that allows options like:
* 180 day elimination period
* single premium/one-and-done
* 10 yr premium/done paying after 10 yrs
Wanted to let folks know that those kind of options still exist to reduce premiums and potential increases.

Who is the insurer with these options?
 

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