Practical analysis for investment professionals
19 September 2016

Long-Term Care Insurance (LTCI): The Good, the Bad, and the Ugly

Nothing can completely sabotage a retirement lifestyle like unexpected elder-care expenses.

My father’s dementia developed rapidly. Within a year, he no longer knew me, much less how to perform most activities of daily living (ADLs). The need for a care facility was immediate and the cost was mind-boggling.

We were “lucky,” I was told. My parents had invested in long-term care insurance (LTCI), and yes, I cannot imagine how they would afford the care Dad needs without it. But accessing the insurance benefits came with several unexpected twists and turns. Forethought and careful planning are essential, because if LTCI is not filed precisely, there are certain expenses the insurance will not cover.

During my reluctant education in long-term care, I realized how ill-prepared most people are for this particular financial risk. Only 10% of the elderly currently have a private LTCI plan in place. How should the remaining 90% fund this expense? Is LTCI their best option? As an adviser, what would you suggest to your clients?

Consider the following pros and cons, including a few alternative suggestions, before you make any recommendations.

The Pluses

As Mark Meiners, a professor of health administration and policy at George Mason University, pointed out:

“70% of those who reach 65 will need long-term care. With long-term care costing as much as $250 a day, it doesn’t take long to completely deplete a lifetime of savings — even if you’re ‘lucky’ enough to only need it for a relatively short period of time.”

LTCI thus provides the peace of mind of knowing that a good portion of your client’s future needs will be met.

Another benefit is the simple fact that it is insurance, effectively pooling the costs and spreading out the risks. While far from inexpensive, LTCI is much cheaper than saving and paying for a long-term care emergency out of pocket. As Meiners put it:

“In theory, it’s true, if a person invested $3,500 a year instead of using it to pay insurance premiums, the investment might grow enough to cover any eventual long-term care bill. But as nice as it sounds, most people simply won’t set aside additional savings for long-term care needs.”

Once a client qualifies, most LTCI policies are “guaranteed renewable.” This means they cannot be canceled because of the policy holder’s age, physical condition, or mental health. In effect, the policy won’t expire unless your client uses up the benefits or stops making premium payments.

Also, the benefits paid through a LTCI policy are generally not taxed as income. If federal standards deem a client’s LTCI policy “tax-qualified” and their itemized medical costs are in excess of 7.5% of adjusted gross income, they can deduct the value of the premiums from their federal income taxes. The amount of the deduction depends on their age.

Finally, no one wants to be a burden to their family. Unanticipated long-term care expenses can wipe out a client’s savings. LTCI can help prevent that, reducing any financial burdens on clients or any of their family members who step in to help.

The Minuses

The two most obvious stumbling blocks with LTCI are qualifying and cost. The American Association for Long-Term Care Insurance (AALTCI) estimates that people should expect to pay an average of $2,170 per year to cover a healthy 60-year-old couple on a plan that provides a $150 daily benefit for up to three years. But this is only an average, and prices vary dramatically depending on the purchaser’s age, the level of inflation-adjustment protection, and the size of the daily benefit.

Using a cost-risk-benefit analysis, Prescott Cole, a senior staff attorney with California Advocates for Nursing Home Reform (CANHR), stated that:

“Long-term-care insurance does not compare favorably with other insurance products. With long-term-care insurance the costs are high, the risks are low, and the benefits are low, but with, for instance, fire insurance, the costs are low, the risks are low and the benefits are high.”

Assuming cost is not a deterrent, your clients must qualify for coverage. Ideally, policies should be purchased when your clients are young and healthy. This is rarely the case, however. If they are older or have serious pre-existing health conditions, clients may not be able to get coverage. Most plans require an individual to pass a physical before offering coverage.

LTCI providers will often decline to insure people with the following pre-existing conditions: Alzheimer’s disease, dementia, multiple sclerosis (MS), Parkinson’s disease, and stroke. “Somewhere in the 15–20 percent range of people who try to buy this insurance are actually denied because they ‘fail’ this part of the process,” Anne Tumlinson wrote. “In other words, the insurance companies think many of us are too big of a risk.”

Should a client have to file for LTCI benefits, the insurance company will not provide them until it makes an independent determination that a severe need for long-term care exists. According to the American Association of Retired Persons (AARP), “benefit triggers” must be met before a policy holder starts to receive benefits: “Most companies look to your inability to perform certain ‘activities of daily living’ (ADL) to figure out when you can start to receive benefits. Generally, benefits begin when you need help with at least two or three ADLs.”

It is not uncommon for there to be a waiting period in a LTCI policy that works like a deductible. Once the benefit triggers have been met, your clients must then wait three to four months before their medical costs are covered. As Cole put it, “Most long-term-care policies don’t pay anything until the person has been in a nursing home for more than 90 days. If more than two-thirds of those going into nursing homes leave before 90 days are up, it is unlikely that most consumers will receive any benefits at all.”

Statistically, the AALTCI reports that “for someone with a 90-day elimination period, the lifetime chance of someone buying coverage at age 60 and using policy benefits was 35%. So, 35% will use their coverage and 65% will not. As you might assume, the decline is because during those first 90 days, some people will recover and some will die.”

Keep in mind that LTCI policies only pay a fixed amount per day for a limited period of time — that daily amount is a critical factor when calculating the initial premiums. The time period is “typically capped at three years, because open-ended plans have proven too risky for insurers,” according to National Public Radio (NPR).

Also, coverage can be limited to that provided by specific certified home-care agencies or state-licensed professionals.

Finally, LTCI premiums can increase: A company cannot single your client out for a rate hike, but it can raise premiums on a class of similar policies in their state, and most premiums do end up increasing during the length of the policy.

As an example, LTCI policy holders in Pennsylvania were shocked when their 2016 renewal notices indicated that premiums would rise by as much as 130%, with annual rates on pace to reach in excess of $8,000 for some policies. And the problem is not unique to Pennsylvania. Many industry observers expect rates to increase dramatically across the country in the years ahead.

“There are a number of factors contributing to the explosive growth in long-term care insurance premiums,” Maryalene LaPonsie explained. “Carriers assumed people would drop policies as they got older. However, that didn’t happen in many cases. What’s more, people are living longer and aren’t necessarily living healthier. As a result . . . many insurance companies have fled the market and those that remain have increased premiums significantly to keep up with costs.”

Meanwhile, premiums for almost all of the federal government’s existing LTCI policies for federal employees and retirees will rise by 83% on average.

So, what are the alternatives to LTCI?

Newly developed hybrid or linked-benefit products are options. One product that’s growing increasingly popular is a form of life insurance that includes tax-qualified long-term care riders. Jamie Hopkins observed:

“These hybrid life insurance and long-term care policies give the policy owner access to the majority of the death benefit if long-term care services are needed. If long-term care services are not needed or all of the death benefit is not used up to pay for long-term care expenditures, the remaining death benefit is paid out to the beneficiaries upon the death of the policy owner.”

These can be sold to older people who have health difficulties and can’t afford long-term care policies, and their waiting periods tend to be shorter. Also, they usually feature fixed premiums and have different coverage rules.

Another option is annuities with long-term care riders. Your client purchases an annuity but rather than taking withdrawals, earmarks the money for long-term care. If the client never requires care, they can elect to receive the money after the annuity matures or bequeath it to their heirs. According to Teresa Mears:

“These annuities require a hefty upfront payment, but if you need long-term care, your overall cost may be lower than what you’d spend on insurance premiums. However, don’t expect much in the way of interest.”

High-deductible health insurance plans featuring health savings accounts (HSAs) are another way to put money aside tax-free for qualified long-term care medical costs. Also, your clients may be able to use their HSA to pay for part of their LTCI, if the insurance is tax-qualified.

A final alternative is using home equity through a line of credit, a reverse mortgage, or selling property outright in order to fund long-term care. This option assumes, of course, sufficient equity exists to cover the long-term care expenses.

Funding long-term care requires a kind of clairvoyance — an ability to anticipate future needs, future costs, and future health conditions. It is an incomplete science at best. But with full knowledge of your clients’ health, assets, and expenses, as well as the pros and cons of all potential options, you will be able to recommend the long-term care plan that best meets their needs.

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All posts are the opinion of the author. As such, they should not be construed as investment advice, nor do the opinions expressed necessarily reflect the views of CFA Institute or the author’s employer.

Image credit: ©iStockphoto.com/Ocskaymark

About the Author(s)
Susan Hoover, JD

Susan Hoover is currently the editor of Connexions, the CFA Society Leader newsletter. Previously, she was the digital editor, Enterprising Investor blog, CFA Institute for two years. Prior to CFA Institute, Hoover worked for McCallum & Kudravetz, PC, and the U.S. Department of the Navy in real estate and labor law. Hoover earned the CFA Institute Investment Foundations™ Certificate and holds a BA degree from Lehigh University and a JD degree from the Washington College of Law, American University.

34 thoughts on “Long-Term Care Insurance (LTCI): The Good, the Bad, and the Ugly”

  1. L. Brody M.D, says:

    THIS IS AN EXCELLENT ARTICLE, BOTH for advisors getting up in age, and for clients who will someday possibly need long term institutional care. I doubt that $250 a day will cover expenses.

    You have to start thinking about this early.

    I have appreciated the warning included in this timely and thoughtful article.

    1. Susan Hoover says:

      Thank you so much for your kind words.

  2. Aaron Skloff says:

    We published an article that compares insuring with Long Term Care Insurance versus self-insuring.We provided an example of premiums and benefits for Long Term Care Insurance. Please see this link:

    
http://www.skloff.com/insure-or-self-insure-for-long-term-care-long-term-care-university-081515/

    
Aaron Skloff, AIF, CFA, MBA
    CEO – Skloff Financial Group

    1. Lee says:

      page won’t show.

    2. Robert says:

      Terrible analysis. With insurance, you have a 100% chance of losing all the premiums. With self-insurance, you have a good chance of keeping the premiums. This analysis ignores that completely. You have to discount the insurance benefit by the chance of using the benefit.

  3. Richard says:

    It’s kind of a damned if you do, damned if you don’t scenario. Sadly, to me it sounds like the best option is to move your parents or yourself to California, Oregon, Vermont, or Washington where assisted suicide is legal.

    1. Susan Hoover says:

      Thank you for your comment Richard, and the damned if you do, damned if you don’t scenario is exactly how we felt!

  4. Before having the conversation about care giving plans there are 6 questions I ask before we talk about what plans to own to protect their cash flow, their commitments now and in the future, and how not to disrupt their estate.

    a. What conversations have you had with your family about your
    caregiving and end of life decisions?

    http://www.the conversationproject.org or http://www.lavineltcins.com to begin the conversation

    b. What health issues are common in your family history, i.e.
    Dementia, Stroke, Heart attack, Frailty due to longevity?

    c. Where do you want your caregiving to begin?

    d. Who will be responsible for managing or being responsible
    for your caregiving? i.e. spouse/partner; family, friends
    service organizations, licensed caregivers?

    e. Where will the funds come from to pay for your care and to
    continue the lifestyle for you and your family? i.e. personal
    assets, family, government, Medicaid, extended care benefits
    (LTC)?

    g. What type of lifestyle do you want to have when you are at
    the age where long-term care is needed?” i.e. Travel, cultural or
    sports activities, family gatherings, activities which are
    accomplished if you have assistance?

    f. What financial responsibilities will you bring into retirement?

    https://goo.gl/M3VrNa

    When will you have the conversation with your family about your caregiving and your exit strategy?

    1. Lee says:

      They are great questions to think about. It is 7, not 6.

  5. Susan Hoover says:

    Thank you for your great comment Raymond, all excellent points. It would have been so helpful had my parents thought ahead to have this conversation.

  6. Thank you Susan for sharing this enlightening piece of information. This is timely and very relevant.

    It is definitely packed with helpful information, that can help clients prepare for their future and carve their way out of premium hikes. It is undeniable that long-term care insurance has helped a lot of Americans pay for their long term care needs but there’s no product that is perfect, so it has flaws too.

    The premium hikes are causing panic among policyholders and alarm to people who are considering to purchase a plan. Despite the increase in premiums, long-term care insurance proves to be the most economical way toy pay for long term care. Relying on government programs is too risky since Medicare doesn’t cover long term care and Medicaid only provides coverage to low-income seniors.

    The bottomline is this, talk to a specialist and shop around if you want to get covered. If you already have a policy, then talk to your long term care insurance provider and strike a deal on how to bring your premiums down. There are actualy variety of options that can help you brave these premium hikes. Lowering your daily benefit amount is one, another is decreasing your benefit period and adjusting your benefit inflation rate is also an option.

    I’ve actually written about different ways to face long term care insurance hikes just recently and here’s the link: http://www.altcp.org/facing-long-term-care-insurance-rate-hikes/.

    1. Lee says:

      Good info. I wonder if there is a life insurance product that offer long term care benefit, preferably, with some sort of investment management option (index funds selection)?

  7. Susan Hoover says:

    Thank you for your comments, Samantha. Very true that the high initial cost and then unknown premium increases are significant barriers to long-term care insurance. I will certainly review your article.

  8. Barbara Stahlecker says:

    There are a lot of facts in this article but also a lot of half-truths. Here are a few I think should be addressed:

    1. Most policies don’t pay until you’ve been in a nursing home for 3 months – this is incorrect. While it is true that most policies sold have a 90-Day Elimination Period, many people satisfy this waiting period by using Home Care or care in an Assisted Living Facility. In fact, most policies sold today have a 0-day EP for Home Care and yet any days used at home count towards the 90-day EP. So it is very likely that by the time the client goes to the Nursing Home that there will be no Elimination Period to meet.
    2. Policies pay a fixed daily amount – untrue. Older policies (and by older I mean ones sold in the 80’s and 90’s) were limited to the daily benefit but most carriers today pay monthly benefits. So if you buy a policy with a benefit of $200 per day, what you’re really getting is the ability to spend up to $6000 a month, not limited by the daily amount.
    3. Waiting periods are shorter with hybrids – not sure where this information came from but it’s completely inaccurate. I haven’t seen a hybrid yet with less than a 90-Day EP. If it exists, it certainly isn’t the norm. In fact, since many LTC policies have a 0-day EP for Home Care, they will pay benefits faster than a hybrid will.
    4. Using the example of 130% increase is unfair. That is certainly not the norm and only works to scare people away. There are many blocks of business that have had minimal rate increases (5% – 10%) or none at all. This more likely the norm than the 130% scenario.
    5. Care is limited to specific HHC agencies or state-licensed professionals – while all policies will pay benefits if the caregiver is duly licensed as such in t their state, there are policies out there that will pay family members to provide care. There are also policies that will pay a cash benefit, which allows the client to hire anyone they want to.
    6. Costs are high, risks are low and benefits are low – this is probably the most misinformed statement in this article. In my agency, our average premium is $2499 annually. That means a couple is paying about $200 a month for both of them or $100 each. Also, there are newer policies out that only pay benefits for a year or less (Genworth says 49% of their claims are for less than 1 year) that are very affordable and can provide meaningful benefits.
    7. Comparing LTC to fire insurance isn’t a fair analogy. The odds of your house catching on fire and burning to the ground are 1 in 1200. The odds of needing some LTC in your life are 1 in 4. It’s estimated that 1 in 2 people over the age of 85 have some sort of dementia. As our population grays with 79 million baby boomers, LTC is going to become our most important issue. We must make plans to prepare for needing care because the government cannot possibly take care of us all.

    I really appreciate that you are writing about long term care insurance, but please talk to LTC specialists for your information. Any one of them will be more than happy to get the right information to you. Most of us are passionate about this industry and want to see people take responsibility for their own care expenses. Not only that, but during such a difficult time, having this insurance can make it so much easier on everyone involved.

    1. Susan Hoover says:

      Thank you for your comments, Barbara. It is always very helpful to have many different opinions. It definitely helps with the information gathering. Please note, the information in the article regarding my parents’ policies did come from an insurance specialist, and they are true. Otherwise, sources for the facts are certainly cited in the post.

  9. Barbara Stahlecker says:

    Respectfully, just because your sources are cited doesn’t make them correct. At the very least, Mr. Cole needs to be better informed. I’ve been in the insurance business 33 years with the last 29 of then exclusively in LTC and I can tell you without a doubt that this statement is not factual: “Most long-term-care policies don’t pay anything until the person has been in a nursing home for more than 90 days. If more than two-thirds of those going into nursing homes leave before 90 days are up, it is unlikely that most consumers will receive any benefits at all.” In fact, according to Genworth (who pays more LTC claims than anyone – $6.1 million a day) 71% of their claims begin as Home Care. So while it is true that a person would need to pay for the first 90 days on their own if they went straight into a nursing home without first getting any care at home or in an assisted living facility, it is incorrect to insinuate that is the norm.

    Lastly, it’s important to remember that whatever statistics went before are going to be irrelevant in 25 years. Using old information is what got this industry in trouble in the first place but then again, it is impossible to predict what effect aging baby boomers will have on extended care. So while the AALTCI might say that only 35% of those who purchase LTCi will use it, that information is based on current data. Once 79 million boomers start experiencing dementia, that number is going to climb much higher.

    1. Susan Hoover says:

      Thank you once again for your comments, and thank you also for reading the blog.

  10. I have been reading articles which are critical of extended caregiving benefits (Long Term Care Insurance) or reasons why owning caregiving benefits has little value.

    1. Caregiving is expensive.
    2. Long Term Care benefits are expensive
    3. If you do not use the plan, the premiums go to money heaven
    and not a beneficiary.
    4. I will self-insure or be in denial about caregiving and wait for the
    crisis to occur and then my family will be in worry and panic with
    how to care and pay for caregiving services.
    5. Family and friends who have no choice but to be personally
    involved with caregiving will be supported where they work or
    if self-employed, employees will keep the business productive.
    6. No worries if you have assets over $2 million.

    Since 2009, long term care plans have been in transition for these reasons:

    a. Interest rates have been low affecting short and longer term fixed
    investment returns.
    b. Actuaries forecast that a percentage of people who own plans would cancel them after a period of time, similar to owning life insurance. This did not occur. People realized that these plans are valuable so the cancellation rate is very low.
    3. People believed or were led to believe that the would only use the plans for a short period then die. This has changed. People need care for longer periods before they die.

    There is an important factor which is seldom considered which is the first question I ask. Where will your caregiving begin and not where will it end? A person maybe 6 months to a year in a care center may have caregiving services for several years while living at home.

    Before owning a plan consider your cash flow, your capital which is producing cash flow, your lifestyle, and your commitments for the future.

    People own a caregiving plan because they love their family and they want to make sure that should caregiving be needed, it will not disrupt the life of a family.

    The affluent understand this and would rather own LTC plans and transfer some of the caregiving payments to an insurance carrier to pay for care services.

    Caregiving is not about you, it is about your family and how they will be affected.

    a. Most people begin caregiving at home.
    b. I have read studies of how much income, savings, and benefits is forfeited by family and
    friends caring for people who need care services. It is in the billions.
    c. There is an emotional and physical toll on people who care for family and friends?
    d. Why would people accumulate or inherit assets for lifestyle want to spend or to go on Medicaid work with an elder care attorney to transfer property and assets just in case they need care services?
    e. Why would people spend a lifestyle of accumulating capital for lifestyle and legacy and transferring to family want to liquidate all or a portion of their estate for caregiving services?
    f. Why would anyone want to spend 100 cents on the dollar versus spending cents on the dollar to own a caregiving plan which will pay a good portion of caregiving expenses?
    g. Money makes the choice whether people remain at home or transfer to a care center. Why?
    It may be that it is better to be in a care center. Another reason is family and friends are
    tired, frustrated, and need to get on with their lives and careers. h. Ask an economist whether studies were of value when they or their loved ones needed care. I doubt their impulse is to say, “sell everything and spend it on caregiving and then go on Medicaid.”

    1. Susan Hoover says:

      Thank you so much for your comments, Raymond. All good input.

  11. Diana Tsang says:

    Hi,

    I have LTC insurance since 2012, They recently raised my premium by 50%. In order to keep the same premium, I have to either reduce the daily benefit from $191 to $127, or increase the elimination period from 90 to 180 days.

    I’d appreciated your take on this.

    Thanks,
    Diana

  12. Well stated Barbara. You are spot on with your response to the author of the article.
    I am a licensed insurance agent with over 35 yrs. experience- over 20 of them spent in LTC.
    Additionally, I have been a caregiver to both parents-one an LTC policyholder.
    Through my own personal and professional life experiences, I can accurately and emphatically state that a LTC policy, not only saves the family a significant amount of money-but also minimizes the “human currency” spent.
    When a long term care event occurs, it can be gut wrenching for the entire family. A LTC policy provides the ability for extensive care coordination services which will set the game plan for the family. Additionally, it will set up a firewall around the assets accumulated to be gifted or spent as desired. Long term care is the largest unfunded liability many people have. Many are unaware of that fact.

    1. Susan Hoover says:

      Thank you for your comment, Jeffrey, and for your perspective on LTC insurance.

    2. Lee says:

      LTC is a land mine field. There are SO many caveats that make ordinary people afraid of even think of getting into it. I hope LTC professionals provide facts and true examples upfront rather than being a insurance sale rep with commission. LTC industry needs to provide better products that are fair and attractive.

  13. Hurrah! At last I got a website from where I can really get helpful information
    concerning my study and knowledge.

  14. With the uncertainly in Washington DC in 2017 surrounding the long term viability of Medicaid and the shortage of quality facilities that accept medicaid as a starting point for care reimbursement , I would not want to just roll the dice and hope for the best when it comes to long term care needs (no private plan in place). Like it or not a traditional tax qualified Partnership eligible long term care insurance plan is still, by far, the best way to go. As far as the 90 day waiting period, there is a rider that I always use with clients that is a Waiver of Home Health Care Elimination Period (you are reimbursed from day one if you start out with home health care which 70% of claimants do). Hybrids do not provide the same robust benefits as traditional plans. Yes, you will be guaranteed something back on a hybrid, but I would rather have a plan that does a better job of mitigating the risk of care (that is where I think traditional LTCI plan shines over a Hybrid). Most CCRC facilities require that you show financial capability for paying for a minimum of two years of care. A traditional LTCI plan can help “unlock the door” to a quality facility and if you run through your plan in say three years they wont kick you out (most will allow you to stay using government benefits or on an ability to private pay basis). By the way, the average length of a long term care event nationally is 2.9 years. It is important to have a long term care plan that will cover a 3 year period per person and have some form of inflation protection.

  15. Care giving is not just for you only but the people who are really affected. There is an emotional and physical toll on people who care for family and friends. Care giving is expensive especially Long Term Care. Thanks for sharing the blog and helping with some the pros and cons of long term care insurance.

  16. Ken says:

    The cost of a 3 year plan with a decent amount of coverage per day and inflation protection is just astronomical! I just don’t see the point of putting that amount of money out for insurance that may not be needed. Also, what happens after 3 years (forget longer terms, too expensive), I guess you are on your own after that. Then, the argument for buying LTC insurance at a young age also makes no sense to me for several reasons: you cannot miss a payment without forfeiting the plan, you need two disabling requirements to get coverage, premiums will continue to go up. At a young age, I think it is better to take the money that one would use to pay the premiums and invest it in a Roth IRA. This would not have a problem with forfeiture, would not require two disabling requirements, would not require legal bantering with the insurance company, and if anything is left over, it can go to heirs.

  17. Morgan Colin says:

    Really amazing guide. Very valuable tips.

  18. Ford Stewart says:

    I’m surprised at how difficult it is to find balanced information about LTCI, so thank you for writing this. Unsurprisingly, most of the material I have found is written by people who profit from selling LTCI.

    We can agree that the cost of long-term care is high and poses risk to retirement. It is less obvious – dubious, in fact – that most LTCI policies address that risk. And when Prescott Cole, who you quote, says that LTCI is expensive, he is referring to its efficiency I’m sure -that more money goes to administration and profit instead of benefits, compared to other types of insurance.

    I would like to see (and may have to create myself, I suspect) some use cases where people with varying levels of health and wealth fall on the probability curves and how each fares with self-insurance or some of the available policies.

    If a dispassionate study like this exists on the web, I haven’t seen it.

    Thanks again,

  19. Garda says:

    I’ve had a full life long term care policy since I was a healthy single 50 yr old woman who had two grandmothers live into their 90’s requiring support from my parents. Now I’m married, have diabetes, and am 71 yrs old. The premiums have skyrocketed to almost $6,000 annually. Have I wasted the money?

  20. Johanna O'Loughlin says:

    Thank you for your article, which I found to be balanced with the exception of the portion which dealt with the likelihood of using LTCI policies. Like several of your other commentators, I too found this information overstated if not incorrect. I would point you to Favreault & Day (2016), who put the estimate for the likelihood of needing long-term care around 50 percent, waiting periods not withstanding. This practice is not without precedent even among social insurance models. Medicaid dual-enrollees face waiting times from one month to a year in some states. CHIP recipients in many states face up to a 90-day waiting period. It is also important to note that care under the 90 day mark is often not considered “long-term” care, having failed to meet the justification of the nomenclature. I had the pleasure of being a student of Mark Meiners at GMU, where I am getting my PhD in Public Policy. I can’t speak for Dr. Meiners, but from my understanding he would have a different take on the issue of waiting periods. My dissertation is on the small size of the private, individual long-term care market. Families facing the realities of long-term care are often unprepared for the circumstances they find themselves and their loved ones in. It is a difficult and complicated time on many levels. It is very understandable that the logistics and administrative hurdles associated even with the best case scenario, when LTCI is owned, can cause added –and in this case–long-standing stress. Respectfully yours, Johanna C. O’Loughlin

  21. Melodie Phillips says:

    Im wondering if anyone has information about whether Medicare (A & B) or our Medicare Supplement (United Healthcare) will help pay or defer costs during the elimination period. We have a 100 day wait. We have used 66 days since our elimination date was confirmed by our LTCI (John Hancock) We really need help with the balance of the days before we are covered. The claim is already opened, confirmed, my mom qualifies, and our elimination period began 66 days ago. We are being discharged soon and we will have at least 1 month of time that we will need to pay for.

  22. Long term care insurance sure is important. As said above it will be hard to deal with the unexpected charges at an old age. Avoiding such problems needs a backup and backup can be in the form of insurance.

  23. Catherine Posada says:

    My long termcare policy states, I need 100days elimination period before they pay for care and a extra 90 days to qualify to stop paying my premium. I have met my 100 day elimination period,I receive home care 2 days a week however, my Imsurance states, I need care 5 days a week in order to qualify to stop paying my premium.Please advise ,what options do I have.

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