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Advisor

LTC coverage snafus?

My CPA and I met on Wednesday.  We tend to have a good talk about things in general, in additon to prepping for our income tax filings. 

This year, when I asked about her family, she told me of her MIL's recent fall, hospitalization and rehab...plus, the problem with finding anyone to take her within the terms of her LTC insurance.  Lady in her late eighties, needs more than assisted living level of care...

Really needs a nursing home, but they cannot find one with the requisite physician-dictated programming of care that is the only thing her policy will reimburse for...in other words, it si great insurance, but no one in their area is offering that specifically-defined care, so no benefits are being paid out for her long paid-up policy. 

My insurance agnet has hounded us for a few years now about LTC coverage.  Philosop[hically, I understnad why it is advisable, but don;t you think it will - in at leasat some exampoles - turn into the next insuracne scam, or that companies will fail to pay when it gets to expensive for them to do so and stay solvent. 

I am sure they calculated the actuarials so that they will profit, if subscribers die in sufficient numbers and soon enough; but, let's say one drug comes along and delays death in Alzheimers' patients, which at present is as certain a terminal diagnosis as they come. 

AIDS is a good comparison from a decade or so ago...when one way to "invest" was to give a diagnosed person a portion of their life linsurnace proceeds while alive, and then wait for the policy to pay off big, soon.  When people started surviving longer-term with AIDS, that business model disappeared, from what I can gather.   

Anyway, i am looking at two of the smartest professionals I know, who between them cannot get a long term care policy to pay a benefit for nursing home care for the mother of one of them.  Not one red cent.  Given this news, I am ever more glad that I have resisted the siren's song to buy into it. 

Any other observations on this usbject?

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7 Replies
Veteran Advisor

Re: LTC coverage snafus?

I am skeptical along with you Kay---have experienced both sides of this issue and wife works geriatrics so I like your swimming pool policy for startersSmiley Very Happy

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Advisor

Re: LTC coverage snafus?

Son and his helper are restoring the pool deck framework and decking last week and next.  Then, the repair company is contracted to install a new liner as soon as the weather stays warm and they get to us...I think we are third in line for repairs this spring.  We will be taking out the diving board, which we never use, and adding a solar cover and reel to retract it, to extend the season. 

It used to irk Mike to fix up and deal with the pool, but now that we heat it with wood, it is so much nicer.  Now, as long as I leave a note under a rock on the deck when I take that final leap, he's okay with my reasoning to have it handy. 

An MD friend mentioned over dinner tonight that so many people in really rotten health have "full code" designations on their charts.  I saw this on clincial rotations, too.  I have heard career nurses talk about the cruelty of cracking bones in frail patients while working to resuscitate them. 

This system is whack...thus, the pool upkeep. 

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Senior Advisor

Re: LTC coverage snafus?

What is the reason the insurance company will not pay for nursing home care? Failure to inform of a preexisting condition?

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Advisor

Re: LTC coverage snafus?

Kay, my wife is an insurance agent with a company that sells LTC insurance amongst other things.  If you have specific questions about it all I will have her answer them for you.   Yes, she talked me into it.  The younger you are when you buy into it, the cheaper it is.  When a landlord went into a home and ran out of funds rather quickly (6 months) and the farm was offered to me to purchase it did get me to thinking.   Not many people have the funds socked away to pay for any length of time in a nursing home.  Yes it's a chunk out of the budget but a small price to pay for what we have to protect.

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Veteran Advisor

Re: LTC coverage snafus?

My grandfather said about policies in the 30's being you where covered for falling "off the barn" -"not for hitting the ground"--enough said--also my banker said years ago "if you read the fine print you won't sign it"-this was in the mid eighties although 3 years later I paid him off--maybe more luck than sense ?

Honored Advisor

Re: LTC coverage snafus?

As explained to me, even after much consultation with insurance pros who said she "ought to be covered," the CPA and her husband finally got an explanation that her policy required a doctor to formulate the policies at her care facility.  They haven't been able to find that...maybe it is not common, so a good way to collect premiums and not pay out?!?!?

Very frustrating and expensive. 

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Honored Advisor

Re: LTC coverage snafus?

Your Granddad's figure of speech is WAY too apt for our day and age.  Thank you for that saying...I will always remember it!

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