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If you own an insurance company or are an insurance agent, and differ with my assessment of long-term care (LTC) insurance, I welcome a conversation.

If you are an adult considering purchasing long-term care insurance, please reconsider.  I’ll explain my reasons why in a bit.

But most importantly, if you are a caregiver for a loved one who once did purchase long-term care insurance and you want to begin using those benefits, take lots of deep breaths; the process to get benefits from your long-term care policy will likely consume a considerable amount of time and emotional energy – ask for help in getting this process going.

So why not buy LTC insurance?  First and foremost, it is always a really big struggle to arrive at a place where benefits begin paying out.

• First, you must initiate a claim.  This involves paperwork, paperwork, phone calls, phone calls, and more paperwork.  What caregiver has the time and emotional energy to add these kinds of struggles and time demands to their days?!
• Then, you will often have to meet the “elimination period”, which means that your loved one will need a considerable number of “visits” from a provider such as home care, with proof of services and proof of payment, before benefits begin kicking in.  Most often I see that this elimination period is ninety days.  Meaning, someone has to receive ninety separate, at least one-hour care visits, with proof of service and payment, before long-term care benefits kick in.  If someone receives three care visits a week, it will take thirty weeks of three visits per week before benefits will kick in.  That is seven-and-a-half months of care that is an out-of-pocket cost to the family.  Wowza.  

I have yet to see a family have an easy time, even when the above requirements are completed, getting the insurance company to begin reimbursing for care.  Oh, yes, it usually happens that the family pays for care, then submits the “claim” (proof of services and payment for services) for reimbursement.  This means several steps for a family to wade through before they see any reimbursement from the insurance company.

Another concern: folks buy these policies many years before they need them.  In that time, their original policy gets sold or absorbed by another company, so now the insured has to visit with someone they have never met, with whom they have no relationship, and someone who most often seems to be a worker in a call center, to get their questions answered regarding this whole scenario.

Most folks wish to remain in their own homes.  Yet the payout for home care, which helps people remain in their own homes, is minimal, usually over $100/day.  This means that the LTC will cover three to four hours of care a day, which is not much as people age or progress with dementia.  I have yet to see this benefit increase to match the rise in cost of living. The payout for a facility is higher, but most people wish to remain in their own homes.  

I also rarely see a policy that will allow reimbursement for a family caregiver.  The statistics are clear that the majority of caregivers are family members.  I know there once was a day when family did not give a single thought of being paid to care for their family, but we live in a different world.  So if we already have family providing the care, and the parents have LTC insurance, should we not use those benefits to help the family caregivers?

Solutions:

1.  If you have a long-term care policy and wish to begin using those benefits, persist in getting the process going.  Get help from your family or a kind neighbor or hire someone who knows this system and can advocate on your behalf.  Persist; you have paid in a bundle of money through the years and now you deserve to make use of those benefits.  
2. If you are an adult considering LTC insurance, reconsider.   For all of the hassle I have described above, you may be better off saving and investing your own money, to use as you wish later in life when you might need help.  My experience is that accessing one’s own invested money is a phone call or two; far more simple than the process I see with accessing LTC insurance benefits.
3. If your parents have long-term-care insurance, take over this process for them.  I have yet to meet a caregiver spouse who does well with the added pressure and struggle of accessing their benefits.

Lightening the load for caregivers is a worthy cause.  LTC insurance, in my observation, contributes to caregiver stress and burden and is less helpful than simply being able to draw on one’s own savings or investments, to receive the kind of care one desires.

Ever the advocate,

Jill