Maybe I've missed it, but I don't understand why seniors aren't pushing for Medicare reform to cover long-term care? The recently passed legislation doesn't affect this issue; I don't ever remember hearing that any noise is being made about it. Can you imagine how much better life would be for families dealing with dementia if Medicare included this coverage? Of course, it would raise costs for the Government, but in reality, Uncle Sam is already paying for nursing home care for lots of people under Medicaid. It sure would make it a lot more equitable if everyone who enrolls in Medicare was entitled, at a minimum, to a nursing home benefit for long-term care.
Under the current situatian the Government does cover the cost, once you are broke. The issue should be why does the government not do a better job getting the message out that you need long term care insurance more than you need a 3500 sq ft house or new cars in the drive way.
I agree that buying private LTC insurance is the responsible thing to do. However, regardless of what educational efforts the government does, I think most people just will never buy it. The recent health care reform did encourage workers to buy it, but it will be interesting to see how many actually do. Also, the current setup with Medicaid causes people to "protect" their assets, so that while many who qualify are impoverished, not everyone on Medicaid is, in reality, broke. Some have just managed to give away their money to children or found other means to exclude their assets from being counted towards Medicaid eligibility. I think Congress tried to fix that situation by changing the lookback period from 3 years to 5 years, but there are still too many loopholes, in my opinion.
My kids-who really can't afford it- have bought LTC policies. I don't think it's fair for people to be able to hide their assets and go on the dole. On the other hand-I don't think it's fair for people who work hard all their lives to have nothing to leave their families when they die. I have no answer.
Unfortunately most people don't think they will ever have a need for LTC and traditionally the premiums are expensive. I agree that a government sponsored LTC plan might be a good option. I really think there is something wrong with a system that allows people to have to spend their hard earned retirement savings on care for a LO with AD/Dementia (or any other illness for that matter) and have nothing. I'm a bit prejudiced about this since we were responsible and saved for our retirement and now all that money is being spent on care for DH, including all that I saved for my retirement. By the time this is over (if I'm not dead first), there will be nothing left for the care I will need for my severe chronic condition. I'm sure our ages (60) have alot to do with how I feel.
LFL, it sounds like you had the funds to purchase LTC policy but thought it would be wasteful to spend the money on something you will never need. The policy we purchased was setup so that you got your money back, if you never used it and if you did the money paid out would be deducted from the refund. The investments they made with your money they kept and there was a yearly $250.00 service fee. I just think you were not given all the facts.
Moorsb, we purchased LTC 7 years ago. If we go a total of 10 years without using it and one of us dies, the survivor will get all the premiums back for the deceased. It is almost like a (gamble) savings account that you hope you never have to use. I am sure we will be using it at some point for my DH, but it also covers in home care, etc. It is the Cadillac of LTC's, costs out the wazoo, but in the end it should be worth the cash. (DH is 60 with Parkinson's and dementia) and I am almost 60 and healthy.
moorsb, I must not have been clear. I do not qualify to purchase LTC insurance due to pre-existing conditions, however my DH did so we purchased the LTC for him through our employer. The plan we have through our former employer is not as comprehensive as other plans on the market, but I am grateful for it nevertheless. When he qualified to use the benefit, they returned the premiums and we no longer pay premiums for the LTC (standard, I believe). There is a lifetime cap (dollar amount) they will pay for in-home and/or nursing home care. Because he was dx'd at 58 and has had severe behavioral problems, the discharge plan from the psych hospital required that we have in-home 24/7 care. The LTC only pays 1/2 the cost of the in-home care, so we have to make up the balance out of our assets. He could easily live 10+ years since now he is only 60 and our retirement savings could easily be depleted.
There are many different types of LTC policies - some with lifetime benefits, etc. Ours is not like that.
LFL, I can get a LT care plan at work for both of us. it has options of $100, $175, $250 a day for either 3 or 5 years. They will pay out the total amount over more years, if we don't use the max. meaning that if I get the $175 and only use $100 a day for in-home then it will last more years. It can be used for NH or in-home. It can also be used for respit time without a certifed caregiver. It has the usual 90-day starting period. It also has special treatment for AZ and other such problems. Once it is started, we no longer pay premiums. If we stop paying after three years, we will still get coverage up to the amount we paid in. I priced the $175 for 5 years without the inflation adder and it will be $40 a month for me and $60 a month for DH. I didn't think that this was bad. Also, when I retire, I can take the policies with me and the preminum will not increase. I'm pretty sure that I am going to sign up for this. I need to do it before DH receives a diagnosis.
Mary in Montana--Are there health questions on the application or a medical exam required for the policy? If so, even if your husband hasn't received an official diagnosis, he may not be approved if there are notes in his medical file re symptoms that could be related to dementia or if he has had brain MRI's, etc. I know that when people apply for LTC insurance, companies request records from the applicant's PCP and from every specialist that was mentioned in those records that has been seen in the recent past. However, in any case, it won't hurt for you to apply and if he is approved, you should probably buy the most coverage you can possibly afford for him.
My husband applied for LTC and was turned down years ago because of something unrelated to dementia they found in the PCP records. They review the applicants medical records for years past.
Mary in MT, sign up for the best benefit you can afford, that's what we did. Take the highest amount if you can afford it, which would be the $250/month. The insurance company will request all his/your healthcare records in reviewing the application and will most likely conduct an interview - in personn or over the phonhe. In DH's case, the LTC company requested med records from every dr he saw for over 10 years. Because I noticed he was having memory lapses I asked DH to talk with his PCP during his annual physical in 2005; the PCP conducted a MMSE (unbeknown to me) the result of which was normal. When he needed his LTC benefit in 2008, the ins company conducted a fraud investigation because he as given an MMSE in 2005 and refused to pay the benefits we'd paid for during the investigation. We were imvestigated for 5 months, denied benefits during that time even though I spoke to the Ins investigators they maintained I was withholding information. Our ELA contacted the LTC investigatirs and finally settled the problem and DH was granted LTC benefits.
As mentioned above DH's LTC plan provides a specific dollar amount in total benefits (ie. $500,00 total) which can be used for inhome care (no more than $112.00/day) or nursing home care (max $6000/mo) up to the total benefit amount of $500,000. You are always welcome to contact me. Get your LTC as soon as you can.
I would also have in print, exactly what it take to make a claim. What is required documentation to make a claim for AD. I had an issue with my insurance where on the phone they told me I have to pay out of pocket for 60 days of care. They then told me later it had to fall within a 180 day window. What is considered a day of care 8 hours, 24 hours? In my case I had to submit bills for 60 days. The Home Health Service had a minimum of 4 hours billing per day. So I started at that level. Once I met the 60 day paid out of pocket I increased the care to 8 hours a day. My plan pays a flat $3000.00 per month for care how ever I wish to use it. It will pay for 5 years. I added a rider that will continue that level of payment for life. Not enough to pay for a nursing home, but it does help alot for in home care.