Can anyone share their experience with long-term care insurance?

The only experience I had was second hand. The insurance company started their position at, "That is absolutely not covered," and ended up, after much negotiation and reporting them to the state's regulatory board, covering for most of the cost of a live-in caretaker.

the experience I've had is with CalPers LTC...don't know how similar that is to their policy. My folks must be about the same age (both have paid into it 20 yrs), stepdad is in an Alz facility (4 months). get your hands on their policy info (amounts paid in determine max amount to be disbursed), check their website, call & ask questions (and be prepared to receive varying responses). Since his care costs over $5,000 monthly, having this insurance money is great (his policy will cover over $4,000). Have they shown you their policy, told you who it's with, etc?

After paying premiums on a LTC policy for 4 years, we decided we could have invested that amount of money and been better off.

My dad is 90 and lives in an AL facility. He has paid on a LTC policy with Met Life since 2000. He is no longer able to drive, shop and cook for himself or pay his own bills. None of those things are mentioned in his policy, so he is currently not able to use it because he is too high functioning according to his policy. For example to fail eating you would have to be no longer able to use a spoon or a fork, not just be unable to go out and buy your own food as my dad is. My dad originally got the policy after my mother passed away thinking he would be covered when he could no longer take care of himself. So far he has had to use other means to fund his care which included selling his house. His policy was marketed to him as a way to stay in his own house, but it does not kick in until someone needs skilled nursing. He is still paying the premium because with early dementia and severe anemia due to a blood cancer, he may need the policy in the future. But given my father's experience my husband and I have decided to self insure our LTC needs. We are lucky to have the means to do that.

I agree with Alexander's answer. Invest your money and stay away from LTC. Wish we had.

Thank you all for the responses. My parents have tended to over-insure all of their lives and never ever make claims. They have been an easy sell for their local insurance agent over the years. I had to help them organize bills a while back, and I could not believe how many monthly, quarterly, semi-annual and annual bills they receive from one insurance company for soooo many policies! They seem to think they are golden with these long term care policies, but I am skeptical they will really pay out if ever needed.

My answer hopefully provides you with much better hope. My mother was 72 when she got her insurance through Genworth Financial services. It cost her about $3500 a year. She started using it at 82. We had to wait 4 months for the majority of it to kick in before using it from being in an Assisted Living facility. She was able to access some of it when we had home care for a month or two, and yes there some a small deductible, but other than that we have been very very pleased with it. Yes, we had to meet certain criteria when we enacted or initiated it's use and there were new questions everytime we moved her to a new facility or an annual review, but she passed all of those easily because she really did need it. It paid out for about 4.5 years as that was the plan she had. It all has to do with the plan. There are so many variables so really study the plan and get the person or persons who sold the plan to your mother, or the company it is with to explain your exact plan. In the end, we got over $250,000 to help us out, an average of $61,000 a year or so. Not bad and it was the smartest thing my mother ever did. All I had to do was fax it a copy of my mother's facility bill and they put money into her account like clockwork each month to cover the portion that was allowable. For my mom, she got a daily amount of about $175 in the last year. It started with $150 per day and her policy added $5 more a day for the next few years until it reached $175 a day. Her daily care was more than that so we used all of our monthly allotment. If the care is less than your daily allotment, they pay for just that amount and the leftover just stays in the bank so to speak and it just helps lengthen your overall allotment as it were. Every policy is different, but if you have a good one, it really does help. And yes, it is a bit of a pain at the beginning to get the ball rolling for them to start paying out, but once it does, you are good to go.

Wow, sdbike, it sounds like Genworth really came through for you and your family. Thanks much for sharing.

My parents had LTC ins with Met Life. Thank God for that policy. I have been able to keep them both in their own home "Together" since 2010. (see note below) Mom had a stroke and needed help with ADL's ( Activities of Daily Living) and my Fathers started when he was diagnosed with Early onset Parkinson's and Alzheimer's and had Cognitive Impairments..
Their Primary Doctor was my first resource and he had a Home Health Care Agency come out to do an evaluation. I believe that with so much fraud, Insurance companies need to take precautions against false claims But at the same time, If a Policy Holder truly meets certain requirements , They will pay the benefit.
I mentioned keeping my parents in their own home. I also learned that with the LTC Benefit, We had a better selection of Facilities should we need to go that route.

My dad (90) and stepmom (75) have had LTC insurance through CalPers, which I think they got when they got married 15 years ago. Not kicked in yet, but we are hoping to get them into assisted living; unfortunately, my stepmom's policy includes home care, but my dad's the one who needs that, but good to see some positive notes here.

Make sure you know what the policy covers and how it works before you need it. I wish I had looked at my mother's when she bought it 15 years ago. Found out last year when considering having home care for her, that she had not purchased any inflationary clauses in order to.keep.the premiums down. The daily allowable amounts of $50/$100 per day home care/NH respectively will help but she will use up her own funds covering the balance long before the policy limit. And it is not an annuity/cash out policy; insurance only, so if she doesn't use it, that money is gone. Also, make sure the company is financially sound. The company she has is is bancruptcy/restructuring, with the State of Illinois guaranteeing funding. Groan. Glad to hear good reports, though, and thanks, uneekguy, for the link. Good info.

In my mother's case I think privately investing the premium amount monthly would have been wiser. What she has paid in premiums as of today equal over half the policy value.

My mom took her policy out just for her (not my dad) while she was working back in the 80's. At that time as mentioned before depending on the variables (how much you could afford each month, how much coverage you thought you needed, etc) it was a great decision on her part to do it. She had gone through a lot with her mom and in laws so she saw first hand how much it would cost out of pocket. My dad kept saying they wouldn't need it but she was determined and now he is singing her praises. Her's will be running out in the next month or 2 but it has been a God send. $1500 a month is better than nothing add that to the VA check he gets for her. She has been using it for 6 years and like I said it is getting ready to run out. Dad is 93 and mom is 90 and in alz/dementia facility. She is declining but no telliing how long it will go on. Just hope they both aren't in a facility at the same time. To answer your question, for my parents it worked out great and we had NO problem with receiving benefits/check. My husband and I looked into Genworth. Pretty expensive but we are still thinking about it due to seeing what it can do to families. I might get it like my mom did and I will put my husband out to pasture. :))))) Good Luck and God Bless

Only know what I have read. If you have the insurance and got it some time ago, it can be the best thing ever. But I also read (if true) that insurance companies don't want to be involved with it anymore, not offering it so getting harder to find it, and it now costs much more than it did.

My experience is similar to sdbike's experience. My mother has Genworth and it has been a God send. We never used it before moving her into an Assisted Living Facility but they did an evaluation and had no problems agreeing to pay once she met her elimination period which I think was 3 months. They sent a nurse for her annual evaluation a few months ago and no problems continuing her care as she is in the Alz unit of the assisted living facility. I think with her plan they will pay out for about 3 years. It turns out it was the smartest thing my mother did as well. I too have only had to send in the monthly statement from the ALF and the money is her bank account clockwork each month.

All I can say is I desperately with my Mom DID have long-term insurance... I've been dealing with pure H*ll for the last 3 weeks, and at this time the most painful is trying to figure out what to do because she doesn't have insurance... She is 95, has been really bright until the last few months, when she's gotten a little forgetful and confused at times, but most of the time she's been "normal". on June 20, 2015 she fell and broke her rt. hip and rt. wrist; she had ER surgery on both the next day, and came through with flying colors! But - the next 5 days in-hospital were really tough - she was confused most of the time, angry, in a lot of pain, etc. Insurance? NO! She retired from the Fed. gov't in about 1971, and basically HR didn't tell her nor advise her about Medicate Part B. She had paid only a little into Social Security years before, when she worked for a private company, so has been receiving a minimal SS payment each month. She only has Medicare Part A, which is "automatic" and only covers in-hospital costs and 20 DAYS AT A SKILLED NURSING/REHAB FACILITY... After that? Absolutely nothing... Her regular medical insurance (GEHA, which is the Government Employee Health Association), covers 14 days at $700/day, but since Medicare becomes "primary", and covers 20 days, GEHA pays absolutely nothing. After the 20 days, private/out of pocket costs. OK... She has modest savings and a month annuity, and is currently in a facility, but on June 14, her 20-day coverage ends and the facility told me several days ago that regardless of whether we are willing and able to pay privately for continued care there, they are not allowed by their insurance to accept private pay patients for skilled nursing... Where will she go? I have no idea... She is medically not in shape to go into assisted living - can't currently get out of bed alone (2-person move), can't stand, has suffered major damage to her feet from the "first" facility I placed her in and had her transferred from after 5 days to the place she is now, has had a weak left leg for years from a back injury/fusion 45 years ago (her back has now "acted up" and is more painful than her recent breaks...). Worst of all, actually, to me is that she is now angry, furious at the world, and most of all at me, because she only wants to go home... She's uncooperative with therapy, is eating only sparsely, and thinks I just don't want her home...(I intellectually know she's "not herself" - is hurt, scared, angry, etc., and is striking out at me because I'm closest to her, but...) It is breaking my heart! This morning I'm headed for a conference with facility staff to "plan" for her upcoming discharge, and she will be attending this meeting, so last night I tried to explain what would be covered.. She became really cold toward me (hasn't been warm lately, but this was worse...). I told her I love her, wish she could come home, etc. She just stared coldly at me, and I finally said "Mom, don't you trust me?" (She's been living with me for 15 years, and I've fought for her all that time...). She responded with a nasty look... Then I said "Do you love me?" and I was stabbed in the heart when she answered "I don't really know - I don't know you anymore...". Sorry for this long post - I have to "go now" because I need to get dressed and leave for the meeting I am dreading. I'll check back for any helpful info when I get back!

Policies vary greatly. My husband's parents and my parents all spent almost 10 years each in assisted living. So I 20 years ago bought a "cadilac" policy with home care, day care, assisted living and nursing home coverage, plus inflation protection. So far we have put more in that taken out - BUT this year with my husband in day care 3 days a week the benefits are much higher than the premiums. Soon he will need full time care - and the policy will pay 90% or more of the cost. If we follow our parents' examples we will be far ahead of the game.

I've helped a few people with their LTC policies and overall, having a policy is great IF you get the right policy - be sure that it covers Home Care & Assisted Living as well as skilled care in a nursing home. I agree that it takes some calls to initiate a claim, and it pays to start looking into the process well before it's needed - each company has their own forms. Also, find out what the waiting period is before a claim is paid, what the per diem rate paid is, how you initiate a claim, etc. and document who you talked to and what was fax'd, when, etc. In general, I've found their customer service people to be very helpful - I would call them and ask questions - be prepared that you'll have to have your parents fill out a release form before they talk to you though. Good luck.

My MIL had long term care insurance. She got it when she was 70, 14 years ago. It cost her $161.00 a month. When she needed to go into assisted living all it took was an assessment from home health and her doctor stating her need for daily help. She had dementia and I could no longer provide to level of care she needed. There was only a 30 day waiting period and then they paid $100.00 a day for her care. We never once had any problems. All that being said, the new rules and requirements are much more stringent than she got hers. She was a breast cancer survivor, had half a lung removed, both knees replaced, carpel tunnel surgery on both hands, multiple stomach surgeries and morbidly obese but was accepted. My husband, her son, on the other hand has been denied for having a high ( 4.11 ) PSA level. Go figure... My premiums are $275.00 a month for the same coverage she got for almost half the price and I have NO medical issues. As with all things, research research research.

I had to fight with my mom's LTC company - it was a shady deal and limited coverage, and they purposely made communications misleading and paperwork demands astronomical as a barrier to elderly people actually getting payments. I had to involve the state insurance commission and put our lawyer's name on a few letters to get it. Genworth is a lot more reputable than the one we had.

ImageIMP, so sorry your situation is such an emotional and logistical mess, and that mom has lost her judgement in assessing your paramount concern for her and would rather have someone to blame for her predicament than an ongoing loving relationship. You do most likely need an eldercare attorney to see what is possible for home care support if you try to go that route, and how you can get Medicaid by any route if that becomes the only way to afford in-home or facility care she needs. The other resource is your Area Agency on Aging, and you may simply want to go around and look at other facilities and ask them what they can do; I'm suprised yours cannot accept private pay, that's unusual. You can also use an assisted living locator service such as A Place For Mom or any other; they will have a somewhat more limited repertoire of facilities who will agree to pay some fees or advertise with them. Finally - just my $0.02 - the current facility social worker should be offering you more help and support - both practically and emotionally- than you are getting. Why they assume we are "OK" and know what we ought to do next is beyond me when this is such totally new territory for the vast majority of us who enter it.

My answer hopefully provides you with much better hope. My mother was 72 when she got her insurance through Genworth Financial services. It cost her about $3500 a year. She started using it at 82. We had to wait 4 months for the majority of it to kick in before using it from being in an Assisted Living facility. She was able to access some of it when we had home care for a month or two, and yes there some a small deductible, but other than that we have been very very pleased with it. Yes, we had to meet certain criteria when we enacted or initiated it's use and there were new questions everytime we moved her to a new facility or an annual review, but she passed all of those easily because she really did need it. It paid out for about 4.5 years as that was the plan she had. It all has to do with the plan. There are so many variables so really study the plan and get the person or persons who sold the plan to your mother, or the company it is with to explain your exact plan. In the end, we got over $250,000 to help us out, an average of $61,000 a year or so. Not bad and it was the smartest thing my mother ever did. All I had to do was fax it a copy of my mother's facility bill and they put money into her account like clockwork each month to cover the portion that was allowable. For my mom, she got a daily amount of about $175 in the last year. It started with $150 per day and her policy added $5 more a day for the next few years until it reached $175 a day. Her daily care was more than that so we used all of our monthly allotment. If the care is less than your daily allotment, they pay for just that amount and the leftover just stays in the bank so to speak and it just helps lengthen your overall allotment as it were. Every policy is different, but if you have a good one, it really does help. And yes, it is a bit of a pain at the beginning to get the ball rolling for them to start paying out, but once it does, you are good to go.

My parents bought LTC ins in late 1980's (?) and nearly cancelled it every year, boy am I glad, and is mom ever glad, that they kept it. After paying 20 yrs of premiums about $1200 per year, my dad started using it for his adult day care, and then continued for over 5 yrs of very expensive nursing home care. They paid about $24,000 in premiums but received over ten times that amount in benefits. Mom continued her policy and used a small amount for in home care, but all in all, it was a win-win for them as a couple, because mom would have been totally wiped out financially from dad's nursing home bills. Some couples think they will "self-insure" but please be very careful doing your Math; current high level SNF costs are $110,000/ year, right now. Ask yourself, with interest rates & investment returns as low as they are right now, how are you EVER going to save enough for even 5 yrs of one person in a SNF? remember the spouse at home still has to have the house maintained, and food to eat, and their own doctors & precriptions. To me it seems very very dangerous to think you could somehow save up over a million dollars and have it ready exactly when you need it. Do your homework, find a good unlimited coverage LTC policy that offers return of premium to your beneficiaries, and don't take the chance that you haven't or can not save enough. My husband & I got ours thru Kof C and also made it so after we pay 22 yrs of premiums, another small life ins policy matures and continues to pay the LTC premium, so we will truly be "off the hook" for ANY catastrophic costs once we hit retirement (at age 70), and yes we do pay something for it now, but there is no free lunch, if you want coverage and peace of mind, work a little for it. If everyone took responsibility for their own LTC then there would be more money left to provide welfare for those who unfortunately cannot qualify for LTC due to ill health. Maybe in the near future they will be mandating everyone buys LTC (and dental).

My folks have LTC. Very old policies- dad's policy has a 90 day waiting period so for 3 months you have to pay out yourself which can add up. It's through Met Life and they assessed him after he got out of the hospital and were going to cover him (and he was not a total "basket case") but he recovered and only really needed care for a few weeks thankfully. Also while he is using his policy, he does not have to pay the premium which is nice. They're possibly looking into assisted living so we'll see what gets covered since they are pretty well functioning. One thing I heard for us caregivers might be a LTC annuity where if you never use it, you can still access the money you put in. Has anyone heard of that as an option?

My mom and dad had LTC. Dad used his some after hip surgery, but he died before using much. Mom has dementia. She is in assisted living Memory Care. She does not need skilled nursing at this point, but needs medication management, meals prepared and reminder to eat. She needs assistance with bathing and dressing. It would not be safe for her to be home on her own. The LTC insurance pays $2400/month. Her total care is almost $6000 which she uses SS & pension. It will run out in about $100,000 more. She did not by an inflation rider which is why it is only $80/ day, but one nice thing was that a few years ago, she had Sarcoma cancer and the policy paid $80/day for the home health care. After she was healthy and not having claims for 6 months the policy started all over again ($150,000). Nice feature for intermittent care. She paid the premiums at all time except for when she uses it. My husband and I have a LTC policy which was recommended by our financial guy. If you have any assets you would like to protect and if you can afford it, I would recommend it.

I forgot, that was another thing I didn't care for- my dad started the 90 day period where he had to pay, but was never ill for long enough to actually get into receiving the benefits of LTC. Hence, 6 months passed and they closed it out and if/when he gets sick again he's going to have to start from scratch paying toward the 90 day period. I wonder if other policies allow for 90 days to elapse over the life of the patient, rather than per incident...

I know this is a bit delayed from when the question was asked, but I didn't see anyone else mention this. My parents bought into a very good LTC policy in terms of benefits, and we are very, very glad they did, but one unforeseen factor for us was how slowly the insurance company pays out claims. In our case, the insurance company is very slow to pay (more than 30 days for each claim), but the AL facility bills their care on the first of each month, so we are always "late" paying their bill, through no fault of our own. The AL facility has been very understanding for almost a year, but lately they have been saying they will have to start charging late fees every month, which are astronomical. The LTC insurance company also has refused to cover some of their care needs, although they are very reasonable and include only necessary ADLs such as bathing help, personal care, medication administration, meal reminders - otherwise they wouldn't remember to eat - and medically necessary assistance like changing compression socks, which my dad can't do on his own due to hip problems. (Basically, all the reasons they're in assisted living to begin with!) There was no way to know any of this until the claims were submitted. We are happy that they had the foresight to purchase LTC insurance and that they got a very good policy, but there are issues to consider that you may not think of until you actually need the policy.

HelperMom, what you do is write a letter stating these facts to the LTC insurance company, copied to your lawyer and your state insurance commission. These companies absolutely prey on the people who can't fight back and don't know their rights when the contract with them is being violated. Went through this with my mom. Her's company's scam was to send both the customer and the facility a cryptic note implying that the other party needed to send some other piece of paperwork that was usually already sent. 30 days is not really OK unless that's what the contract states. You might have to pay a month to stay ahead of the bills and you would get that back at the end, presumably.

vstefans, Thank you! It hadn't occurred to me to contact the Insurance Commission about this. I don't remember seeing anything that stated when they would pay, so I don't know if the contract specifies it. We definitely would pay a month ahead to keep them current if we had the resources, but we are unable to do so. This 30-day gap completely blindsided us, so I doubt it's in the contract. Thanks again for your helpful advice.

My mother-in-law paid premiums for 20 years and she passed without ever needing the policy. There was no refund. Also, a friend's mother has terminal cancer and the closest nursing home that will accept her LTC insurance is an hour and a half drive away and home care is not covered. If you go with LTC insurance please read the policy carefully to determine what is covered.

So glad my Mom and step Dad signed up with CalPers LTC. Had to utilize it this year for my step Dad, he passed last month. My hope is that they use that money left in his account to train their call center staff how to access data in their computer system. Unbelievable how many times I rec'd varied responses to the same inquiry. Mom has always been an excellent record keeper, but there's no way she could have handled all that was required. Glad I know what to expect if/when we need to use the funds for Mom's care.