Long term Care Insurance

wilkins57 · February 3

I’m looking for info on long term care insurance. Will I be able to purchase it for my husband if he has been diagnosed with dementia? How much does Medicare cover for in home assistance? How much does it cover if he needs to be in a memory care facility at some point? Is this kind of insurance worth the expense? Thanks for any advice you can provide!

towhee · February 3

I am sorry, but you cannot get long term care insurance when you have a diagnosis of dementia.

Medicare covers very little when it comes to in home care assistance, and that is usually very short term after a hospitalization. Medicare does not cover any type of facility stay with the exception of short term rehab in a skilled nursing facility. The program that does cover care assistance and facilities is Medicaid, and to qualify for that you need to be under certain income and asset levels. Each state has different requirements. You can get a general picture of Medicaid for your state by looking at Medicaidplanningassistance.org It is generally recommended that you consult an elder care lawyer to make sure you do not do something that would make your LO ineligible for Medicaid.

If you are thinking about long term care insurance for yourself whether it is worth it depends on your health and financial situation. The older you are the more expensive it is, and the premiums will go up at some point as you get older.

wilkins57 · February 5

https://alzconnected.org/discussion/comment/265140#Comment_265140

Thanks for this information. I’m hoping to care for him at home for the majority if not the entirety of his illness. We would not be eligible for Medicaid. I was hoping that at least some at home respite care would be covered by Medicare; this is quite disappointing. My husband was diagnosed this summer so we are still learning. His neuropsychologist suggested a neurologist may be able to prescribe infusion medication that some have found helpful in delaying progression. Are these generally covered by Medicare drug prescription plans? Any info on this would be appreciated. Thank you

towhee · February 5

There is a relatively new Medicare program called Guide. It can provide up to 75 hours of respite care a year, and is starting to be available in more areas. I do not know much about it, use the search box here to find discussions on it.

I think the infusions are generally covered, there are several discussions on benefit vs risk.

persevere · February 5

Here's a couple of other pieces of info. If/when your husband qualifies for hospice that is covered 100% by medicare. Also there are medicade trusts that can be formed. You'd have to get a lawyer that specializes in these.

wilkins57 · February 6

https://alzconnected.org/discussion/comment/265304#Comment_265304

Thank you! I’ll do some research on that! We don’t need that right now, but will likely be helpful in the future.

Arrowhead · February 12

It’s probably too late for him, but I do suggest you get Long Term Care insurance for yourself. We bought ours in 2009 at age 55. The cost for each of us was $1,212 per year. In 2023 I placed my wife in memory care. Within nine months they paid out more than both of us paid in premiums over the previous fourteen years. I no longer need to pay premiums for her and last year mine was $2,338 for the year. It has been worth more than the cost for us.

Arrowhead · February 12

wilkins57 · February 13

Thank you! This is also very helpful info. I appreciate it.

Lisamarie62 · February 23

My DH bought Long Term Health Insurance through his company about 10 years ago when we were in our early 50's. At that time I asked him "why do we need that?" I recall him saying, "You need to be prepared for anything," The cost for a policy for him and a policy for me is $236.00 a month each ($472 total a month.) He had to retire in December 2022 because he could not keep up with the fast pace of his job as a VP/Finance. He also traveled extensively overseas for his job. In November 2023 (10 months after he retired) he was diagnosed with EO at age 62. It has been over 2 years living with this horrid disease and I do not know where it will take us, but I am thankful he had the insight to purchase Long Term Care not knowing that he would need it.

Lazuza · March 2

https://alzconnected.org/discussion/comment/265304#Comment_265304

In terms of respite provided by GUIDE, it depends on if it has been setup in your area. In the Boston area, we have providers claiming that they cannot find agencies that will accept Medicare's reimbursement rate because it is far below average costs locally for home care/respite. In general, I do not find GUIDE helpful but ymmv, especially re locality differences.

Lazuza · March 2

In terms of LTC insurance, you generally cannot purchase it after the diagnosis.

My neighbor cares for his elderly father who purchased LTC insurance. He says the policy covers next to nothing. IDK if that is the norm.

The Commonwealth of Massachusetts is investigating whether LTC insurance offered by the state is a viable option. See the actuary report here: https://www.mass.gov/doc/long-term-services-and-supports-feasibility-study-commissioned-by-eohhs/download. Having gone through this with a loved one, this is something I would buy if it becomes a reality.

Long term Care Insurance

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