In previous blogs I have described that my current priority is providing long term care for my wife Joan who in the middle to late stages of Alzheimer’s. One result is that I have not been actively writing for the past couple of years. I took up writing sixteen years ago at the age of seventy three and self-published three novels and a number of short stories. My intent had been to determine if I had the ability to write things that people would be interested in reading. I spent enough time and energy to determine that I didn’t so closing that chapter of my life is not difficult. Now it is being determined if I have the ability to provide the care Joan needs now and in the future. The jury is still considering the matter.
When my wife and I were in our 60’s we became concerned about the possibility of the need for long term care. It was something we hoped we would never need but decided to buy a long term care insurance policy to take care of the need if it should occur. Buying the insurance made us feel responsible and we believed would take care of our long term care needs if needed. The premiums were substantial but we felt worth the protection provided. We didn’t give the matter a great deal of further thought until Joan was diagnosed as having dementia of the Alzheimer’s type when she was eighty two. At that point we began to understand how long term care insurance works.
One thing we learned was that although there is an inflation escalation feature in the policy, it was based on the national inflation numbers, not the inflation numbers that have been experienced in the medical field during the duration of our long term care insurance policy. The national rate has been at less than two percent and the medical inflation rates have been running in the double digits. As a result cost of full time nursing home cost could run two to three times the daily limits of our insurance payout. This could be hundreds of dollars a day. So unless a person has the means to cover the difference between the insurance payments and the long term care costs, the government would take over and assume costs not covered by the insurance. If there is a surviving spouse remaining assets will be assumed by the government except those needed to meet a spouses minimal needs.
I am able to care for my wife at the present time. However, since the long term care insurance will pay for home care within the limits provided in the policy I did apply for two hours of daily assistance; As a result I learned more about how long term care insurance works, at least with the company that we have our policy with. There is a lot of bureaucracy and control. They don’t make it easy to apply for or be approved for the policy benefits.
Naively I had thought I would like to have help for about three hours three days a week. I knew about the sixty day rendition requirement, but hadn’t noted that it had to be continuous for sixty days; every day, seven days a week for sixty days. OK, I proceeded as required. The care giving service had to be approved by the insurance company and then there has to be an approved care plan. While all this is going on you don’t know if the long term plan would be approved and won’t know until the rendition period is completed and it took the insurance company over a month to approve the long term care request after the rendition period. Meanwhile I continued to pay the seventy dollar a day care service cost, a cost finely covered retroactively after the long term care was approval.
We continued the care service for about five months and then discontinued it. There were several reasons for discontinuing the service. One was that my wife did not want or believed she needed the services of a care giver. That is true as long as I am able to provide the care she needs. The care giver was more for my benefit than my wife’s benefit. Another reason is that that my wife would sometimes become angry and physically confront the care giver. It made it nearly impossible for the care giver to provide personal care for my wife. That the care giver stayed with us for as long as we kept the care services was pretty amazing. The experience became frustrating to everyone involved. To continue it would have been more difficult than doing without the service.
We only had one care giver during the time we had the care service. That person was dependable and capable. Other people we know have experienced a variety of caregivers with a variety of capabilities and level of dependability. The agency we used paid the caregivers $15 an hour when working two hours, $13 an hour if working more than two hours. The caregivers provide their own transportation and have no benefits. Obviously you can’t expect highly qualified professional help for those kinds of wages. The cost to the user of this service is $35 an hour for a two hour period, reduced to $30 dollars an hour if the service if for more than two hours. So the cost of for the long term care is expensive while the pay to the providers of the service is poor. There is a lot of overhead built into the system.
Knowing what I know today, I would not have bought a long term care insurance policy twenty- one years ago. The initial premium cost of $212 a month has nearly doubled over that period. I don’t know what the average premium has been but assume it is $300 per month. If I had invested the premiums at 6% I would have accumulated approximately $150, 000 which I would now have available to spend as I wish for long term care. I wouldn’t be tied to the insurance rules and regulations for the service and wouldn’t have to pay the overhead for the service. I could contract directly for the type of service I needed when I needed it. Now if I need twenty four hour long term care the insurance I have would only pay a small portion of it and if my other assets were limited they could soon be depleted and I would eventually become dependent on the government to cover the cost of my long term care. I would end up in the same situation as one with no insurance and no assets. On the other hand, if I did have enough assets to cover the cost of long term care, I wouldn’t need the insurance. So I recommend investing the money that would be used for long term insurance premiums and hope that you become wealthy enough that you can pay for long term care if needed. If not, in the current conditions, even with a comprehensive long term care insurance policy, you could become dependent on the government. The purpose of insurance is to protect against financial circumstances that could be ruinous. Currently, long term care insurance doesn’t provide that kind of protection. It can provide the government assistance in paying part of the cost of care of for individuals who are covered by long term care insurance. That is not why I would want to invest in insurance.
Alfred Wellnitz Published Book and Short Story Information at: