Is Long Term Care Insurance Really a Good Idea?

Clients are often concerned that long term care insurance is too costly, but it may not be compared to the cost of private paying long term care.

Forbes’ recent article entitled “Is Long-Term Care Insurance Right For You?” says that a big drawback for many is the fact that long term care insurance (“LTCI”) is expensive. However, think about the costs of long term care. For example, the current median annual cost for assisted living is $43,539, and for a private room in a nursing home, it’s more than $92,000.  In many urban areas it is much higher, so utilizing long term care insurance my be best.

Another issue is that there’s no way to accurately determine if in fact you’ll even need long term care. Much of it depends on your own health and family history. However, planning for the possibility is key and unfortunately most clients don’t plan for long term care either with insurance, retirement or in their estate plans.

Remember that Medicare and other types of health insurance don’t cover most of the cost of long term care—what are known as “activities of daily living,” like bathing, dressing, eating, using the bathroom and moving. Medicare will only pay for medically necessary skilled nursing and home care, such as giving shots and changing dressings and not assisted-living costs, like bathing and eating. Supplemental insurance policies generally don’t pay for this type of care.  Those who meet financial guidelines may receive care provided under Medicaid or other benefits such as Veterans benefits.

It is important to shop around as there are no one-size-fits-all long term care insurance policies. Check the policy terms and be sure you understand:

  • The things that are covered, such as skilled nursing, custodial care, assisted living and in home care
  • If Alzheimer’s disease is covered as it’s a leading reason for needing long-term care
  • If there are any limitations on pre-existing conditions
  • The maximum payouts, including if maximum payouts are by day or year
  • If the payments are adjusted for inflation, which depending on the time of purchase might be key
  • The lag time until benefits begin
  • How long benefits will last, including whether there are lifetime caps on the amount paid or time periods paid
  • If there’s a waiver of premium benefit, which suspends premiums when you are collecting long-term care benefits
  • If there’s a non-forfeiture benefit, which offers limited coverage even if you cancel the policy
  • If the current premiums are guaranteed in future years, or if there are limits on future increases
  • How many times rates have increased in the past 10 years
  • If you purchase a group policy through an employer, see if it is portable (if you can take it with you if you change jobs).

Typically, when you are between 55 to 60 is the most cost-effective time to buy LTCI, if you’re in good health. See my prior blog on this point.  https://galligan-law.com/when-should-i-consider-long-term-care-insurance/   The younger you buy, the lower the cost. However, you will be paying premiums longer. Premiums usually increase as you get older and less healthy. There’s a possibility that you’ll be denied coverage, if your health becomes poor. Therefore, while it’s not inexpensive, buying LTCI sooner rather than later may be the best move.

The best thing to do is to consult your financial advisor and your insurance agent on whether a LTCI policy, and which, will work best for you.

Reference: Forbes (April 17, 2020) “Is Long-Term Care Insurance Right For You?”

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How to Be a Good Caregiver

Being a caregiver is both a rewarding and demanding role.  Here are some tips to be a good caregiver.

If you find yourself suddenly in a caregiving role, you may not know where to begin.  CaringBridge’s recent article entitled “5 Tips to Be a Good Caregiver” provides some great advice on how to be a good caregiver.

Communicate. This is the most important factor, when trying to be a good caregiver. Caregivers should strive to communicate with patience, understanding and empathy.  A person being taken care of can sometimes feel like they’re a burden or a nuisance. Good communication and reassurance can help prevent that. You should also have communication between you and your other family and friends. Asking for help isn’t always easy, but those who care about you will want to support you.

Take Care of Yourself.  When you’re constantly on call caring for a person who is ill, it’s easy to forget about your own needs. Caregivers can be so overwhelmed that they’re unable to take time for their other family or interests. They can feel guilty being away from the person in need.  Studies even show that serving as a caregiver often takes a toll on the caregiver’s health.

Your health and well-being are important too, and you can’t be a good caregiver to your loved one if you aren’t healthy. Prioritize your own health, physical and mental—it’s vital for both you and your loved one.

Have a Lot of Patience. This is important because it’s helpful to be patient with yourself. You’ll make mistakes, but remember that you’re trying your best, and no one’s perfect. You should also be aware that communication can sometimes be difficult when you’re caregiving. Your loved one might say or do something that hurts your feelings. This is often due to the underlying illness which may affect your loved one’s personality.  However, do your best to be patient and empathetic. Don’t take it personally. Try to look at the situation with understanding and acceptance to battle discouragement.  This article provides guidance on the topic as well.  https://galligan-law.com/caring-for-an-elderly-parent-without-ruining-your-relationship/

Create Boundaries. When spending so much time with one person, and sharing their most intimate moments, it’s still important to have some boundaries. These can include you knowing your own limitations and what you’re comfortable doing for that person. Boundaries also apply to the person receiving the care and things, such as the way in which that want to be cared for and their likes and dislikes. Boundaries allow both people to be happier.

Remind Yourself of Your Mission. Sometimes, you can become a caregiver out of necessity or a sudden crisis. Nonetheless, at the center of the situation is love and empathy. Caregivers love and want the best for the person they’re helping. You should try to harness that compassion to keep you motivated through hard times.

Get Help.  With so many people serving as caregivers across the country, there are a wealth of resources to support caregivers and their loved ones.  Organizations like the Alzheimer’s Association, Dementia Society and others have information, support groups and other resources to help you in your mission.

Remember that a good caregiver is one who cares. You’re not expected to be perfect, so make certain that you give yourself just as much love and patience as you offer your patient.

Reference: CaringBridge (Feb. 13, 2020) “5 Tips to Be a Good Caregiver”

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What Do We Know about Early-Onset Dementia?

There is an increase in early-onset dementia cases which presents unique issues for families. Consider early testing and long-term care insurance to help.

Rita Benezra Obeiter, 59, is a former pediatrician who was diagnosed several years ago with early-onset dementia, a rare form of the disease. When this occurs in people under age 65, the conditions cause additional and unique issues because they are so unexpected and because most of the potentially helpful programs and services are designed for and targeted to older people.

One issue is that doctors typically don’t look for the disease in younger patients. As a result, it can be months or even years before the right diagnosis is made and proper treatment can start.

WLNY’s recent article entitled “Some Health Care Facilities Say They’re Seeing More Cases Of Early-Onset Dementia Than Ever Before” reports that her husband Robert Obeiter left his job two years ago to care for her. She attends an adult day care, and aides help at home at night.

If Dementia is a generic term for diseases characterized by a decline in memory, language, and other thinking skills required to perform everyday activities, Alzheimer’s is the most common. The National Institute of Health reports that there’s approximately 200,000 Americans in their 40s, 50s, and early 60s with early onset Alzheimer’s.  These numbers have lead to the consideration of Alzheimer’s legislation.  See here.  https://galligan-law.com/elder-law-community-follows-proposed-new-alzheimers-legislation/ 

One conference discussed a rise in early dementia because of the processed foods and fertilizers or the other environmental hazards, and there are definitely some genes more associated with Alzheimer’s—more so with early onset.  There is no clear answer, and most of the treatments help to slow down the progression.

There is some research showing the Mediterranean diet can be protective, as well as doing cognitive exercises like crossword puzzles and Sudoku.

It’s true that no one can predict the future of their health, but there are ways financially that families can prepare for early-onset dementia. It can cost $150,000 a year or more. That’s why you should think about purchasing long term care insurance starting at the age of 40.  You should also have your estate plan reviewed well before memory becomes a significant issue to make sure the plan facilities long-term are planning.

Long-term health insurance can pay for an aide to come into your home, and it can pay for the cost of assisted living. And, remember that health insurance doesn’t cover long-term care, nor does Medicare.  Making sure you have a financial power of attorney prepared by an elder law attorney will provide your family with the flexibility they need to handle your financial needs, bills and so on.

If you are faced with this condition or have a family history of it, consider long-term care insurance early and make sure to review your estaet plan every few years to stay up to date.

Reference: WLNY (Feb. 12, 2020) “Some Health Care Facilities Say They’re Seeing More Cases Of Early-Onset Dementia Than Ever Before”

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