When do you start using LTC plan to pay for care?

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When do you start using LTC plan to pay for care?

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My parents are 86 and 91, one with kidney failure on dialysis and the other with dementia. They live together and we have just started getting some help in. They are doing okay, but spending lots of money on care. They have LTC insurance for 5 and 3 years, respectively. How do you know when the smartest time to use it is?

Financial Planning Long Term Care Long Term Care Insurance Paying for Care

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I had LTC insurance for my husband and I. He was 77 when I started using it. He had dementia and I used it when he could no longer stay at home alone. I got paid care takers when I went out with friends or on errands. There was a 90 day use period before I started getting benefits. I had to pay out of pocket for those days - cost me $18K the first year - March though December (I used them about 2 x a week for about 6 hours each time.) Our policy is for 2 year (Nursing Home) so it would have lasted a lot longer (max of $200+K) for in home care. He passed in June of last year and my LTC ins. ended up paying $10K. I say USE IT NOW, they will come and evaluate and if they approve they may be able to go back and allow what they already paid towards the deductible. Obviously it depends on the plan. You need to find out the details, but call LTC now, don't delay.

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Reply to neetava

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You are right about the ninety day period. If you go direct from home to an AL or SNF many policies require private pay for the first 90 days. Rehab stays typically count towards the 90 days as does any amount of home care if you have already activated a claim. Sometimes that lessens or totally avoids the out of pocket cost.

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Not an easy question. Here is my situation: My parents bought LTC policies when they were in their 60s. In 2020, my father fell off a step stool and broke his hip. He was 94 and still active and driving. He and my mother were living in their own house. He almost died in recovery from surgery. The anesthesia kicked his a$& and he coded three times right in front of me at the hospital. They intubated him and for all intents he was in a light coma. Within two days, COVID shut the hospital down to family. Somehow he made it through to discharge to a rehab and came home in a wheelchair. Meanwhile my mother was living at their house where she used a walker. My brothers and I put money down on a local AL in May 2020 and planned to move them in. It seemed like the right thing. But, it was during COVID and we ultimately decided against it. Three months later, my mother could no longer get up and use her walker - just too weak. After a short hospital stay and rehab (that did nothing but cause the beginnings of a bedsore from neglect), I moved her to my house. At that point I activated LTC claims for both for home care assistance. Five years later, she is still at my home and still has benefits. She is 98. He recovered his ability to walk in 2020. He just turned 99 and I have finally moved him to a nearby AL so he is using benefits too, but at a much faster rate. He is getting mediocre care and terrible food so I still have to supplement those things for him but it helps me and my brothers have some life. We are making the best of a bad situation. The point of all of all this is that it would have been a huge mistake to use their benefits at that AL rate 5 years ago. They would have been used up and with two of them surviving, they would have been in danger of exhausting all of their assets and winding up in a state Medicaid facility somewhere. I have tried to balance what my brothers and I can provide against their needs and what their finances can support. It would have been easy to just use their insurance early but in our case that would have been a waste. There is no crystal ball to know with 100% certainty what is right. Use your best judgment based on their needs, your needs, their longevity and their finances. Good luck!

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Reply to jemfleming

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At their ages, I would say now is a good time to start using those resources.

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Reply to Taarna

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TheMiddle1: Now would be the time to use the LTC.

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Reply to Llamalover47

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Won't you kick yourself if they don't live for that many years, when the policies could have helped them now? Not meaning to be snarky, just that this is what the policies are for. The money they're spending now can then be saved (or invested) to use if they outlive the policies' coverage.

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Reply to MG8522

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You probably could have already started it and I would do it now rather than wait and possibly have it never be used as planned. Old policies aren’t just for a facility but will cover the help you need . I have one on my hub and he’s in MC now with end stage Alzheimer’s after an accident with a TBI. I had it started before him going into the facility as I needed help at home and had him going to some adult day care too so I could take care of my needs too and not having to take him with me to my appts. His wait period was 30 days but some are 90. Once activated they waived the premium but in the anniversary date they readjust amt at usual 3 1/2%.at their age and medical issues as a retired nurse I suspect they probably won’t outlive their policies as they would be in their mid to late 90’s . If they do you will have other options as mentioned but you have the ability to use it and provide for them and that’s the whole purpose. Don’t forget that this caregiving takes a toll on us too and we can’t help them should something happen to us. I had to make my hub a DNR because of this awful disease and I take it a day at a time. It’s all we can do. So start the ball rolling, provide for them and breathe , and love them the best you can…. The journey will end as it always does with them passing but the time you can spend with them are the last memories you will make and will treasure.

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Reply to Db2024

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Speaking from experience as my mom has a LTC policy that pays for her assisted living facility…Call the insurance company that holds the policy and get the ball rolling. The claims process will take several months. They will most likely require records from doctors, hospital stays, etc. They will probably send a nurse to visit your parents to determine how much care they require. I think it all boils down to how well your parents can or cannot perform ADLs (activities of daily life).

I wish you the best in this. It can be a very challenging process to get through but if your claim is approved for payment, it is very much worth it.

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Reply to DD1963

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You should consider calling your LTC insurance provider and asking them to send a rep out to your parents' home for an assessment. They can help gauge what is needed at this time and what LTC may fund now while they are still at home. Leverage their recs/experience with a grain of salt, but it is still super valuable. The longer your folks stay in their home, where their familiarity and routines stay the same, the longer they will likely live in a positive way (research is pretty clear here). For my FIL, that meant getting him, and having LTC pay for, a motorized stair chair lift, a guy that came in 3x a week to cook for him and take him out to activities as well as a medical alert device (we got him the Kanega Watch, since there was no way he was going to wear a neck pendant and we didn't want him removing it to charge and having to remember to put it back on). The nice thing about his medical alert is that he wore it all the time, so we could cut down a bit on in-home care, since he could always get help if he needed it (and he fell several times and his device worked great each time). In short, you do have options and should explore them so you can make the best decision for your folks. All the best in your difficult journey.

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Reply to Livingsum

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Check the policy. A lot has changed through the years. A 3 k monthly payout will not help a 6 or 7 k facility unless the parents still have cash to pay the difference

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Reply to MACinCT

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To be honest I would start now. After that money is gone then there are other assets. After those assets are gone there is Medicaid and by that time they won't much care; and to be honest I don't think the future is that predictable in terms of care.
I would use it now were it me.
You might want to get the advice of a financial advisor if you have one. But I would use it now. Especially in terms of someone in 90s with kidney problems.

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Reply to AlvaDeer

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Thanks, AlvaDeer. Appreciated. I think I am more thinking about my dad who is the one with dementia not the kidney issues and the older one. He has a healthy body, but after a while his brain will start to impact that, I assume. Maybe I am being too optimistic that he will live more than 3 years.

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I would use it now then as they decline and they begin spending more of their assets look into Medicaid. But they will have had to spend down assets. Be cognizant about the Look Back period.

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Reply to Grandma1954

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I’m not an expert but I would say right now. I don’t see the benefit of delaying in their situation.

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Reply to MidwestOT

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When do you start using LTC plan to pay for care?

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