A-rated companies that offer long term care insurance?

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ssgao
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A-rated companies that offer long term care insurance?

Post by ssgao »

Ontario resident here. I am trying to buy LTCi for my parent, but going through the list of companies / institutions that offer it[1], there are only 3 companies that have a rating of A or above. Manulife, SSQ and Sun Life. From browsing their website, only Sun Life gives an in-depth look at the coverage. How's everyone else's experience buying this insurance? Were you able to find more trustworthy insurance companies that offer this type of insurance that I'm not aware of?

1. select LTHC from http://www.olhi.ca/insurance/find-insurance-products/.
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Re: A-rated companies that offer long term care insurance?

Post by Hopetoretire »

Bumping ...

Considering LTC insurance as:
1. I plan to live in Canada after retirement (no snow-birding, etc)
2. Have no family to care for me when I get old
3. Would rather stay at home as long as I can and hire a personal support worker than abide by the rules in the nursing home as I visited a few in the GTA and they were sad environments.

Questions:
1. Is this worth buying and at what age?
2. Are premiums tax deductible?
3. Are claim payouts taxable?

Would anyone who has this coverage say it was a good decision to buy? Or better to get critical illness or long-term disability insurance? No life insurance required - no heirs.
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Re: A-rated companies that offer long term care insurance?

Post by AltaRed »

I would suggest it depends on one's monetary resources/reserves. If one is well financed, I'd not buy LTC. One's POA can pay the bills on a pay-as-you go basis from assets. I don't see it as any different than any other kind of insurance. Self-insure for what one can afford to pay out, and buy insurance for the rest. Example: 8 year old car. Don't buy collision as it is only worth maybe $5k anyway.
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OnlyMyOpinion
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Re: A-rated companies that offer long term care insurance?

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But it sounds like you are ok with a long term care home eventually? then I think the cost of premiums may not be worth it. You could for example, cover your home care costs with your income/resources (possibly even buying an annuity), and if your needs begin to exceed that capacity then I think it indicates a LTCH. Those currently cost from $2275/mo for a private room down to as little as $0 if you do not have sufficient income.

Are you familiar with what is offered (in theory) provincially if you need assistance at home? It is worth understanding, but I wouldn't blame you for discounting it. I know a senior recently released from ICU who needs essentially continuous home care and was offered 2 hours a week (four 30 min visits/week) by LHIN. So family are paying for more extensive care as they wait for LTCH bed. In my experience it is highly variable depending on the competence of staff you get and the advocacy you have.
This lack of resources for high need seniors is only going to get more critical with time.

Have you referred to some of the info available from insurance companies at: Manulife, and Sun Life?

As to tax deductability of premiums, it doesn't appear so. Sun Life makes no mention while this question at Manulife says not.

And this Globe article Should you buy long-term-care insurance? mentions the lack of premium deductability as a drawback. It is worth reading.

Finiki's long term care insurance page uses some of the above as references.
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Re: A-rated companies that offer long term care insurance?

Post by Hopetoretire »

Eventually is the key word - probably when I reach stage 5 and even a PSW can't manage. It costs a lot for home care (about $25/hour x 24 hours x 7 days) for several years, so nest egg won't cover this. Sponsoring an immigrant for live-in care is not cost-effective as they will leave for higher pay as soon as they can. Also sadly if dementia sets in, POA's and PSW's can drain all the funds in their own way. With no family members to trust, long term care insurance is certainly a consideration for me (some policies pay out for home care if one can provide official receipts). The max hours for a terminal patient that CCAC provides in Ontario is 14 hours a week home care, but it's usually 4-6 hours for bath and light house cleaning for the disabled.

I visited some LTC homes who advised that they can take over financial POA for a resident and prefer to do so, so they can ensure they get paid. I assume this is only for a semi-private or private room as the government will fund shared rooms (usually 4 beds in a room). It's not that I can't afford $40k a year for LTCH but have no one to manage their payments, so it's either insurance or an annuity. I guess an annuity is a better choice as the funds can be used at one's discretion.

Apologies for my rambling - how did I get from happily planning my retirement to this rather sad scenario?
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Re: A-rated companies that offer long term care insurance?

Post by kcowan »

Hopetoretire wrote: 23 Apr 2019 17:08Apologies for my rambling - how did I get from happily planning my retirement to this rather sad scenario?
I suspect it was your poor experience with your Dad that has got you (and me) thinking about late in life scenarios?

I have seen similar situations with a neighbour, and also a friend who got Alzheimers at age 58. The LTC facilities look good on the surface but are not! So how to set up an affordable alternative? The missing link seems to be making provisions for paying a helper who cares. And some form of oversight to ensure the care gets delivered long term.
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Re: A-rated companies that offer long term care insurance?

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It is that latter part that is hard to find too, i.e. a helper that cares. There are numerous stories about private helpers who were anything but, as uncovered by secret cameras placed by concerned family members. A rogue in-home helper may be the very worst kind, e.g. no oversight at all.

It simply is the pits to get into that kind of vulnerable situation and I think assisted dying will become a bigger thing over time as today's technology can uncover more and more elder abuse.
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Re: A-rated companies that offer long term care insurance?

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I interviewed each time about 9 PSW's before I could hire one. Most of the private applicants were working 7am-7pm in a LTCH or hospital and wanted to work from 9pm-6am for us. Didn't realise this until I found them sleeping through multiple requests for help from my disabled parents. Searched internet for advocacy programs but could not find any. Wrote to CARP - apparently only the US has such services (pay a professional for advocacy who also knows LTC legal policies for escalation).

Would much rather pursue my bucket list and lose my life while having fun, like skydiving, rhino tracking or trekking through some jungle - than be put down like an old unwanted pet. I think my thought process from this thread has discouraged me from LTC insurance, so thanks for sharing your experiences :D
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Re: A-rated companies that offer long term care insurance?

Post by OnlyMyOpinion »

Hopetoretire wrote: 24 Apr 2019 12:34 I interviewed each time about 9 PSW's before I could hire one. Most of the private applicants were working 7am-7pm in a LTCH or hospital and wanted to work from 9pm-6am for us. Didn't realise this until I found them sleeping through multiple requests for help from my disabled parents. Searched internet for advocacy programs but could not find any. Wrote to CARP - apparently only the US has such services (pay a professional for advocacy who also knows LTC legal policies for escalation).

Would much rather pursue my bucket list and lose my life while having fun, like skydiving, rhino tracking or trekking through some jungle - than be put down like an old unwanted pet. I think my thought process from this thread has discouraged me from LTC insurance, so thanks for sharing your experiences :D
HTR, Not sure what advocacy support you were looking for, and past needing it now by the sounds of it, but I had good experience with Advocacy Centre for the Elderly (ACE) in Toronto.

I agree with other comments about hoping to never get to the point of needing extensive home care, or having to go into a LTCH. Even my best experience with them is my worst. The issue of sufficient resources and quality of some of the individuals is only going to get worse with time.
I plan/hope to exit on my own terms as well.
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Re: A-rated companies that offer long term care insurance?

Post by OptsyEagle »

I am not sure LTC insurance would solve your problems of not having anyone you can trust to help you. Obviously you will need to be in pretty bad shape before you could even hope to see a claim paid and no claims get paid until someone files it properly. Plus, insurance companies sometimes require someone who cares on your side to offset the bias of the person who cares on their side.

Also, have you obtained a quote for LTC. It does not take a person too long to figure out who is actually paying for all this once a quote is obtained. To add insult to injury, they usually will not guarantee premiums. What that means is if you are on claim, you would not have a problem. No premium is required when on claim. It is before you go on claim, where the problem can arise. As you age, they may find that they need to hike the premium even more to pay for the claims that are starting to come in. It may end up that a few years before you need it, it all of a sudden becomes unaffordable and you need to cancel it. I don't like buying any insurance, that isn't widely used, where the insurance company does not guarantee the future premiums.

Hence I don't have LTC insurance.
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Re: A-rated companies that offer long term care insurance?

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I'm doing some contingency planning, for my retirement plan. Long term care seems to me like the main risk in terms of potential cost from an "unexpected" (or at least difficult to predict) event. I've looked at reverse mortages as a potential last resort source of liquidy, but the maximum loan at age 70 is less than 50% of home equity; in our case this might not be enough to pay for an extended stay in an private LTC facility.

So its either self-insure through a contingency fund (dedicated financial assets, not necessarily all cash) or buy LTC insurance, or a combination.

From what I've read in order to update finiki's LTC article, there is only one serious insurer left that offers a stand-alone product that covers stays in a LTC facility, Sunlife. And it is not the traditional LTC insurance anymore, but a "light" version they call Sun Retirement Health Assist, with less stringent underwriting. You have to be at least 65 to make a claim, they only pay after 1-2 years of the client having been declared "dependent" (long waiting period). But then they pay a predefined weekly benefit without a time limit. The benefit goes up by 3% a year after it starts. (As usual, premiums are not guaranteed beyond 5 years.)

I like the idea of a long waiting period but that once benefits start, there no time limit: that covers only the tail risk and should make coverage much cheaper, especially for the two year waiting period. We can definitely self-insure for 1-2 years of LTC costs, but planning for 5+ years of paid care is a real drag and is quite unlikely to be needed (the type of risk you typically want to insure against: unlikely but large consequence). I couldn't find any quotes online, so I've contacted the company and will report back.
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Re: A-rated companies that offer long term care insurance?

Post by OnlyMyOpinion »

Quebec wrote: 25 Mar 2024 19:43 ... there is only one serious insurer left that offers a stand-alone product that covers stays in a LTC facility, Sunlife. And it is not the traditional LTC insurance anymore, but a "light" version they call Sun Retirement Health Assist, with less stringent underwriting. You have to be at least 65 to make a claim, they only pay after 1-2 years of the client having been declared "dependent" (long waiting period). But then they pay a predefined weekly benefit without a time limit. The benefit goes up by 3% a year after it starts. (As usual, premiums are not guaranteed beyond 5 years.)

I like the idea of a long waiting period but that once benefits start, there no time limit: that covers only the tail risk and should make coverage much cheaper, especially for the two year waiting period. We can definitely self-insure for 1-2 years of LTC costs, but planning for 5+ years of paid care is a real drag and is quite unlikely to be needed (the type of risk you typically want to insure against: unlikely but large consequence). I couldn't find any quotes online, so I've contacted the company and will report back.
I note that Sun will cover care in i) your home, ii) in a retirement home, or iii) in a long term care facility.
My experience is limited to Ontario, but ISTM that it would be in settings i) and ii) that you could use the insurance. Once you are in a long term care facility, the care is provided and you are only responsible for a co-pay of ~$79 to $93/day. That can be further reduced (at a semi-private level) based on application and an income means assessment.
My experience with assisted living in a retirement home (typically a dedicated floor) is a bit dated now, but I seem to recall it costing about $5k/month, and limited to residents who can transfer themselves (e.g. bed to wheelchair) and feed themselves.
Understanding the options is a confusing subject. The long wait lists mean that some options are not options at all.

[OT]
It's interesting that retirement homes (think 'upscale living') are having a tough sell these days, It's nearly impossible to find a place to rent. But retirement homes have room to spare.
Some regional health boards in ON have taken to leasing entire floors of some retirement homes to establish transitional care units. These are staffed (under contract) at a LTC home level and house residents who would otherwise be occupying a hospital bed as they wait for a LTC home bed, or to return to the community with necessary supports. It seems mutually beneficial - solving the hospital's capacity problem and the RH's vacancy challenges. Residents pay LTC home co-pay rates.
[/OT]
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Re: A-rated companies that offer long term care insurance?

Post by Shante »

They're probably the only company still offering it because they don't pay out what the policy entitles you to, if the LTC claims management is anything like SunLife's EHB claim management.
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Re: A-rated companies that offer long term care insurance?

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OnlyMyOpinion wrote: 25 Mar 2024 21:04 ...Once you are in a long term care facility, the care is provided and you are only responsible for a co-pay ...
The public facilities in Quebec, called CHSLD, have often been in the news for the wrong reasons (before, during and after the pandemic). My impression -- based on reading the news, not personal experience -- is that things are not improving. There are staffing issues, building maintenance issues, etc. Plus there is a waiting list of up to two years (assuming one wants to go there). I'd like to have some options other than a CHSLD if I can afford it.
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