LTC policy for retirees??

COcheesehead said:
The LTC rider that I have is pretty clear on when payments start. They are called ADL’s, Activities of Daily Living and are very common in medical insurance. They involve the ability of the patient to bath or use the bathroom, eat, etc. Once any one of the seven cannot be performed, payments can start.
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They've been known to play with that one too. Like medical insurance. You need a drug or procedure but the insurance company thinks you don't. Can't eat? Eat slower. Have meals delivered. We think you can do it if you tried harder, so we won't pay. I still wouldn't trust them even if "you get it in writing" because the writing always A) favors their position and B) Is left up to their interpretation. Or at least that's how they'll stonewall it even if they know eventually they'll have to pay.
 
COcheesehead said:
The LTC rider that I have is pretty clear on when payments start. They are called ADL’s, Activities of Daily Living and are very common in medical insurance. They involve the ability of the patient to bath or use the bathroom, eat, etc. Once any one of the seven cannot be performed, payments can start.
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We have one poster who was denied because even though their parent could not get up from the toilet without assistance, the insurance company claimed the parent was still able to use the toilet. Cr@p like this is apparently very common.
 
Brat said:
imoldernu, doesn't your policy have a % benefit increase yearly? Ours is 5%.
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At the time we bought, we had the choice of a benefit increase, but never considered it. To bring the benefit to $200/day would mean more tripling our annual fee if we did it today. We're just going with the odds.

SHIP is a non profit Health Insurance Company out of Pennsylvania. Price of benefits is controlled by an involved legal document that means that prices can change only under certain defined situations, which have only changed once, about ten years ago.

Senior Health Insurance Company of Pennsylvania (SHIP). We are focused exclusively on providing high quality service and meeting the Long Term Care policy commitments of our policyholders. Senior Health Insurance Company of Pennsylvania operates without the objective of a profit, which means that customer premiums are applied to supporting service and claims, rather than returning a profit to shareholders of a corporation. In fact, Senior Health Insurance Company of Pennsylvania is owned by an independent Trust, created by the Pennsylvania Insurance Department to ensure that its mission is supported. We invite you to read more about our company, the Trust, and our exclusive commitment - to serve you, our policyholders.
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We "self insure" also but that term is a little misleading since there is no risk-pool, or it is a pool of one, just us. So what really happens with self-insuring is first you hope you never need LTC, but if you do, you just have to pay the bills.

We do not have a special bucket for LTC costs, if they should arrive. It will be another expense so will be paid like all other expenses, out of our portfolio. We do however make sure we have sufficient liquidity so that we are not forced to sell an asset that is under water.

This issue with LTC is why I don't agree with the notion that you can stop playing once you have "won" the game. LTC is the wild card that means you never know if you have won or not and basically have to keep playing to some degree.
 
razztazz said:
They've been known to play with that one too. Like medical insurance. You need a drug or procedure but the insurance company thinks you don't. Can't eat? Eat slower. Have meals delivered. We think you can do it if you tried harder, so we won't pay. I still wouldn't trust them even if "you get it in writing" because the writing always A) favors their position and B) Is left up to their interpretation. Or at least that's how they'll stonewall it even if they know eventually they'll have to pay.
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I guess worst case, I still can pull the cash out of the policy. Trying doing that with regular LTC insurance. :LOL:
 
LTC

Health care & Medicare changes continue to drive personal care out of the NH facilities to home care and assisted living facilities. CMS is pushing for more services in home as older adults want to "age in place".

As DH and I age, this type of care will be more common so we are self-insuring or explore non- profit CCRC where my aunt lives.
 
REWahoo said:
Clif, after Nords documented his saga with his dad's LTC insurer I contacted the elder law attorney who did our estate planning to see if she did that sort of work. She recommended using the services of a local medical claims professional who who specializes in jumping through the required hoops to get insurance companies to pay up.

Based on that, I informed my two smart kids to contact one of these folks and use ther services if DW or I ever needed to use our LTC policy and they had trouble getting claims paid. Alliance of Claims Assistance Professionals (ACAP)
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I really think a health advocate is a good idea. We move my mom into memory care this year, assisted living last year, and for the previous 3 or 4 years, she's had increasing amounts of care. Without family members around or some type of advocate, I could easily see how we could have been in catch-22 situation.

If she started asking for the LTC to kick in 5 or 6 years ago when she started to get care while she was physically and mentally able to advocate for herself, they very well may have turned her down. Certainly this year and very likely last year she would have been too confused to figure out how to file a claim.
 
joeea said:
How much have you set aside for LTC use?
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The only assets specifically earmarked are our HSAs which are currently about $86,000. Rest would be from general funds, but our SWR is about 150% of our actual spending so t here is some leeway for adverse experience.
 
My wife and I bought it when both of us were under 50. I cancelled mine about 4-5 years later. She still has hers but is about to cancel and switch to a new type that upon death still pays out all the original principal paid in plus a few percent interest to her designated beneficiaries.
 
clifp said:
I really think a health advocate is a good idea. We move my mom into memory care this year, assisted living last year, and for the previous 3 or 4 years, she's had increasing amounts of care. Without family members around or some type of advocate, I could easily see how we could have been in catch-22 situation.

If she started asking for the LTC to kick in 5 or 6 years ago when she started to get care while she was physically and mentally able to advocate for herself, they very well may have turned her down. Certainly this year and very likely last year she would have been too confused to figure out how to file a claim.
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Yep. The issue with my father's first denial of LTC is that he didn't precisely need help with the activities of daily living as "clearly" defined by the policy. However he equally clearly could no longer live independently. This whole issue arose because my father ended up in the hospital with a perforated ulcer (caused by self-imposed malnutrition). The doctor who saved his life even documented a diagnosis of Alzheimer's based on his interviews of my father.

The second issue is that he kept passing the mini mental state exam. This is quite common among dementia patients. In my father's case, he could still pass it even after his LTC insurance policy ran out. *

The key to getting John Hancock to pay out was having my father interviewed by a neuropsychologist. It took a couple hours to do and another couple weeks to write up. Among other things he asked my father to draw an analog clock and show a certain time on the clock, what my father would do if a fire broke out in his kitchen, and how he'd dial 911. Due to early-stage dementia, my father failed all of those tests-- even when the doctor handed him a desk telephone to dial 911. That exam (which cost $3670) was also necessary for the probate court to agree to my petition to become Dad's conservator.

Getting the LTC claim approved was bad enough, but the payout was worse. Hancock consistently found the most inconvenient ways to process the paperwork and couldn't even track their own payment process. Fraud may be illegal, but apparently incompetence is not.

I'm a fairly high-functioning guy and yet I found the LTC policy claims process (and monthly reimbursements) to be highly stressful. I can only imagine what the average elder spouse/caretaker has to go through. I'm not subjecting my family members to that. We're self-insured.
https://the-military-guide.com/wont-buy-long-term-care-insurance/



* [Dad was an electrical engineer and a Westinghouse sales guy during his working years. In early-stage dementia he still had enough cognitive reserve to make a good impression of articulate competence, but he couldn't handle his affairs.
For his first three years in the care facility, he was the "street mayor" who could carry on a conversation with the other patients ("How do you feel today?") to the point where other patients' families thought he was on the facility's staff. He could carry on a coffeehouse conversation for 20 minutes before he started repeating himself.
When I was with him in the Grand Junction hospital, I made friends with the medical staff (macadamia nuts and Kona coffee) and we got to know each other. A nurse walked into Dad's room one day, saw me sitting there, and asked him: "Are you enjoying having your son visit with you?" Dad had already forgotten who I was, and he responded to her question with pride: "I have two sons. My younger one lives in Denver, and he's a good boy. My older son, Doug, lives in Hawaii-- and he's one smart sonofabitch!"]
 
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She still has hers but is about to cancel and switch to a new type that upon death still pays out all the original principal paid in plus a few percent interest to her designated beneficiaries.
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Was this her idea to buy this "new type" or did she receive the assistance from a LTCi salesman?
 
My older son, Doug, lives in Hawaii-- and he's one smart sonofabitch!"
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Well, your dad didn't forget everything.

A few other thoughts on cognitive tests that I think are going to be applicable to most folks on this forum.

My BIL, age 75, has recently been diagnosed with early-stage dementia. My sister has been sure it has been going on for 3+ years and the rest of the family maybe 1-2 years.

My BIL, like Nord and his dad, is a smart sonofabitch. A mechanical engineer, who built rockets, and later worked on nuclear submarines he was thesis short of Ph.D. in Economics. He was one of those disgusting people, that could do seemingly anything well from playing golf, to guitar, plumbing, building an elaborate cattery, navigating the Pacific on a sailboat, using only a sexton. He also could have held his own on the investment forum, he also retired early twice (a little too optimistic on his ability to make alpha on investing, but this was decades before the Trinity study).

My sister had him seen by several neuropyschologist over the last few years, up until recently he easily passed the test they gave him. The analog clock thing screwed him up also. The problem is the baseline for these test is the population as whole. In a world, where we all shake our head at sale clerks who freak out after we hand them a $20 and them a $1.30 worth of change to a $16.30 bill, a smart person who loses 30-40 IQ points due to dementia is now merely average.
 
A close friend of mine was brilliant and got it young in her 50's. When she finally had a evaluation at 62 she couldn't draw a clock and show the right time and thought Kennedy was president. Her husband was in denial for a long time.
 
clifp said:
Well, your dad didn't forget everything.

A few other thoughts on cognitive tests that I think are going to be applicable to most folks on this forum.

My BIL, age 75, has recently been diagnosed with early-stage dementia. My sister has been sure it has been going on for 3+ years and the rest of the family maybe 1-2 years.

My BIL, like Nord and his dad, is a smart sonofabitch. A mechanical engineer, who built rockets, and later worked on nuclear submarines he was thesis short of Ph.D. in Economics. He was one of those disgusting people, that could do seemingly anything well from playing golf, to guitar, plumbing, building an elaborate cattery, navigating the Pacific on a sailboat, using only a sexton. He also could have held his own on the investment forum, he also retired early twice (a little too optimistic on his ability to make alpha on investing, but this was decades before the Trinity study).

My sister had him seen by several neuropyschologist over the last few years, up until recently he easily passed the test they gave him. The analog clock thing screwed him up also. The problem is the baseline for these test is the population as whole. In a world, where we all shake our head at sale clerks who freak out after we hand them a $20 and them a $1.30 worth of change to a $16.30 bill, a smart person who loses 30-40 IQ points due to dementia is now merely average.
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Two of my best friends are sliding down this slope as we speak. One can't remember what we did together yesterday and the other can't complete a sentence. I am two years older than both of them and it's driving me crazy to spend time with them without getting frustrated.
 
My friend could only talk about the past. I heard the same story over and over. It’s a gift you give your friends.
 
joeea said:
That's not really the way it works.
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Really, why not? My understanding is that dementia impact higher cognitive functions first (so things like being able to have a casual conversation tend to be the last thing to go) Where as stuff with abstract reasoning, like math and money go first.
 
clifp said:
Really, why not? My understanding is that dementia impact higher cognitive functions first (so things like being able to have a casual conversation tend to be the last thing to go) Where as stuff with abstract reasoning, like math and money go first.
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I'm watching a relative loose it. But she seems to have used lists most of her life. She had a PhD in Education and taught higher level math in High School. But I can't remember her solving math problems. Not something one does at a casual get together.

Come to think of it I have not solved systems of partial differential equations in quite a while. Am I loosing it? Or do I just not use it in RE?

Things like math abilities degrade with people use of calculators and other devices/programs that do the work for you. It might not be mental degradation in general, but just natural loss due to lack of use. Now when someone who has used analog clocks all their life can't tell time.... that is a bad sign. But kids today who may have only used digital clocks may not understand the analog clock.

Early on it can be difficult to identify by casual observation.
 
bingybear said:
I'm watching a relative loose it. But she seems to have used lists most of her life. She had a PhD in Education and taught higher level math in High School. But I can't remember her solving math problems. Not something one does at a casual get together.

Come to think of it I have not solved systems of partial differential equations in quite a while. Am I loosing it? Or do I just not use it in RE?

Things like math abilities degrade with people use of calculators and other devices/programs that do the work for you. It might not be mental degradation in general, but just natural loss due to lack of use. Now when someone who has used analog clocks all their life can't tell time.... that is a bad sign. But kids today who may have only used digital clocks may not understand the analog clock.

Early on it can be difficult to identify by casual observation.
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I've thought this about google, Alexa, GPS and not using maps and information at our fingertips. We don't have to think about solving problems anymore. My GP told me it's good for your brain to go get lost and find your way back. Easy to do around here in farmland and country roads. Those murder mystery, find the bomb type clue games are becoming popular. We played one against the clock with my family. It wasn't cheap, but we had a blast and I found family members I thought were dumb, were really smart.
 
clifp said:
Really, why not? My understanding is that dementia impact higher cognitive functions first (so things like being able to have a casual conversation tend to be the last thing to go) Where as stuff with abstract reasoning, like math and money go first.
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There are no cases where a "smart person" with dementia turns into a "normal person". As I said, it simply doesn't work that way.

If you really want to know "why" you'll have to study a lot and learn about IQ. Then you'll have to learn about the effects of dementia.
 
joeea said:
There are no cases where a "smart person" with dementia turns into a "normal person". As I said, it simply doesn't work that way.

If you really want to know "why" you'll have to study a lot and learn about IQ. Then you'll have to learn about the effects of dementia.
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Well, that's not what that Neuropsychologist told my sister when Bil passed the math and logic test, and she said well he used to be lightning fast with these things. He said if he was a very good math, his decline could be significant but still be able to past the test.

I've read extensively on IQ, and with two grandparents, both parents, and now a BIL suffering from dementia (fortunately not all Alzheimers) also sadly have had to read plenty about Alzheimer's and dementia.

The great thing about ER board is there are plenty of subject matter experts on things from banking, nuclear engineering, policing and more than a few doctors and lawyers on the board. So I'm happy to learn from them.

But the answer to why, I'm wrong? Isn't "oh go learn more."
 
Just finished writing the check for my annual LTC premium payment.

Every year, I get a feeling of buyer's remorse. Like damned if I do, damned if I don't have LTC coverage.

I get about as much satisfaction paying a LTC premium as I do writing a check for a speeding ticket :(.
 
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