Long Term Care

What You Must Know Before You Shop for Long Term Care Insurance

As I mentioned in the last edition, I continue to receive questions from Relaxing Retirement members who have heard the “Don’t let a nursing home take your home and your life savings if you become sick and need care” sales pitch on the radio.

After all, who wouldn’t be a little disturbed hearing that pitch?

“Elder care” attorneys run ads with this message over and over because they know it generates an emotional response.

I want to take the opportunity to bring this to your attention because how you deal with the financial risk of paying for extended stay health care, i.e. nursing home, assisted living, or care in your home is a very, very important issue for you and your family.

The emotional toll of placing a loved one into assisted living or a nursing home is bad enough.  Dealing with the financial toll at the same time makes it even harder.

As we laid out in the last issue, if you don’t need care right now, then you have some significant long-term planning issues to consider.  After experiencing this up close with so many of our members, I strongly recommend giving this a lot of thought.

I recognize that this is not the easiest topic to discuss, especially for those of you who are currently caring for your spouse or your parents.

At the same time, however, I think it’s a good idea to evaluate all of your financial risks on an annual basis so that you can continually make educated financial decisions.

If you have not purchased long term care insurance yet, but you believe you need to consider it to manage your risk, then there is a very important process that I recommend for you.

What to Focus on First

Before you jump in to the “insurance policy” discussion, you have to understand who you’re dealing with and what their agenda is.

Insurance companies and their agents are doing a great job out there stirring the pot about long term care insurance.  This is good and bad for you.

I’ve witnessed individuals and couples for years beginning the conversation about long term care at “Point Five” when they really need to take a GIANT step back to “Point One”.

One of the reasons why they begin at Point Five is because an insurance agent has rushed right into the bells and whistles of a particular long term care insurance policy before even diagnosing why you should even be thinking about any of this in the first place.

Or, if you even need to.

Not to pick on insurance agents, but they have an axe to grind.  They don’t receive any compensation until you buy a policy and pay the premium, so there’s some urgency on their part to move the process along at a faster pace than what may be in your best interest.

However, this is too important to rush through, so let’s take step back for a moment and walk through a real-life case scenario to clarify what you must know first:

  • Ken and Louise are 62 years old,
  • They’re now both retired, so they receive no income from work,
  • They’ve done their homework and created a comprehensive Retirement Blueprint™ which illustrates the following:
    • They receive $3,500 per month from social security, and $2,500 per month from pensions for a total income of $6,000 per month,
    • On the spending side, they’ve done their homework and calculated that they need $12,000 per month to live exactly the way they want, including paying income taxes, taking vacations, and buying loads of presents for their grandkids,
    • Given their social security and pension income, they need an additional $6,000 every month, or $72,000 per year, from somewhere else,
    • They’ve done a nice job saving, and their Retirement Bucket of Investments, which includes all of their liquid savings and investments they’ve accumulated over the years, including IRAs, 401(k)s, and non-IRA accounts amount to $2.25 million
    • Their Retirement Resource Forecasters™ illustrate that Ken and Louise have enough money in their Retirement Bucket™ to provide them with that $72,000 per year including annual cost of living increases to keep pace with inflation.
    • They can achieve this without having to hit home runs with their investments.

Now, the scenario I’ve just described to you with Ken and Louise is precisely where I recommend you begin to have the long-term care insurance conversation!

If you don’t know these exact numbers that I just revealed in your own unique situation then you can’t even begin to properly evaluate the financial risk of you getting sick.

In far too many situations, individuals and couples are confronting critical issues that affect them for the rest of their lives without any understanding of how the issues affect them personally.

They just use some “rule of thumb” that they read in a magazine, or they’re “sold” on one thought or another by a financial advisor who makes their income through sales commissions.

It all has to start with you knowing your own personal numbers first.

Once you’ve done that, then you can make educated decisions that you can feel confident with.

Evaluating a Policy for You

Let’s now assume that you’ve carefully projected out all of your retirement resources into the future and determined your true needs.

You’ve determined that you’re not comfortable absorbing 100% of this risk, and want to begin looking at long term care insurance as an alternative.

Before you approach an insurance agent or broker, become comfortable with the five main components of a long-term care insurance policy.

Five MAIN Components of any Long-Term Care Policy

There are five main components to every long term care insurance policy that you want to pay attention to in order to evaluate and create the most cost effective plan for you.

Each of these elements controls the cost of the insurance, so adjusting one or all of them up or down will significantly change the cost.

What I recommend you do is carefully think about each of these components and then have an independent agent present multiple combinations for you to evaluate.

  1. Maximum Daily Benefit: How much will it cost you to receive care where you live?  That depends on where you live and what kind of care you will need and want for yourself. (in a nursing home, assisted living, care in your home by a private nurse, etc.)  This is the amount of coverage the insurance company will pay per day, i.e. $370 per day. The higher the daily benefit you purchase, the higher the premium.
  2. Benefit Period: How long do you want to cover yourself?  Benefit periods range from 2 years to lifetime  The longer the period of time the insurance company pays benefits, the more costly the policy will be.  (Statistics tell us that the average length of a long-term stay is 2.8 years)
  3. Elimination Period: How long can you wait and self insure before benefits kick in and begin to be paid by the insurance company?  This is very   Like a deductible for homeowner’s insurance, the longer you can wait, the cheaper the policy will be.  Remember, you’re trying to manage the costly long-term risk.  Chances are great that you can afford to absorb the cost of 3 to 6 months of care.  Absorbing some of the short-term risk saves you money.
  4. Home Health Care: Very few people I meet are lining up to receive care in a nursing home.  Most people want to avoid it like the plague!  So, if you’re able to and would prefer to receive care in your own home, make sure that your policy provides equal coverage for you to receive care in the privacy of your own home if you choose to do so.
  5. Cost of Living Riders: Receiving care today is costly enough.  Imagine how much it will be 10-20 years down the road.  To offset this, there are several cost of living riders you can choose from.  The 2 main options are simple interest and compound interest adjustments.  Each provides inflation protection for you, but at varying levels.  Compound Interest will pay out more benefits in the long run because the inflation protection element compounds with interest.  (Note: this can be as much as 50% of the cost of your premium depending on your age and the option you choose)

There are other options to consider, but these five main components will help you stay focused on what is most important when you purchase coverage.

Shared care, for example, is one of them.  Under a typical policy for a husband and wife, once benefits are used up by one spouse, no more coverage exists.

With shared care, if you use up your benefits, you my “tap into” your spouse’s unused benefits thus providing you with more coverage.

I will tell you that it’s easy to get caught up with the intricacies of different policies and lose sight of what you’re trying to accomplish in the first place.

Remember that you’re looking to pass off some or all of the financial risk.  Protect yourself from the risk you can’t afford to assume, i.e. the large, long term risk of care over an extended period of time.

As I mentioned above, have a complete handle on your financial situation before you enter the discussion with an agent or broker about which policy to buy.

When you do this, you remain in complete control and can act in your own best interest and save yourself a lot of time and money.

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