A single room in a nursing home might run about $120K a year; are you prepared to cover that for an extended time if needed? If money is a factor at all, would having some insurance to fall back on help you afford a nicer arrangement? What's the worst that can happen if you never need the insurance, you've blown some money that you're not too concerned about anyway?

In your case I'd approach this by putting most emphasis on what affords you the best living in a worst case scenario.

Dave Ramsey talks about this, a lot. He's the expert I defer to:

Quote: Long-term care insurance is crucial since long-term care is super expensive—and the costs are only going up. Here's a link to a Dave Ramsey article on THIS subject: Link

Thank you both. My friend is in similar situation buying into a 50k upfront Securian hybrid program. The thought of writing a 50k check upfront makes me ill.

nicole, I've not heard of Dave Ramsey but following through his link, his business is selling a variety of services, including insurance. Someone who sells insurance will never give a potential customer objective advice, and most especially would never say they don't need it.

State laws cover things like Medicaid so you may want to check into that and what it provides. If you're not needing to save the money for your heirs, then I wouldn't bother with LT care insurance. Rather, if you end up in a home, you'll spend down your assets until there's nothing left and then medicaid will kick in. It's your money, why shouldn't it be used for your care?

While articles by insurance companies usually recommend you buy the insurance, they are not an objective source. Perhaps something like this will help as it's a little more objective: https://www.schwab.com/learn/story/should-you-purchase-long-term-care-insurance

If you have assets you want to protect for your heirs, then the decision might be different.

Whether you choose to carry the full load on your own, or decide to go the route of having support from insurance, when your wallet loses its ability to function but your heart, lungs and brain are still bravely functioning ...

... what level of support may be available from public sources to enable their continued functioning, Anne ... (then somewhat?) grietful?

(Looks like the above was quite a lengthy sentence ... but at least there wasn't any costly fine levied - could one get insurance for that, do ya figger, Ann?)

ole joyful

For someone who isn't concerned about leaving anything to heirs, the only thing that would give me pause about relying on Medicaid is that the Medicaid-paid options around me are basically worse than death, IMO.

I went through this with my Dad. He had the funds to self pay for assisted living and home health care for quite some time. There are a wide variety of pretty good places available if one has the financial resources to pay for them.

If you haven't run the numbers yet, they are shocking though. He stayed in his home with aides and that worked for a few years - then he needed 24 hour care and a congregate setting became his only viable longer-term option. (If you haven't priced out 24 hour care in your own home recently....it's a wild number - again at least here in the northeast.)

If you know the monthly costs of whatever assisted living you have in mind, and you believe you have sufficient funds to cover you through the end of your life - then a LTC policy is unnecessary for you. But if you haven't priced anything out yet - you may be in for quite a shock when you do.

There's an oldster on my wife's side of the family who got to the point of needing a senior residential facility (not for memory or dementia reasons) and had exhausted her savings kand was left with no assets other than her house. Which, though modest in features, had appreciated considerably over the decades of ownership.

Her family had structured her estate planning so that the house was no longer hers for Medicaid assets purposes and she qualified for its coverage. Apparently, when her more immediate relatives looked at what facilities Medicaid would pay for, it was as Ally De describes - such places were a fate worse than death. The outcome was that her more immediate relatives share the cost of her living in a facility with better care and more features.

Remember that long term care coverage is really more akin to a prepayment for future services rather than being like other policies which provide insurance against the possibility of a loss. Unless one drops dead while still able to live and care for oneself, long term care is a more likely than not need for most people.

Oh wow Elmer and Ally De. I got it. I will get the insurance. Now I just have to figure out what d. kind. It's so complicated. I'll start studying.

@Elmer J Fudd...Dave Ramsey doesn't sell insurance. smile He is endorsing an honest insurance seller...that he has experience with. Dave decides what is best for his followers based on the financial numbers of covering costs...then makes recommendations. Overall, he's a financial advisor. He's quite famous.

Last year I switched from a LTC policy (the premiums had been raised several times) to a combination LTC/ life insurance policy. Under this policy, if I never need for LTC it will pay out to my children. If I use only a portion of the benefit for care before I die, my heirs get the remainder; this was not the case with my original policy. An added benefit of the combined policy is that the premiums will not increase. FWIW I’m 72, and bought the first policy when I was 60, and I don’t listen to Dave Ramsey because of his… beliefs that I do not share.

As I said, it depends on the state. Both my MIL and her sister ended up in nursing homes and running through their assets and ending up on medicaid. As they went in as private pay, nothing changed when they went on medicaid, not the home, not their room, not their bed, not their level of care. And the home my MIL was in was one of the only ones inspected by the state where they found not a single deficiency and for which they received an award...so hardly a hellhole. That may be different if you don't go in as private pay...I don't know. But it sounds like you'll have funds to start out private pay anyway. My MIL ended up spending an unusual 11 years in the home (plus 3 more in congregate living at the same facility). I suspect she would've run out of funds even if she had LT care insurance as those policies -- at least IME -- are capped with lifetime payouts. (The average stay is around 3 years.)

Remember too that many people never end up in a home...like my DF and FIL and brother...or end up there short term like my DM who was there for 4 months. If that's the case then the cost of the insurance is for naught, and you'd be better off investing the funds and self-insuring. Only thing is, we can't predict those outcomes ahead of time.

One alternative I would consider is the kinds of places that have multiple levels of care that you buy into, like buying a home... with a monthly 'service charge' that you pay. You start with a private apartment then can go through the various levels of care as needed while staying at the same complex. I think it's called continuing care.

I would suggest you talk to either a financial planner or an elder care lawyer to get more insights into how these things are handled in your state and what things you should take into consideration. Either way, it can be an expensive proposition.

Most people only need nursing care for about six months.. There is a dizzying amount of options and careful research is needed. Many nursing facilities accept private pay and medicaid .

one thing to consider with LTCI is the price is often raised and what is covered becomes less, so policies arent worth it. You must also copare what the policy covers, does it include in-home care or only nursing care, does assisted living qualify.

the fact one is in a private pay facility does not insure good care. And many places with great lobbies and sitting areas are to impress families, it is important to have an advocate for you if you are unable to advocate for yourself.

Memory care is very expensive and if dementia and longevity runs in your family, I would consider it.

Myself, i plan to self i sure by selling my house which will cover me for many years if needed.

I never heard of Dave Ramsey until I saw a headline stating he is being sued for 150 million so I looked into it. I guess he was pumping a company that guaranteed they can get people out of time shares, Well the company didn't do as they claimed and never gave any money back, and estimates state Dave collected about 30 million in kick backs from the company. I don't know his beliefs but sounds like he was pushing snake oil.

I had some quotes for LTC last month and one was like the one Annie switched to, the premium was $1500 a month. Had $250K life insurance and after 10 years the policy will pay the premiums, but payout was capped at $5K per month if I did go into LTC. Knowing for a fact the cost for a 24 hour live in care giver is $13,500 a month I'd still be on the hook for $8500 a month. Not exactly a bargain I was willing to buy.

So I'll take what life gives me and If I burn up every asset I have I really don't care. I've been in a few medicaid subsidized nursing homes and honestly It wouldn't bother me a bit. One had 4 people of the same sex to each big room but well taken care of. It was like a big happy family and I loved talking to the people. Kind of like Army life, 3 square meals and a bunk without a worry in the world.

When my Mom was a widow she took out LTCI in her 80's. She was told to drop it but refused. By the time COVID killed her at age 96 she was wheel chair bound with round the clock Aids in a nice retirement facility. Never could have happened with out the Long Term Insurance.

When I was looking for a place for my mother after her stroke, I was informed by all of the "nicer" facilities that they saved their "Medicaid" beds for their long term patients who had exhausted their funds. They would not have a bed for her since she was starting out on Medicare but would end up on Medicaid.

Her experience was similar to what AllyDe and Elmer describe - once she transitioned to Medicaid, the facility suddenly needed to move her into a much smaller, noisy room, with a demented roommate. Her water was always out of reach - her call button often was too - but they made sure that she got every service that Medicare/Medicaid would pay for (even when unneeded, like a nail "debridement", and new eyeglasses that were never put on her face...)

" Dave Ramsey doesn't sell insurance. smile He is endorsing an honest insurance seller...that he has experience with "

It's a for-profit business, not a public information exempt org. He's either charging the actual product providers a fee for getting connections from the site (like Angie's List) or he's getting a commission. Reputable/professional service providers, whether financial, legal, health care providers, or whatever, provide a number of names and contact info of people they have experience working with when asked for a referral - like 3-5, and never receive compensation for doing so. A site like this with nationwide reference destinations can't possibly have "worked with" all those they send referrals to.

" He's quite famous. "

Certainly not in the mainstream financial community, to my knowledge. Is he famous for being famous?

I always thought Suze Orman offered good insight: https://www.suzeorman.com/blog/Suze-School-for-Long-Term-Care-Insurance

The fact that Dave Ramsey is so highly touted scares me for the future of humanity. Most of his "advice" is basic math - occasionally with his own personal bias built in, of course.

I swear I'm not picking on your Nicole! :) You just happened to use his name to make a point. My point is that if anyone needs Dave Ramsey's advice to figure out finances, they have bigger problems than Mr. Ramsey can solve for them.

@Elmer J Fudd...Have you heard of Suze Orman?

Ally....everyone needs a financial planner if they're not good with money or don't understand their way around investing or planning for their future. Dave and Suze are just famous ones. They advise a LOT of people, publicly. They are experts in their fields. I defer to "experts". No offense taken.

My husband and son are financial advisors at Merrill Lynch. We purchased Long Term Health Care from Lincoln. We are very pleased with how it is set up. You might take a look!

I agree with theresafic.

Few people need nursing care for very long. (She cites 6 months.) There's also a difference between broad actuarial numbers and your particular health/condition. Well-to-do Caucasian Americans usually have health advantages.

DH and I took LTC insurance offered by his employer while in our fifties. When I looked into our *likely* health needs, we dropped it. Premiums were creeping up. Benefits were lagging against the costs of care. We decided to self-insure. By paying for ten years, we were left with a minor benefit -- a few dollars on this and that.

Now 82 and 85, we've yet to see how this works out, but we've saved many thousands in premiums. Now that I have multiple myeloma, my end is in my own hands. I can stop treatment. We hope our health needs can be met by home health care until we need skilled nursing in a facility. Then we will be tap our savings and sell our home to pay the freight.

Continuing care sounds better than I think it is experienced. Assisted living will be expensive but OK -- nice (small) apartment, meals, etc. But when the facility decides you need nursing care, it's the same drab hospital bed in a shared room for however long -- 3 to 6 months? (THIS is the part of the facility you want to inspect carefully before buying in, not the pretty apartment or the menu in the dining room.) IRL many people resist the move and pay OOP for help, so the benefits of continuing care at a set price are wasted. The monthly bills will also rise to meet increased costs of providing services.

Nursing care may not typically last long, but assisted living sure can. The plan my wife is offered at work pays 2/3 daily benefit for that. Curious what the premiums were, if you don't mind sharing.

nicole, I think an understanding of basic money and investment management are fundamental life skills everyone needs to have. I think of the panopoly of job titles many people turn to for financial help are akin to using a gardner for yardwork. You can hire someone else to lift a shovel and mow the grass so that you don't have to but you can't offput the responsibility for doing so and for the results of their work. With personal finances, work can be assigned to others but overall management of one's own situation is a task that can't be outsourced.

There are a lot of scoundrels and inept people in this field. I have sympathy for those who need information and self-education to know enough to fulfill the oversight role for their own affairs. I'd no sooner take financial "advice" from any of these media personalities than would I take medical advice from Dr Oz.

I've heard of Orman and a few times have spent a few moments looking at her on TV while channel surfing. I wasn't particularly impressed, she seemed a bit too "showbiz" to be credible. From what I've seen and heard, she's developed a special following among women for trumpeting a visible presence in what 50 years ago was a male dominated service sector. That particular aspect of the financial world has been gone for decades but people on the outside think she's something exceptional for that reason. She's not.

There are many resources available to gain an understanding of essential personal financial management for those who are starting out. Books and community college courses are a good place to begin.

Of course, Elmer. You've spent "a few moments looking at her on TV" and then decided it was that she was female that made her attractive to other women. The fact that she knows what she's talking about and can put complex issues into layman's terms with solid, basic advice has nothing to do with it. Not everyone has the time, money or desire to devote months to taking Finance 101 or attend community college. Not everyone need become an expert in everything in their life and not everyone has the talent to do so. Relying on experts in areas where your talents don't lie is a sensible thing to do.

I disagree that getting a financial advisor is akin to hiring a gardener. I think of it more like hiring a landscape architect. You may still do your own weeding and shoveling, but when it comes to overarching design to achieve your long-term goals, taking into consideration many factors including your income, spending, savings, taxes, debt, housing status, family status, health conditions, existing insurances and your potential future needs, having an expert who can help with the cash flow analysis, do risk analysis, model the results under various assumptions and come up with a sensible plan can be a wise move.

" You've spent "a few moments looking at her on TV" and then decided "

Read it again, you've misunderstood and mischaracterized what I said.

You are welcome to your opinions. As I said, it's wrong to think basic skills and knowledge needed to function as an adult can be fully assigned to others to handle. Those who think they can do so are the ones who become victims of the scoundrels so numerous in this field.

Jusy a snippet of my past. My mother mocked me one time when I expressed a desire to learn about finances. She shamed me enough so I never asked again. I think my financial life would have gone a lot better had she not done so and had I learned some basics. My parents never ever talked about money in front of us kids. Nor did they ever talk about how to choose advisors.

Learning these kinds of skills by experience can be tough.

That's awful, lucille. Parents unfortunately can unwittingly or otherwise misdirect their kids in terrible ways, including by assuming whatever bad decisions or misfortunes caused problems for them are a trap for everyone. It sounds like that's what happened to you.