U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Retirement
 [Register]
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
View detailed profile (Advanced) or search
site with Google Custom Search

Search Forums  (Advanced)
 
Old 09-29-2017, 03:31 AM
 
11,205 posts, read 8,594,278 times
Reputation: 28265

Advertisements

Quote:
Originally Posted by oldsoldier1976 View Post
I agree with you. But we are talking about alternatives to LTCi. One way as you said is to have a separate account not tasked with anything but doing long term care. How many policies can take a person 6 years? How expensive would that be as well.

So lets say we have an individual that has income that is cola adjusted that includes SS pensions and they can live on that exclusively. They have a savings account that has a million. That person could then take 500k and set that aside in a mattress to draw upon when they need it for long term care. They are living on the other income and supplement it with the other 500k. Sounds to me to be quite reasonable to live on.
Have you been reading this forum. Hypotheticals aside, most people can't set aside $1mm solely for LTC expenses. Most people are planning on using Medicaid as their coverage.


I'm one that doesn't find the cost of LTCi to be expensive. From people who have posted, it's running $200-$400 a month or so. As I see it, for what you pay per year (approx. $4,000), you get $5k a month in actually coverage should one need the care. For some people, LTCi will make sense. I'd rather have my own coverage than become a mooch off the system.
Reply With Quote Quick reply to this message

 
Old 09-29-2017, 03:49 AM
 
72,033 posts, read 72,043,164 times
Reputation: 49605
our original plan was to self insure . but after an article money magazine did on us where they pitted my financial planning against their pro's they convinced us it was a poor idea for us and we agreed .

laws change , the money for the self insuring really need to be segregated and protected in low yielding investments . in short we ended up paying for the policy with just a piece of the gains we get just leaving the money fully invested and not taken out of the income producing money .

basing an income on the money that includes the self insuring money is a bad idea since the swr assumes you can have a buck left 30 years later and pass .

so a formal plan with insurance was the best idea for us . other plans people use is insurance to get through the look back stages and then have a plan in place for when the insurance ends . but look backs can change and already did as they went from 3 to 5 years so that can be a bit unstable as a plan .
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 03:55 AM
 
Location: Central Massachusetts
4,800 posts, read 4,864,124 times
Reputation: 6379
Quote:
Originally Posted by charlygal View Post
Have you been reading this forum. Hypotheticals aside, most people can't set aside $1mm solely for LTC expenses. Most people are planning on using Medicaid as their coverage.


I'm one that doesn't find the cost of LTCi to be expensive. From people who have posted, it's running $200-$400 a month or so. As I see it, for what you pay per year (approx. $4,000), you get $5k a month in actually coverage should one need the care. For some people, LTCi will make sense. I'd rather have my own coverage than become a mooch off the system.

I have been reading this thread. In fact I have started two just like it on the same topic.

As for your cost I agree it is kind of a small price to pay 4k a year for 5k per month for 3 years of coverage. But let me give you a little bit more that isn't written into the contract. That 5k doesn't pay for everything involved. You will have out of pocket expenses and that amount will depend on where you live.

Also that 4k is per person not per couple. You could get a hybrid that will be a bit more to cover both but only one at a time or pay half per. So think on that.

Lastly there are other ways to skin the cat. LTCShop and I have debated this a number of times and in our case we would not be mooching off the system either. I am not rich but I do have income. Our income not counting our savings is more than what we had while working. Top that off with about 3/4 of a million in retirement savings and a paid off house valued above 400k and rental property that nets another 1k per month in additional income above all the other income. We have decided that should one of us or even both of us be put into a nursing home or have to have home care we would take the proceeds of our home and move into a smaller apartment or condo. While waiting for the sale of the home we can draw on our nest egg to supplement any income draw the care would require.

We are both 60 and are healthy. We eat healthy and do not smoke. We are betting that we will not need that sort of care and if we do there will be either a sudden reason like an accident or it will be something that comes on over time. Each of those circumstances will either allow us to get compensated in the case of an accident or adjust and react to the illness. Yes it is a bet but we feel better about that then to make insurance companies wealthier. Our feeling only. Good luck on yours. We have our plan in place.
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 06:59 AM
 
29,884 posts, read 34,936,573 times
Reputation: 11793
^^^^^^^^

That last line says it all. Compared to most you have a plan. How many can say that? Best of luck having yours work. I understand your plan.
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 07:12 AM
 
Location: Central IL
15,250 posts, read 8,585,320 times
Reputation: 35707
Quote:
Originally Posted by oldsoldier1976 View Post

We are both 60 and are healthy. We eat healthy and do not smoke. We are betting that we will not need that sort of care and if we do there will be either a sudden reason like an accident or it will be something that comes on over time. Each of those circumstances will either allow us to get compensated in the case of an accident or adjust and react to the illness. Yes it is a bet but we feel better about that then to make insurance companies wealthier. Our feeling only. Good luck on yours. We have our plan in place.
The assumption of many seems to be that if you're healthy at 65, and you don't smoke or drink (excessively) you're pretty safe.

Are there ANY stats at all? I mean, there aren't THAT many smokers and alcoholics out there - don't a good number of the people who fit your characteristics STILL end up in LTC/nursing homes - those place do seem pretty full, right? Don't the REALLY unhealthy people die relatively quickly (even if not young) from massive heart attacks and strokes while the moderately healthy live longer and perhaps take a lot longer to die from debilitating causes that may mean being even more likely to need LTC/nursing home care?

Do that many healthy oldsters just die in their sleep after a day of hiking? So I would love to see length of stays by age and health status.
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 07:21 AM
 
72,033 posts, read 72,043,164 times
Reputation: 49605
you would have to include lots of other stats like assisted living and those who are being cared for at home to get the full picture .

many like my dad fell off the statistics as many healthcare professionals care for people so bad they can't be home so they care for them in their home. the couple that my dad was with were healthcare workers who took 2 like my dad in who was paralyzed by a stroke .

florida is filled with these types of care situations where they do not show up in statistics of those in a snf .

as insurers found out there is a whole lot more usage of ltc insurance than they ever imagined when they set premiums based on statistics .
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 08:36 AM
 
3,115 posts, read 832,457 times
Reputation: 1771
Quote:
Originally Posted by reneeh63 View Post
The assumption of many seems to be that if you're healthy at 65, and you don't smoke or drink (excessively) you're pretty safe.

Are there ANY stats at all? I mean, there aren't THAT many smokers and alcoholics out there - don't a good number of the people who fit your characteristics STILL end up in LTC/nursing homes - those place do seem pretty full, right? Don't the REALLY unhealthy people die relatively quickly (even if not young) from massive heart attacks and strokes while the moderately healthy live longer and perhaps take a lot longer to die from debilitating causes that may mean being even more likely to need LTC/nursing home care?

Do that many healthy oldsters just die in their sleep after a day of hiking? So I would love to see length of stays by age and health status.
Like you, I read the statistics but I'm never quite sure what they SAY. Some seemingly reputable studies show that about 50% never need LTC; others project the need at about 70%. What's so-often missing is the definition of care. Frankly, most maybe about ALL elderly need some sort of support - much of it provided by a healthier spouse, family member. In the case of some family, parents of friends, the long-term cleaning lady ups her hours to the satisfaction of all with the support of a weekly nurse visit.

Do these stats reflect that kind of care; or that which qualifies for a LTCi policy to be paid out? No idea.

So many of these threads focus on the financial side, with little information on PROVISION side - and what works best and what does not.

I probably fall into your category - might well need LTC that stretches for years. There's a history of heart disease and strokes in my family, so I've had lots of screenings. The guess physicians made in my 40s that I won the gene-lottery (blood chemistry) seems to be playing out - not a sign of anything. Nada. 0% plaque. Consistently low blood pressure. Low HbA1c. Stamina (nuclear stress test) of someone much younger than my years. No bad habits. A major aficionado of public transportation, spend little time in a car.

Is this good? Not really. Live long enough, and the probability of care needs will INCREASE. Dementia. Osteoporosis. Arthritis. I'm not likely (statistically) to be one of those who die within a year or so of admissions to a nursing home.

A 3-year exclusion policy followed by unlimited coverage meets my health profile. My risk is on the tail end. To my knowledge that product does not exist. I can easily self-insure the first 3 years. Plus an even initially qualifying health condition will only worsen over time making it harder to rely on the type of support that Americans have received for generations.

Current policies with unlimited coverage from 90 day or even 365 days (if available in my state) are not affordable. And by affordable I mean not that I couldn't find the money for the premium but that the cost over time (and statistically I'm looking at possibly 30 years out) would hamper other life plans that ALSO address possible health care.

I never had access to a relatively cheap (even with subsequent cost increases) unlimited LTCi policy through a corporation 20 years ago - THAT would have been great.

The research I did back then suggested the best time to buy on the individual market was about 61 or 62. THAT information turned out to be wrong. Likewise, the policy that I delayed buying a year or so when I first retired in 2008 because I was immersed in other financial planning also turned out to have a very different cost profile than what was pitched a year earlier making me think I'd dodged a bullet.
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 09:11 AM
 
3,115 posts, read 832,457 times
Reputation: 1771
Quote:
Originally Posted by mathjak107 View Post
you would have to include lots of other stats like assisted living and those who are being cared for at home to get the full picture .

many like my dad fell off the statistics as many healthcare professionals care for people so bad they can't be home so they care for them in their home. the couple that my dad was with were healthcare workers who took 2 like my dad in who was paralyzed by a stroke .

florida is filled with these types of care situations where they do not show up in statistics of those in a snf .

as insurers found out there is a whole lot more usage of ltc insurance than they ever imagined when they set premiums based on statistics .
Precisely. And this is my objection to LTCi.

Most folks WANT to stay at home as long as possible. Sure LTC policies have now been modified to permit payments to in-home care providers. I'm FAR from knowledgeable here but my general understanding is that payments are made to the provider not to the user for disbursement and that the provider must meet certain qualification standards.

As mentioned earlier, the experience of some friends is that they can't get qualified providers to work the sometimes *minimum* number of hours really needed - particularly in the early stages of a disability. All this ups use-costs.

And, of course, having paid premiums for years, folks will logically use them and pay for the care profile mandated by the policy. This, in turn, raises premium costs.

It is THESE raised costs that I (who as I said earlier don't even WANT initial coverage) am being asked to cover if I enter the insurance pool by buying a policy.

No argument that around-the-clock care is another issue and cost-profile. But as a start, it, too, becomes a matter of managing risk and anticipated longevity. Length of time available under the policy? When to initiate a policy? How long to keep providing home care (perhaps with family assistance) vs cost that an unexpected early death may lead to benefits unused?

For many, the answer is to self-pay (or insure) for a set number of years then rely on a Medicaid bed. But that, too, contains uncertainty. Who knows what Medicaid will look like in a few years. Likewise, who knows how states will look at existing irrevocable trusts. Perhaps there will be NO look-back period. Medicaid "planning" may be futile.

My main point is that there is a LOT of unknown. What does make sense is to consider financial resources - family resources - housing - community - insurance availability - your health profile to try to envision multiple scenarios then try to address each with one or two possible plans, certainly a back-up.

The current model is to take a very "industry-oriented" approach to this question. A financial instrument to pay for "corporate" care following insurance-company regulations. For some, that may work out well.

Last edited by EveryLady; 09-29-2017 at 09:25 AM..
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 09:13 AM
 
Location: Central Massachusetts
4,800 posts, read 4,864,124 times
Reputation: 6379
Quote:
Originally Posted by reneeh63 View Post
The assumption of many seems to be that if you're healthy at 65, and you don't smoke or drink (excessively) you're pretty safe.

Are there ANY stats at all? I mean, there aren't THAT many smokers and alcoholics out there - don't a good number of the people who fit your characteristics STILL end up in LTC/nursing homes - those place do seem pretty full, right? Don't the REALLY unhealthy people die relatively quickly (even if not young) from massive heart attacks and strokes while the moderately healthy live longer and perhaps take a lot longer to die from debilitating causes that may mean being even more likely to need LTC/nursing home care?

Do that many healthy oldsters just die in their sleep after a day of hiking? So I would love to see length of stays by age and health status.


Yes there are and they were posted here in this thread. Here is a recap:

Quote:
According to a 2016 report from the National Association of Insurance Commissioners (with credit to Christine Benz’s excellent “75 Must-Know Statistics About Long-Term Care” for directing me to the report), for people turning age 65 in 2015-2019:

48% are expected to have no long-term care costs during their lifetimes,
15.4% will have costs of up to $50,000,
9.7% will have costs of $50,000-$100,000,
11.7% will have costs of $100,000-$250,000, and
15.2% will have costs that exceed $250,000.

The first line with just under 50% of people not needing LTC at all. That obviously will include those that die prematurely. So read through those statistics and put them into perspective.

So if we end up there it will probably be because we will have been involved in an accident or a long term illness. There will be signs along the way for the illness and we would have been penalized or not even allowed to have LTCi. Remember they are going to come through you and your history with a fine tooth comb. You might not even be allowed to get the LTCi. In the case of the first well two things come to mind. Deep pockets of the person or entity causing the accident or we adjust and follow through with our plan. Our family know of the plan as well so should both of us become incapacitated our family will know what to do.

But do those stats mean we will end up in nursing home? Do they mean we won't? Does our plan at least have enough resources to cover the possibility for at least a 2 or 3 year stint? I think on the last one it does. Also remember if you are not covered by insurance and you need to work with healthcare professionals on care, you have the ability to negotiate a fair price. Since we would be essentially paying cash, much like buying a new car, if you are not financing or having them wait for their money from a third party entity like a bank or insurance you can negotiate a better price.

Lots of people as the stats above will only be forking out under 100k during their life. In fact it is just under 3/4's of them. I like those odds when I have essentially a million in assets that I can use over the next 25 to 40 years.
Reply With Quote Quick reply to this message
 
Old 09-29-2017, 09:22 AM
 
3,115 posts, read 832,457 times
Reputation: 1771
Quote:
Originally Posted by oldsoldier1976 View Post
Yes there are and they were posted here in this thread. Here is a recap:




The first line with just under 50% of people not needing LTC at all. That obviously will include those that die prematurely. So read through those statistics and put them into perspective.

So if we end up there it will probably be because we will have been involved in an accident or a long term illness. There will be signs along the way for the illness and we would have been penalized or not even allowed to have LTCi. Remember they are going to come through you and your history with a fine tooth comb. You might not even be allowed to get the LTCi. In the case of the first well two things come to mind. Deep pockets of the person or entity causing the accident or we adjust and follow through with our plan. Our family know of the plan as well so should both of us become incapacitated our family will know what to do.

But do those stats mean we will end up in nursing home? Do they mean we won't? Does our plan at least have enough resources to cover the possibility for at least a 2 or 3 year stint? I think on the last one it does. Also remember if you are not covered by insurance and you need to work with healthcare professionals on care, you have the ability to negotiate a fair price. Since we would be essentially paying cash, much like buying a new car, if you are not financing or having them wait for their money from a third party entity like a bank or insurance you can negotiate a better price.

Lots of people as the stats above will only be forking out under 100k during their life. In fact it is just under 3/4's of them. I like those odds when I have essentially a million in assets that I can use over the next 25 to 40 years.
I looked at the report quickly - including plowing thru the comments. Any idea what the 50% figure MEANS? Is it LTC where 2 or more activities of daily life cannot be performed (potentially initiating a policy claim). If so, how disabling really are these issues in terms of the care/cost profile? Or is it where a senior cannot manage their daily life without some sort of more minor (albeit vital, order in food, prepare a meal) supplemental assistance?

The distinction has enormous implications for the cost/care profile.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:

Over $104,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Retirement
Follow City-Data.com founder on our Forum or

All times are GMT -6.

© 2005-2019, Advameg, Inc. · Please obey Forum Rules · Terms of Use and Privacy Policy · Bug Bounty

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35 - Top