Long term care insurance

[hillview]

I am considering this for my parents. Anyone an expert? They have NO money to their name, they live with us. We would be hard pressed to afford a good nursing home for them yet would not be great with a sub par home for them either. Anyone btdt?
/hillary

[sste]

Hillview, not expert but I think, as things stand (and of course there could be medicaid cuts, etc), that having no money to your name is a GREAT thing for nursing home care. Most elderly have to "spend down" their assets before they qualify for government assistance. Just make sure your parents aren't or don't become your legal dependents . . .

[BillK]

Find an agent near you that sells GE (called Genworth now) or John Hancock Long Term Care. Those 2 are normally picked as the best ones out there. That agent should be able to advise you about what daily benefit limit and riders to choose.

[hillview]

Find an agent near you that sells GE (called Genworth now) or John Hancock Long Term Care. Those 2 are normally picked as the best ones out there. That agent should be able to advise you about what daily benefit limit and riders to choose.

Thanks Bill!
/hillary

[hillview]

Hillview, not expert but I think, as things stand (and of course there could be medicaid cuts, etc), that having no money to your name is a GREAT thing for nursing home care. Most elderly have to "spend down" their assets before they qualify for government assistance. Just make sure your parents aren't or don't become your legal dependents . . .

Right that is a good thing however not sure how happy it would be with just gov't options?
/hillary

[LMPC]

I know you are in a different part of the country, but pre-DD I worked as a psychologist in several assisted living facilities and long term care facilities. They all accepted medicaid. Some were bad but some were very very good. It might be worth a peak at what their choices would be if they went the medicaid route. Also, my mom does assessments for long term care insurance. It's not always easy to get. There are several common issues (e.g., A-fib) that can keep you from being able to get a policy. Sorry, I don't mean to sound like a downer with that last comment....

[marge234]

No answers, just info FWIW. http://www.nytimes.com/2010/11/05/business/businessspecial5/05CARE.html?pagewanted=1&ref=business&src=me

[hillview]

There are several common issues (e.g., A-fib)
What is A-Fib?
NEVER MIND -- i found it thanks.
/hillary

[LMPC]

What is A-Fib?
NEVER MIND -- i found it thanks.
/hillary

Sorry, I was afraid that I would misspell Atrial fibrillation :bag

[ShanaMama]

I know you are in a different part of the country, but pre-DD I worked as a psychologist in several assisted living facilities and long term care facilities. They all accepted medicaid. Some were bad but some were very very good. It might be worth a peak at what their choices would be if they went the medicaid route. Also, my mom does assessments for long term care insurance. It's not always easy to get. There are several common issues (e.g., A-fib) that can keep you from being able to get a policy. Sorry, I don't mean to sound like a downer with that last comment....

I work in nursing home medical billing. I agree with the pp who said that someone who has no money is in a simpler position than someone who has assets. The question is what you are trying to anticipate. IME LTC insurance can be helpful for short stays in a nursing home for rehab (which Medicare often covers in part). If you are thinking about true long term care (as in long term to end of life...) most people are going to end up needing Medicaid eventually. It sounds terrible & these are very hard decisions to make. It varies by state & obviously the details of every situation are different, but to completely oversimplify things: If someone has assets and needs to be in a nursing facility long term, they will have to spend down/ liquidate their assets until there is no more money & then the government will kick in. (Policy differs by state regarding property & life insurance, but cash & CD's, annuities, etc always have to be spent down.)
I don't know how helpful long term care insurance is going to be if one of them needs to be in a facility for long term. I'll be happy to give you more info- if this wasn't already overkill! If you want specifics, feel free to PM me.
Two things to remember: 1. You never have to use your money to pay for their care. (meaning if their money is gone you can apply for Medicaid, regardless of your financial status.) Children sometimes assume that they need to pay their parents' bills. 2. If you have the slightest thought that they may need Medicaid in the future, find out the regulations now. In NY & NJ the regulations currently call for a 5 year lookback of bank statements & every transaction will be examined.

There are some facilities that don't take Medicaid, but many many very good nursing homes take Medicaid. Most will assist you with the application process if your parent already resides there.

[HIU8]

Also, if you look at policies for in-home nursing/aide care, there will be differences in policies where you have to wait 14 days, 100 days, 0 days from an illness for your policy to begin. FWIW, FIL bought himself and MIL policies YEARS ago. MIL needed in home care when she fell and broke her heel. The wait for services to start was 100 days. OTOH, my mother has a newer policy with a higher premium. Her wait is 0 days.

[HannaAddict]

I am not an expert, but true long term care insurance is very expensive to buy if you are anywhere close to needing it (over 50 I believe it goes up quite dramatically). It makes sense to talk to an estate planning attorney or attorney specializing in elder issues if there are any assets, in order to plan for the look back for Medicaid coverage, as another poster mentioned.

[hillview]

Thanks all!
/hillary

[ThreeofUs]

ITA with PP's. LTC ins is well worth it for short-term (a couple of years or less) stays for problems like broken bones, strokes - things that will send you to a rehab facility. Nursing home stays are different.

[kam]

Just to disagree with some of the PPs -- My parents bought LTC insurance, and it cost a FORTUNE. (6 figures, paid over a few years). BUT it will cover everything, not just the short term care described by some PPs. Absolutely everything with a 0 day wait before it kicks in. They researched it thoroughly with their financial planner, estate planning attorneys and insurance broker. They will not pay a dime for 24-hour in-home care, top of the line nursing home care, etc.

However, the reason they bought it was to protect their estate -- they didn't want to run it down to pay for care. (What if one got seriously ill before the other and used most of their assets? Then the living spouse wouldn't have anything, etc. They also want to leave an estate for children/grandkids.) They're really lucky to have this "problem."

I'm not sure I'd know the value of it for other reasons. The gold-plated plans are ridiculously expensive, and if you have no/limited assets, then the Medicare/Medicaid plans pay for everything anyway. Like PPs said, I'd talk to a good insurance broker/estate planner/elder care attorney about the types of plans available and the value to you and your parents.

[Binkandabee]

Just to disagree with some of the PPs -- My parents bought LTC insurance, and it cost a FORTUNE. (6 figures, paid over a few years). BUT it will cover everything, not just the short term care described by some PPs. Absolutely everything with a 0 day wait before it kicks in. They researched it thoroughly with their financial planner, estate planning attorneys and insurance broker. They will not pay a dime for 24-hour in-home care, top of the line nursing home care, etc.

However, the reason they bought it was to protect their estate -- they didn't want to run it down to pay for care. (What if one got seriously ill before the other and used most of their assets? Then the living spouse wouldn't have anything, etc. They also want to leave an estate for children/grandkids.) They're really lucky to have this "problem."

I'm not sure I'd know the value of it for other reasons. The gold-plated plans are ridiculously expensive, and if you have no/limited assets, then the Medicare/Medicaid plans pay for everything anyway. Like PPs said, I'd talk to a good insurance broker/estate planner/elder care attorney about the types of plans available and the value to you and your parents.

The situation the OP is talking about is different, though. It sounds like they don't have much of an estate, so in that situation it doesn't make sense to buy LTC when Medicaid will likely cover it. Where there are assets to protect, LTC insurance is a great idea. But where there aren't, it doesn't make financial sense.

[kam]

The situation the OP is talking about is different, though. It sounds like they don't have much of an estate, so in that situation it doesn't make sense to buy LTC when Medicaid will likely cover it. Where there are assets to protect, LTC insurance is a great idea. But where there aren't, it doesn't make financial sense.

:yeahthat: In my long winded way, that's what I was trying to say!

[kijip]

I would familiarize yourself with the options available to medicaid patients in your area, now before you need nursing care. My mother was on medicaid and the options for her were excellent, however we opted to keep her at home with us because she was dying of cancer and we could manage her care at home and get those precious weeks and months. Had she needed such care for years and years (was not terminally ill) we would have needed to use a nursing facility. When it came to the very end, there was an amazing hospice program available to her paid fully via medicaid. She was there a for a few weeks before her death. At that point, she was basically immobile so it made the most sense for us to get help caring for her so we could just be with her 100% of the time.

My father is considering moving into a Seniors only housing type place where he would have his own apartment but get dinner in a shared dining hall. There is a nursing care option on site for those that come to need it. It is a HUD building and he will pay $200ish a month rent out of his Social Security, plus a $125 meals charge. It is really, really nice. Were he to switch to the nursing care there (likely not for more than a decade- he is the picture of health pretty much) he would pay more out of his Social Security but he would not owe beyond that, the tab would be picked up by Medicaid.

All of this is my longwinded way of saying that Medicaid provided access to a level of care and quality that I was rather shocked by. I assumed the worst. So tour places now and see what you think for yourself. Check things like waiting lists etc.