Will Long Term Care Insurance Last?

A recent article in Investment News, a publication for investment advisors, examines the possibility that long-term care (LTC) insurance may go the way of the dinosaur. The article notes the recent mass exodus of insurance companies offering the product.
Over the last three years, Unum Group, Guardian, MetLife (MET), and Allianz have all exited the business. And Prudential (PRU) said in March it would stop issuing individual LTC insurance.

The problem for insurance companies is that they had little idea of what they would actually need to pay out since they had so little experience. Insurance companies collect premiums for years before the vast majority of the insured will become old enough to need the care. That problem is compounded by the low fixed-income returns insurance companies are making on the premiums.

Insurance companies that have stayed in the LTC business have had large rate increases. That naturally drives healthier plan members to drop coverage, making those who remain in pool more likely to need care. This happens year after year (the healthier leave and the sick stay) leading to an insurance phenomenon known as the “death spiral.” Eventually, the product or insurance company collapses under its own weight.

Is LTC insurance right for you?

For years, I’ve been somewhat agnostic on long term care insurance because of the uncertainty over premium increases. My first advice is that, if you can self-insure, don’t buy it. Yes, assisted living is expensive, but don’t forget the costs you will save by not traveling, needing a car, etc. On the other hand, I also think you don’t need such coverage even if you have little money set aside. Save the premiums and live a nicer lifestyle. If you ever need assisted living, just understand that Medicaid may not provide the most luxurious care.

If you do buy LTC insurance, buy a plan that allows fixed premiums over, say, 10 years that then fully pays all premiums. That way, the insurance company can’t raise your rates later. Consider partial self-insurance by buying longer wait periods and even skipping the inflation rider. Make sure it’s from a highly rated insurance company (although my confidence in ratings agencies such as S&P and Moody’s (MCO) is shaken).

Medicaid Alabama Launches Latest Long Term Care Plans

Three new long-term care options for elderly and disabled Medicaid recipients were announced Friday in Mobile at a news conference by Alabama Medicaid Commissioner Dr. Bob Mullins Jr.
Two of the options are statewide initiatives. The third, known as PACE, short for Program of All-Inclusive Care, will be limited, for now, to recipients in Mobile and Baldwin counties ages 55 and older who meet certain criteria.
All three options are aimed at offering more long-term care choices for those who may not have been able to afford high long term care insurance costs in the past.
Mullins spoke prior to the grand opening of Mercy LIFE on Springhill Avenue, an inclusive-care facility where those who qualify for Medicaid and Medicare, and meet other criteria, have begun participating in PACE.
Mercy LIFE is the first in the state to become designated for PACE.
Twenty-three patients have been accepted into the Mercy’s PACE program thus far, and there are plans to enroll as many as 200 in the next few years.
The PACE participants at Mercy typically live at home, but visit Mercy several times a week to see a doctor, eat daytime meals, stop by the chapel, have laundry done or play board games. Mercy also offers rehabilitative services.
“It’s one of the few programs that has been shown to increase quality of life without increasing costs,” said Dr. J. Eugene Lammers, new medical director at Mercy LIFE, which stands for Living Independently for Elders. “It works.”
The reason it works, said Lammers and Mullins, is because people tend to do better when they live at home or with family.
“The ultimate goal,” Lammers said, “is to keep them in the community where they want to be.”
The two other programs announced by Mullins Friday include would:
• Help some patients with physical disabilities who are living in nursing homes to transition back home and receive care there.
• Assist patients who depend on a ventilator to breathe get treatment closer to home.
PACE provides comprehensive services and support to Medicaid and Medicare enrollees by enlisting a team of health professionals who create care plans.
PACE funding is capped, but providers have flexibility to deliver services by need.
The state pays about $55,000 a year for a Medicaid patient to live in a nursing home. For PACE, the state will pay about $41,000, a significant savings, Mullins said.

How to Plan for Long Term Care in Pennsylvania

About nine million people over the age of 65 will need long-term care this year, according to Medicare.gov, and that number is expected to rise to 12 million by the year 2020. Fortunately, thanks in part to the increasing demand as the baby boomer generation moves toward retirement, people with long-term care needs have more options today than in years past.

What Is Long-Term Care?

Long-term care is an umbrella term that refers to a wide range of medical and non-medical services for elderly individuals, as well as for those with disabilities or chronic illnesses. In most cases, long-term care helps people meet day-to-day health and personal needs like dressing, eating and bathing.

Long-term care comes in many different forms, including:
-In-home care: People who receive in-home care can continue living at home while getting the help they need from care providers who come and go on a regular basis according to the individual’s needs. Depending on the situation, in-home care may be limited to everyday tasks like bathing and eating, or may include more specialized health care services.

-Assisted living facilities: An assisted living facility is a group housing arrangement that provides on-site services for elderly and disabled individuals. Residents often have their own apartments and live relatively independently with easy access to the care they need.
-Nursing home care: Nursing homes are similar to assisted living facilities in that they provide on-site care to residents, but the level of care provided by nursing homes tends to be far more intensive. Typically, nursing home residents are older individuals who require constant care.

Costs of Long-Term Care

With increased options comes a greater need for careful planning — but, unfortunately, most people are unprepared. According to a survey conducted by Lincoln Financial Group, only 44 percent of Americans have taken steps to plan for their long-term care and compared long term care quote.

In Pennsylvania, the median cost of in-home care is $19 per hour for homemaker services and $20 per hour for home health aide services, both of which are slightly above the national average. Meanwhile, the median cost of assisted living in Pennsylvania is close to average at $39,015 per year, and the median cost of nursing home care is well above average at $99,280, according to MarketWatch.com.

Legal Help

Although the task of planning and preparing for long-term care may seem overwhelming, there are a wide range of resources and options available to help create a plan that works for your circumstances. To discuss the type of care you want and create a plan for financing it, contact a certified elder lawyer experienced in helping clients plan for their long-term care.