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She has mid-moderate Alzheimer's disease, and want to get the most out of her benefits at her stage.

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First you need to know if the policy is limited by the time it pays out or the amount it pays out. Read the policy carefully. Most of the older policies only pay out $100 a day for 2 years, 5 years etc.
It's not going to cover the whole thing.
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Thank you. I believe it mentioned $116 a day and she has it for life. That's about as far as I have gotten so far.
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Is she in a facility or at home. If she is at home be sure they cover someone from a company coming into the home. As most companies will not allow you to hire an individual.
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Thank you. She lives in her home next door to me. I'm doing research and trying to find out how I will get help when needed at a later point.
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If she needs personal care, I would begin the claims process as soon as possible to help pay for it. My friends' LTC policy had a 90 day waiting period and a daily limit on the amount and also a total amount limit. The wife's care began in April with 3 days a week, the became 24 hour care in May, and into a memory care apartment in June. The husband's care began with the memory care apartment move as they went in as a couple. The wife's policy was larger because she was 17 years younger and they always assumed the husband would go first and wouldn't need as much. Just the reverse has happened. The wife passed near the end of October and used just a fraction of the money she could have received if she lived longer. I submit a copy of the monthly bill to them and they pay the maximum daily amount for that the following month, so I am always paying ahead. The husband could well live longer than the payments will last, but it looks like we can pay for this for 3-5 years with the value of his condo and the IRA assets and his savings account. Once his assets are low enough, he will qualify for veteran's benefits. The AL facility agrees to take public financing once he's lived there 18 months at their regular rates, some $7,000 a month. His monthly retirement benefits pays for about half of this now and his long-term care policy kicks in about $2100 a month and the rest comes out of his assets. Generally speaking, long-term care policy companies are "reluctant" to pay, I have been told. In talking with the reps on the phone, however, I have found this company to be knowledgeable and supportive. When I complimented them on this and thanked them for it, they acted surprised because they usually just get grief. All the limits are spelled out in the policy and it's up to me as their P.O.A. to read the policy and understand the limitations. I want to use the policy benefits as quickly as possible as that is the only way to have it pay out to the agreed upon limits before my friend passes on. Good luck with this journey. I hope you find good answers and lots of support.
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A few more suggestions. Start as soon as possible because of the waiting period where you have to pay cash. You can use only a fraction of it to begin with but ours had to be approved by a nurse from the LTC, then had to meet the criteria (ours was 3 required specific needs such as bathing, travel). Then you may have to be re-evaluated (every two months for us), have the doctor of record send in forms, lots of hoops. Keep on top. Other requirements may be if you stop care for hospital or something else, the policy may stop and you have to go through 90 day waiting period again. Ask them about that. Our LTC and home health tended to fight and blame each other. Don't let them pull you in. Get one representative you know by name who will help you - all the difference between getting ALL the information you need. Good luck.
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These are excellent answers to help guide me along this journey with Mom. It looks like, with all things, it pays to be on top of things. So, even though my Mother is not in need of assistance yet (outside of me helping her) I better have gotten a plan set up. Thanks so much!!
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My 85 yr spouse has dementia. Then you don't need the other 3 things to qualify. Our policy had a 90 day our pay in licensed facility. I talked to care facility licensed & they agreed to take spouse for 1 hr day for 90 days @$15 hr. I was blessed as we finished 90 days LTC started to pay. We then moved and we had max $120 day for 6 yrs. We had added to policy alternative care so we can hire unlicensed persons but must periodically use licensed person or place to get the continuing waiver of premium. Must have Dr fill out form for care needed once yr. I suggest Dr. put max care so you are covered whether you go to care 7 days or 3 days you satisfy LTC. I also needed DPOA not POA. Lots of loops to question & every policy is different. I pay caregiver make copy of ck, record date, time in & out, amt paid, policy #, I then sign/date & send in to LTC so I am reimbursement. Takes lot of time but welll worth it. He is at home W caregiver unlicensed but goes to licensed adult Day Care once in 2 wks & will go there for 2 wk respite care. I ckd several places. Prices vary greatly as do home care. I have called LTC many times as policy is not always understandable. I've even called on same question to make sure of answer given by different people. The 120 day for 6 yrs is really not the years but will give 20 years if total money not used in our policy. We don't always use max in one day as this could go on who knows how long. Dementia/alz is staying w slow changes in my husband & want $ there for when it gets really bad. Who ever thought we would use it. You are smart to stay ahead of what is to come. As a wife I read a lot about alz & support grp is invaluable preparing you for what may happen & then I'm not devastated. Bless you for your care. God has been along my side all the way.
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LTC Policies have a standard requirement for needing assistance with at least 2 ADL's. (Activities of Daily Living), please read the definitions in the policy.

Also once on benefit; the premium might be waived.Policy may have a max Dollar payout amount, and may go beyond a given year payout if daily payout is less than max.

Also check on who is "payable",,some care provided by you might be included.

If she has an existing Life Insurance Policy, that may also be converted.

Contact me in private message if so.
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Last summer I was in a nursing home recovering from surgery. For a reason I still don't understand, there was a week in the middle of the period which Medicare did not cover, so I had to shell out some $7000 for my room and board in the Rapid Recovery wing of the nursing home. At least that counted toward the 90-day waiting period for the LTC policy to kick in. Although my wife is 2-1/2 years older than I am, her LTC premium is higher than mine, because she is still expected to live longer by virtue of her gender. Fortunately, our policy will cover home care, so as long as we're both alive we can stay at home, which is way much cheaper. But whichever of us survives the other will definitely have to move; I because of physical difficulty (I live in a wheelchair and can't drive), and she because of mental issues (3-years-older sister has full-blown Alzheimer's and is in a nursing home, and mother and maternal grandmother had problems too). Her short-term memory is almost shot. She can still drive and cook, but needs me along to find her way almost everywhere. Our LTC policy has a dollar limit of about $365K, which will go pretty fast in a nursing home. Will Medicaid still be around if a Republican wins the White House?
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Dear Gaga,
I am so happy you are thinking ahead. I wish I had done more of that taking care of my 92 year old mom. yes. you CAN do everything for your mom now with no help, but is this the best thing for you and your mom? If you get burnt out with her needs it is hard and guilt producing when you bring in help you could have always had. What I am saying is try not be a super woman for your mom right now. it is sort of like on a plane when the rules are to put on your own mask first and then assist a loved one. As many on this site know, I went through a year of legal battles with my out of touch brothers and now work quite nicely with the state aid that is available for her. If we did things the way they were suggesting, money would have gone down the drain that didn't need to be spent. The anger mom has toward them is still there, but at least I know I won't be getting phone calls like...."this is the way we are going to be doing things with mom."
Do you have any siblings? You mentioned you live next door to your mom. do they trust you to make the best decisions for her? What type of help can you expect from them as your mom needs more help and more resources?
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Quite a discussion. I'm going to keep tabs on this question.
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"Most of the older policies only pay out $100 a day for 2 years, 5 years etc.
It's not going to cover the whole thing." Quoted from pamstegma

My policy basically says the same.
Question: After 5 years the policy is up no matter if all of the Certificate Maximum is not spent?
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Well let's do the math $100x365= $36,500 per year x5years=$182,500. Is your certificate more than that?
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pamstegma, $182,500 is the benefit as you say.
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Cheyenne, the numbers are staggering, especially when I know the rate for mom was $400 a day just last year. Just incredible. I hope I fall off a cliff when my time comes.
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Did she put the LTC into her investments? If so, she should contact them. I'm only asking because my husband and I have that in place.
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"pamstegma, $182,500 is the benefit as you say."

So, after the $182,500 is gone that's it! ?????
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Yup, that's it, all used up in 5 years. Bear in mind that once a patient enters a nursing home, they average about 2 years life expectancy. For my MIL, it was only 3 months. That's 90 days and YOU pay the first 90 days.
Now if your loved one dies in a short period, the payout ends and you do NOT get any kind of refund. None. Zip. Zero. The insurance company profits.
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WOW! and that 182,500 will go Fassssstttt. Thank you Pamstegma.
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In addition to this question... In most LTC policies that many of you have or are familiar with, have you ever ran into the LTC claim only paying out 80% of the daily benefit because the living faculty is not a "nursing" home but rather an assisted living or memory care facility? I just ran into this with my mom's LTC and although her policy is a pool of money type for unused policy funds at the end of her 3 years to be available after the three years, I find this 80% odd. She's getting more care in memory care than a nursing home.
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I have seen policies that cut it back to 50% !!
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Wow! So reading a policy carefully is key here as well as is looking into buying one for ourselves. This particular company changed their policy while we had already started the claim process 1 year in. They were paying 100%. Maybe they caught their mistake or changed their payout. I just cannot find anything on my mom's original policy from 1999 that states the different % amounts. Only shows on her updated policy printout in 2015. I didn't know if they can change things or not. Sorry to deviate from the original question but it also adds to the conversation to READ THE POLICY CAREFULLY. ;)
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I'm might off the this topics....My pay are paid by LTCI, but it is not all cover by insurance co., I'm independent caregiver,my client has the lifetime cover $240 a day and her insurance co., send RN to update my client condition and make assessment for every year. I do charge her more then $240 that for 24 hours care...... because when insurance kick in that rate of $240 will not change, so my client and whoever taking care of her finance paying me the difference. I still think that this is very good deal for my client whom receiving lifetime benefit. I'm with
Myself has LTCI for over 13 years and has a 5% increase every year for when I need it, maybe paying for nothing who knows..... I do often check my policy and my live-in boyfriend's(82 young) policy also, that we got together same time.
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One more thing, I do not think any insurance co,. that they sell life time benefit.
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But, after the money is gone there is public financing to help. The AL facility my friends are in will accept public financing after 18 months of payments are the regular rate. Between the monthly retirement income, the savings account, the value realized from selling the condo, and the IRA investments, I can pay the charges for 4-5 years. After that, my friend Jim also qualifies for VA benefits. It is costing some $7,000 a month for his care at this point--far higher than I ever thought it would be. Just a snap shot of how I think things will work.
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As I said, many people are putting into their investments LTC because care IS expensive.
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Another not-pretty on LTC insurance is that some NH will not accept LTC policies as payment at all. My moms second (& much better) NH was one. The issue for NH is that some LTC policies - especially older ones - require specific staffing & educational level &/or certification on the care providers & in detail in order for payment to done. Add to this that the older policies were issued based on a much much lower cost of care anticipated payment which doesn't come close to paying the better part of a day of NH stay. For a NH that's a lot of extra paperwork required and a lot of back&forth with the insurance company for approval and there's still a shortfall....!!!

At my moms NH the biz office told me that Medicaid residents were from a billing perspective simpler than LTC insurance ones as the state - even @ $155 day reinbursement- was preferable as the state pays in real time & consistently.
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I know all policies are different. For licenced adult Day Care secretary faxes cost to LTC & me. I pay & LTC remberses me directly into checking acct. So I actually pay the bill but am rembursed up to daily max or less, what ever the bill but not over his $120 a day.
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Igloo: Your comment about NH's not accepting LTC-that problem won't exist when you put it into your investments.
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