Q&A: If long-term care insurance costs too much, you have a choice to make

Dear Liz: We were told to buy long-term care insurance early because waiting too long would make it more expensive and perhaps unavailable. I bought mine when I was 55. At the time, it was $2,400 a year. Unfortunately, the premiums just kept going up. I am now 77, and the premium this year was $4,470. The letter informing me of this increase said that next year it will go up 6% to $4,738, and 6% again the following year to $5,022. It’s very clear to me that buying the insurance early was definitely not an advantage. The insurer will obviously keep raising the premium at will. Since I am, like most people my age, on a fixed income, the time will come when I simply cannot afford these premiums. I will then lose the insurance plus all I have paid into it all these years. People should be told that the premiums will continue to rise, and that the time may come when the cost is beyond what anyone on a fixed income can afford.

Answer: Many people are in the same unfortunate situation. They purchased policies because they thought it was the prudent thing to do, only to face the possibility of losing coverage as premiums continued to rise.

Companies that offered long-term care insurance starting in the 1980s and 1990s discovered they didn’t price the coverage accurately. Far fewer people dropped their policies than expected, while the costs of long-term care increased more than anticipated. Many insurers stopped offering the coverage, and massive premium increases were the norm for a while.

Insurers can’t raise premiums “at will,” by the way. The increases must be approved by regulators, who weigh the effects on customers against the possibility an insurer might go under and be unable to pay anyone.

The companies still selling long-term care coverage now offer less generous policies that probably won’t require huge premium increases. Still, many financial planners advise their clients who are buying coverage now to expect their premiums to increase 50% to 100% over their lifetimes.

It’s important to keep in mind that insurance is not like an investment or a savings account. You don’t buy homeowners insurance hoping your house will burn down someday so that you can get your money back. You buy it to protect your finances against catastrophic loss. So it’s not as if you received nothing in return for your long-term care premiums: You were protected against a potentially catastrophic cost that — fortunately — didn’t happen.

That doesn’t mean you were wrong to expect your premiums to remain affordable. Given your current reality, though, you’ll need to decide if you want to risk dropping coverage entirely or if reducing coverage might be an option. Many people in your situation have opted for longer waiting periods, lower inflation adjustments or a reduced benefit period to keep premiums affordable.

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Unexpected ways to save on insurance

Zemanta Related Posts ThumbnailMost ideas for saving money on insurance are pretty shopworn. You know the advice: Raise your deductible. Get discounts. Shop around.

So I was pretty psyched to hear a Certified Financial Planner talk about less common ways that advisors can save their clients money. CFP Mark Maurer is president and CEO of Low Load Insurance Services, which caters to fee-only planners. Maurer recently conducted a webinar that covered ways to save money on the big-ticket policies: life, disability and long-term care insurance.

What I learned:

Beware of riders. Two commonly-pushed riders are “waiver of premium” and “return of premium.” Maurer calls these the “undercoating” of the insurance business; in other words, they’re pricey add-ons that may not have the value you’re told.

Premium waivers allow you to stop paying your premiums if you’re disabled, but you typically have to be totally disabled to qualify (unable to work in any occupation, vs. your own occupation, for example). Some policies have the same definition of disability as Social Security, which is notoriously tough to qualify for.

If you’re really concerned about not being able to pay your premiums, then the solution may be disability insurance, Maurer said. Each dollar you’d spend on a DI policy would likely buy you far more insurance than what you’d get from a waiver of premium rider.

Return of premium also sounds good—the idea being that if you don’t use your long-term care policy, your heirs will get back the money you’ve paid in. These riders come with restrictions, too. Typically you have to own your policy at least 10 years and not have made a claim within those 10 years. Any claims thereafter would be deducted from your heir’s payout.

Again, Maurer suggests asking, “What are you really after?” In this case, it’s money for heirs. Buying a permanent life insurance policy likely will offer a better and more certain payout compared to an ROP rider, he said.

Apply the 80/20 rule to long term care insurance. If you’ve ever had a loved one in a nursing home, you know how shockingly expensive custodial care can be. Those who buy long term care insurance often opt for the daily payout amount that will cover either a private or a semi-private room in their area.

Maurer points out, though, that nursing home costs include expenses the patients would be incurring whether or not they were there—expenses like meals and laundry, for example, that typically account for 20% of the total.

So, one way to reduce premiums is to insure for 80% of the costs. Instead of the $255 a day that the average Florida nursing home costs, he suggests, shoot for something like $200 a day…which typically lowers your premium by, guess what, 20%.

Lifetime benefits on disability insurance aren’t a slam dunk. If you have to be disabled, wouldn’t you rather get checks for life rather than having them stop at age 65, when most DI policies cut off?

Well, of course! But like the riders mentioned above, adding lifetime benefits may not give you all the coverage you think you’re getting.

A typical policy will continue 100% of your benefit only if you’re disabled by age 45 and continue to be disabled until age 65, Maurer said. Those disabled after 45 get a smaller benefit, based on a sliding scale that gives you less the older you are when you become disabled. Someone who’s disabled at 58, for example, might get only 35% of his monthly benefit after age 65.

Is that worth premiums that might be 33% higher? Only you can answer that question, but Maurer, who has two disability policies, has decided against adding lifetime benefits to either.

“I didn’t think it was worth the additional premium,” he said.