Long-Term Care?: Hey guys I need your... - Advanced Prostate...

Advanced Prostate Cancer

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Long-Term Care?

Bruce66 profile image
61 Replies

Hey guys I need your opinions on Long-Term Care.

I live alone and have until the end of this month to decide if I want to get a policy that costs around $425/mo, and at 70 years old this is my last chance to get a policy without a medical exam. I can manage the payment, but just barely. I’m in otherwise decent health, no mets yet and reckon I have probably ten years until I need it, but who knows? I'm with Kaiser in California and they don't cover LTC.

Ten years of payments would be around $50,000, and yearly LTC costs are expected to be some $195,000/yr by 2033. The policy would pay out $2,000/mo. Monthly payment is guaranteed not to go up regardless of age.

I’m really undecided and don't qualify for Medi-Cal. Does anyone have thoughts on this? I sure could use some input or alternate suggestions.

Thanks all.

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Bruce66 profile image
Bruce66
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61 Replies
NanoMRI profile image
NanoMRI

I cancelled my LTC a couple years ago. 67YO next month, single and likely will remain, and have PCa and had melanoma; 'otherwise' healthy and fit. Bought my LTC before I was 50 for super 'deal' and in event I needed it when I was young and for long term. Annual max price increase was exercised every year. As I got into 60's realized from other's experiences these policies fight payments -so maybe not the coverage we think they are.  Also, came to learn, as we age up, need for LTC is generally not that long and data suggests some 75ish% of folks die within three years. I concluded to self-pay upgrade costs over medicare or maybe just go out into the woods. I also have a daughter who could step in and step up too. Hope this perspective helps. All the best!

Bruce66 profile image
Bruce66 in reply toNanoMRI

Thanks Nano, I'm leaning towards the same. A benefit of $2k/mo would hardly make a dent in full-time home care, I think it's somewhere in the neighborhood of $10k/mo in CA. I'm thinking maybe I'll just put that monthly premium aside and call it good.

It's just something nobody really wants to think about, but I thought it's time I took a good hard look at the (likely) inevitable. Appreciate your input, thanks.

mrscruffy profile image
mrscruffy in reply toBruce66

we paid 3K a month in CA for 24hr care 5 days a week. We looked outside of agencies

Bruce66 profile image
Bruce66 in reply tomrscruffy

Wow - $3k for 24 hr care? That seems like a bargain. Maybe the insurance company is inflating numbers to scare me into their policy... clearly I have more research to do. Thanks Scruffy 😀

mrscruffy profile image
mrscruffy in reply toBruce66

She took care of my father in law and when he passed started care for my friends dad. There were a few in that price range

Bruce66 profile image
Bruce66 in reply tomrscruffy

Nice. Any chance she's in Santa Rosa? 😅

mrscruffy profile image
mrscruffy in reply toBruce66

Nope Corona in SoCal

tsim profile image
tsim in reply tomrscruffy

The good Corona,?? Or the one I lived in.

mrscruffy profile image
mrscruffy in reply totsim

The one I grew up in from 60's to 90's

vintage42 profile image
vintage42 in reply toNanoMRI

I have had Long Term Care insurance for about 20 years. I pay $160/month and it pays $266 per day for 3 years or $292,000. That covers about half the cost of LTC and I would pay the rest. But with prostate cancer now, I don't think a long stay in a nursing home is the way we go.

CancerConcierge profile image
CancerConcierge

My husband and I don't have long term care insurance....our tentative plan is at some point sell our home and use those funds to buy into a Continued Care Retirement Community( Independent, Assisted and Memory Care levels)...I don't have children, and my husband's son is across the country and not likely to be able to help. I am 70 ,husband 73, hoping to live in our home at least 10 more years....(It would take us that long to declutter and downsize! :))

Bruce66 profile image
Bruce66 in reply toCancerConcierge

LOL You're lucky to have each other. Thanks and all the best to you!

CancerConcierge profile image
CancerConcierge in reply toBruce66

Yes, we are lucky!

vintage42 profile image
vintage42 in reply toCancerConcierge

We looked at a CCRC a year ago. Its monthly fee was called Life Care, because it allowed transition to skilled or memory care for an additional $5,000/month per person. The entry fee for a 2BR 1350SF apartment was $578K rising to $662 in 2025, and the monthly fee for 2 people was $6700 rising to $7500 in 2025. And they wanted assets to be 2x the entry fee and income to be 1.5x the monthly fee.

It was too expensive for a door on a hallway, and we did not need the costly "life care", so we have gone to a patio home in a community without "life care" in the fee. We get priority access to higher levels of care in the main building, for which we would use our long term care insurance.

CancerConcierge profile image
CancerConcierge in reply tovintage42

Yes, there are lots of incarnations of CCRCs… but the numbers you quote are eye popping!

There are several here locally ( Phoenix area) that we are looking into… Two have hefty entrance fees ( but much less than what you found) and one doesn’t have a buy in, but has higher levels of care you have priority admission to. .

I like the idea of a patio home … apartment living doesn’t sound appealing to me.

Bruce66 profile image
Bruce66 in reply toCancerConcierge

I agree a patio home is the way to go. Personally I got wiped out in a divorce some years ago and am now living the apartment life - certainly not my first choice, but it looks like there are a lot of options I need to look into. Appreciate your input!

CancerConcierge profile image
CancerConcierge in reply toBruce66

So many variables for sure! Best of luck!

Cactus297 profile image
Cactus297 in reply toCancerConcierge

Which ones did you look at in the Phoenix area? I would like to check them out too. I’m going too turn 79 soon. Thank you ☺️!

CancerConcierge profile image
CancerConcierge in reply toCactus297

My checking out has been online and on Facebook...no in person visits yet.

-The Terraces, Phoenix

-The Clarendale Arcadia, Phoenix

-Friendship Village, Tempe

-Royal Oaks Retirement Community, Sun City

They all have pros and cons....The Clarendale Arcadia doesn't have the huge buy in fee, but I don't know how much the higher levels of care are ...

Hoping to start making some field trips in the near term!

Cactus297 profile image
Cactus297 in reply toCancerConcierge

Thanks! I agree you won’t know until you visit. The only one I am a bit familiar with is Friendship Village Tempe. It seems to get good reviews but one review mentioned the casitas needed remodeling. There are also newer condos. I read awhile back somewhere that the staff to resident ratio was very good. That’s really important as one needs more help aging. I am hoping to remain in my home but will see what the future brings! No crystal balls available!

CancerConcierge profile image
CancerConcierge in reply toCactus297

Yes, it’s a big decision!

Cactus297 profile image
Cactus297 in reply toCancerConcierge

Very!

APK3 profile image
APK3

I've had a LTC policy for about 20 yrs. Bought it young. Was told the rates were quarenteed never to increase. That was 5 increases ago. After joining this club It makes those increases rather minor now .

Bruce66 profile image
Bruce66

Good on you, planning for the future. Sounds like a class action lawsuit could be in order though.

Lyin' bastids 😂

APK3 profile image
APK3 in reply toBruce66

There was a class action suit. It was dismissed. I was a federal employee as were the others. Basically we were told to take your ball and go home. I've kept my policy as it will mitigate the cost of care somewhat about 7k a month. I'd rather that go to the family. It's going to be hard enough on my adult kids and wife to watch an ugly death. I will not put them through the stress of daily care of me just to save a few dollars on premiums. Best of luck on your journey.

babychi profile image
babychi

Bruce hi. We have a plan. When we are no longer happy with our QOL we will end it. Easy! Who wants to lose their freedom? We are facing our reality and happy to go at our own choosing, if possible. 72/78.

addicted2cycling profile image
addicted2cycling in reply tobabychi

Told wife 50+ years ago that *I have no desire to be taken care of and will take care of things on my own terms.* She scoffed at me back then but now agrees since we've been through the entire *end of life dying with dignity* bovine excrement.

p.s. - Bruce and all others, simply hoping your able to make arrangements as you wish to *exit stage left*

youtube.com/watch?v=Q3-a4qW...

babychi profile image
babychi in reply toaddicted2cycling

Yep! Experienced it with family and very close friends. Not for us! No siree! I got my “stash” and know the drill!!👍🏻

addicted2cycling profile image
addicted2cycling in reply tobabychi

Wife said "please no gun 'cause loud and messy" I replied - "how about in the pool 6' under water = relatively quiet and just need to drain + bleach cleaning then refill and swim" 😉

awb1 profile image
awb1 in reply toaddicted2cycling

The humor in your reply made my day ! I had a gf a few years ago that said a whole bottle of nice red wine then go outside and sit in the snow on a 20 degree night in the Sierras. I myself don't want to waste money when QOL is that low and it will go to my friends and causes !

Bruce66 profile image
Bruce66 in reply tobabychi

I'm of the same mindset. I too have the means to unalive myself in a "rapid unscheduled disassembly" (except it would be "scheduled") but, too messy. The Death With Dignity deal here in CA makes it relatively easy I think to move on to the next big thing. I'm not afraid to go and when the time comes, will throw a big going away party, drink the goodies from the little sippy cups they give you, and fade out.

Biobro profile image
Biobro

Hi Bruce, Made same calculations myself at 65 and decided against a policy. No guarantee that insurer would be around when needed and could see massive premium increases on the horizon. Having just seen my beloved husband "out" I have a sense of care costs via excellent home health agency. About 28k a month for round the clock care. Around 5k per month for decent assisted living and 7k for standard non profit nursing home --if you can find a non profit. These are Texas prices.

Husband had a long term care policy which he dropped when he retired. He would not have qualified for payments. A) it didn't kick in for 90 days and B) technically, he wasn't "needy" enough until 2 days before he died. So he made the right call.

That said, if you are on your own, a policy would give peace of mind. I'm now looking at a continuing care community but baulking at the upfront lump sum. Out on an ice floe is starting to like a better and better idea!

Bruce66 profile image
Bruce66 in reply toBiobro

Ice floe LOL!! Nary none to be found in these parts of the world though so I'll have to come up with something else 😜

skiingfiend profile image
skiingfiend

I went through end-of-life care with my widowed father recently, he died at 94.5 years of age.

He fought to stay in his home as long as he could. We supported that as best we could remotely. He engaged local service providers like lawn and gardening, home cleaning, etc (local individuals not corporate) and a nurse who checked up on him once every 1-2 weeks. So there was always people through the place who could keep an eye on him.

Ultimately we convinced him to check himself into a care home due to declining cognitive and functional capabilities. He lasted 10 months.

Once he checked in we sold his house and reorganized his finances. There was no expectation that he was ever coming out again.

The lessons learned here were:

1. Try to maintain independence as long as possible but realize when its time to make a change.

2. Build a support network of friends, family and service providers.

3. Take stock of your assets and develop a plan. If you own your own home you might want to sell it and free up that money to help finance your ongoing care.

Finally, since you have PCa your path might be from home to hospice bypassing LTC altogether.

APK3 profile image
APK3 in reply toskiingfiend

"Finally, since you have PCa your path might be from home to hospice bypassing LTC altogether". I really hadn't thought of that timeline before. Perhaps the $195 a month is better spent elsewhere.(Scripts). With a 90 day waiting period it could be all over before that if things go south really quick. Food for thought.

skiingfiend profile image
skiingfiend in reply toAPK3

I'm pretty sure that's the path I'm on.

Johnkelsey profile image
Johnkelsey in reply toAPK3

"Finally, since you have PCa your path might be from home to hospice bypassing LTC altogether"

my plan exactly. Except if I have the strength to short-circuit hospice.

Bruce66 profile image
Bruce66 in reply toskiingfiend

Thanks for taking the time to post these great thoughts. If only we could see the future! I'm just afraid that at some point I may be wheelchair-bound, or bedbound, perfectly mentally competent, and yet have years to go. That would suck! Being unable to wipe one's own ass would make life pretty miserable. Like many here, I'm hoping when things go south, they do so in a hurry and make it easy on everyone.

GrantB47 profile image
GrantB47

It sounds as if you expect to pay at least $51000 to get back $24000 the first year. With all of the variables it is hard to be sure but this sounds like a no-brainer to me. Too much expense for too little return. (It could be different if there were a way to collect and remain in your own home.)

Bruce66 profile image
Bruce66 in reply toGrantB47

Hey Grant I'm with you. The more I look at the numbers, they may not make sense at all. At my current state of health, modern science should be able to keep me alive for a good ten years, and that's a lot of $$ to put into a policy that pays so little. On the other hand, if I needed it in the next couple years I would come out ahead. I'm on Lupron and Xtandi at this point, with a lot of other treatments to go, so I think my expiration date is quite a ways down the road.

gsun profile image
gsun in reply toBruce66

When you feel you are done just stop taking your meds. maybe shoot up some T. You won't last long.

lookout4 profile image
lookout4 in reply togsun

What is "T"?

Bruce66 profile image
Bruce66 in reply tolookout4

Testosterone. Too much work to spell it out 😀

Bruce66 profile image
Bruce66 in reply togsun

That was my thought too! When we're out of options, maybe we just load up on T and go out with one last boner 😂

Shamrock46 profile image
Shamrock46

Well, since you live in the USA and are 70, have you considered palliative care followed by hospice... all paid for by Medicare? Last April 2023 when my husband experienced his 2nd recurrence, he decided to stop all treatment since he's one who suffered all side effects and was sick of them all getting worse and more intolerable/debilitating. We started with our local hospital's palliative care team and found them very helpful and caring. His condition has worsened and he's now being cared for by their hospice team. Both offer home care with no hospital visits since he has a DNR in place and told them he wants to die at home. Hospice provides even more with covering the costs of prescription drugs, equipment like a walker, additional personnel like a chaplain, social worker, podiatrist, massage therapy, etc. The drugs and eqpt. are all delivered to your home as needed. We have found this a much better option than spending our legacy on long-term care in a nursing facility. When I experienced that with my dad 15+ years ago it cost over $7,000/month and I can't even think what that has risen to. The choice is yours, however, and hope you give this serious thought before depleting your resources.

Good question and brave of you to have the forethought. My husband was in home hospice for 6 months before he passed away peacefully at home. He’d have been SOL if he hadn’t had me to care for him. He lost the use of his legs due to a compression fracture of T7 vertebrae so he needed help with everything and was eventually bedridden. I say this only to throw in a “what if” scenario.

We live in a right to die with dignity state and he went through with all the meetings and requirements; he wanted to have that option available. But he never used it, he kept saying he wasn’t ready yet and then gradually lost the mental capacity to make the decision himself. His pain was manageable with meds so I’m sure that had bearing on him not feeling “ready”.

Now I’m alone; we have a son but he lives too far away to be helpful to me should I become incapacitated. Maybe down the line I’ll sell out and move to an assisted living home in Mexico.

Bruce66 profile image
Bruce66 in reply to

Thanks Blue, I really appreciate your input.

APK3 profile image
APK3 in reply to

Good morning Blue. I was wondering if your husband was ever offered Xgeva or Zometa during the course of his treatment?

in reply toAPK3

He had several infusions of medication for his bones that was done in Mexico but the oncologist never told me what it was so, it could have been Zometa or something like it. After we returned to Oregon and he started treatment at VA he was never offered either medication

APK3 profile image
APK3 in reply to

Thank you for your reply. I hope your day goes well.

Bruce66 profile image
Bruce66

Thank you all my brothers for taking the time to share your thoughts. I know this has been helpful for more than just me. It looks as though there are a lot of community resources that can help, and it would behoove me to start making contact and connections at this young age of 70.

Appreciate you all and this forum (thanks Darryl!). We truly are fortunate to have one another.

StillDancing profile image
StillDancing in reply toBruce66

Agreed. All other comments and suggestions aside, we truly are fortunate to have each other. It sure helps to organize our thoughts!

CousinGrandpa profile image
CousinGrandpa

the average stay for a man in ltc is about 30 months. I decided to invest my money and if needed pay out of pocket. It’s the medical part or hiring help that’s costly. Not so much room and board.

Still_in_shock profile image
Still_in_shock

If anyone has seen Rockstar with Mark Wahlberg:

I going to go take a piss.

Runner4000 profile image
Runner4000

My sister paid for LTC insurance for 50 years. When she recently needed it--met all of the criteria--they turned her down and told her to sue them if they did not like the result. Pay attention to the criteria and how they determine if you meet them. If it looks too good to be true, it might be.

Bruce66 profile image
Bruce66 in reply toRunner4000

Wow that sure sounds like fraud to me. Thanks for sharing that.

TJGuy profile image
TJGuy

I just cancelled my LTC policy. Let me tell you why. They are a racket. We were lied to by the gold standard company Genworth.We were told our coverage and premiums would never change. But that was a lie, we received 5 changes to date, about 12 years if I remember correctly.

Each change gives you choices, keep what you have and pay a whole LOT more. Reduce you coverage in a number of different ways, none good for you.

Anyway a class action lawsuit was filed against Genworth and we won. There again were a number of special offers. And this time the company stated in black in white that there would be continued increases in premiums. These premium are HUGE increases, even more than the huge increases of the past.

We received a special offer based on the lawsuit which allows us to get back some of our premiums, gave us a frozen dollar amount of future care, and never pay a cent again for coverage.

I can't warn you with any greater voice to say these LTC policies are a racket. And my company " the gold standard in the industry" settled to avoid being found guilty of fraud.

Don't get involved with LTC, run for the door as fast as you can!!!

j-o-h-n profile image
j-o-h-n

Hey Bruce,

Move to God's waiting room (Florida), find a rich old widow and marry her (no prenup for bride and on your terms). To find one, just let those widows know you can drive at night and you'll have tons of them breaking down your front door.....

Good Luck, Good Health and Good Humor.

j-o-h-n

Don_1213 profile image
Don_1213 in reply toj-o-h-n

John, that's the best plan I've heard... wonder what my wife would say...?

Bruce66 profile image
Bruce66 in reply toj-o-h-n

Don't think I haven't thought about it! A lot of lonely widows out there...

I especially like the part about driving at night. I may use that!

JPnSD profile image
JPnSD

$425/mo for $2000/mo benefit? Sounds expensive for little benefit IMHO. I would pass. But that's me.

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