Long-Term Care Insurance

cleo · Posted: Sat Jul 03, 2004 10:08 am Post subject: Long-Term Care Insurance

Though I am still ambulatory, I do have PPMS and cannot ignore what the future might hold. I have done an exhaustive search, on my own and with a Long-Term Care Insurance Agent, and cannot find LTC insurance for people with MS. Has anyone been able to locate a company that offers what is called "high risk" LTC insurance?

I have contacted the NMSS. The two people I spoke with had no idea what I was talking about, which is a sad reflection on the NMSS. Why doesn't the NMSS lobby congress on our behalf so that we can prepare for our future?

willysnout1 · Family Elder Joined: May 24, 2004 Posts: 125

I would doubt long-term care insurance would be available to MSers after they've been diagnosed. It would be a little like buying car insurance after you've wrapped the chariot around a tree. There is, of course, the Medicare and Medicaid programs for nursing home and home care expenses. Here's a web site with good information about disability insurance.

Some specialty insurers offer DI coverage for MSers, but it's expensive and limited in scope. It's worth remembering that insurance companies aren't your parents, your friends, your neighbors or the good hands people. They are financial companies that collect premiums and pay benefits according to contracts they sign; they're playing the odds, not taking a vow of caring for you.

The way their business basically works is that they study groups of people and say, "How likely are they to suffer a loss?" They allow individuals who fit the characteristics of the study group to buy a contract to be paid if they suffer the loss. They hope that the premiums paid, plus the investment income on those premiums, is greater than the losses they pay out. It's all very bloodless, regardless of what their advertising says.

cleo · Posted: Mon Jul 05, 2004 9:18 am Post subject: Long-Term Care Insurance

As I mentioned in my original post, I have done an exhaustive search for high-risk LTC insurance and certainly understand the business of "insurance." No one should depend on Medicare for any "long-term care" help beyond 20 days in a skilled nursing facility. According to THE MEDICARE PLAN which can be accessed at www.medicare.gov, scroll down until you get to Medicare Benefits, go to page 39, you will read the following under "What do YOU pay in 2004?"
YOU pay the following amounts for each benefit period in 2004
(following at least a related three-day covered hospital stay):
Days 1-20 $0 for each day
Days 21-100: up to $109.50 for each day
(Nursing Home care averages $100 per day)
Days beyond 100: You pay 100%.
Plus, you must be admitted to a Medicare-certified Skilled Nursing
Facility. Medicare does not cover Assisted Living which is what most MSers would be interested in.

Medicaid, on the other hand, is a state administered program and each state sets its own guidelines regarding eligibility and services. For general information about the Medicaid program, including eligibility requirements, go to http://cms.hhs.gov/medicaid/eligibility/default.asp. Medicaid Planning is another avenue. There are attorneys that can help with Medicaid Planning.

So, I come full-circle again. Does anyone know of any LTC insurance offered for high-risk individuals with MS?

lindamae · Newbie Joined: Jul 05, 2004 Posts: 2

Hi, I can tell you what my husband and I did. We got a long term policy for him that has a clause that if he is unable to care for himself then the insurance company will send a provider to care for him and me also, since he will have been taking care of my needs. The company we chose is John Hancock. My husband researched this quit exhaustively. One of his degrees is in law. I hope this helps. I feel more secure with this policy in place.
Linda

seelie · Posted: Tue Jul 06, 2004 12:44 pm Post subject:

I have CNA - Independent Solutions... which I got through work. Fortunately they set it up where they have to take you if work there. I feel very fortunate to have it.

I tried to add my wife who has Type II Diabetes -- Managed completely with diet and pills - and they turned her down. I'm sure if I had to fill out the 'short form' application - they would have nailed me too...

Still it's no panacea... you have to be disabled for 90 days before they will even talk to you... so for us RRMS types....

=G

SlowI · Getting to Know You... Joined: Jun 17, 2004 Posts: 13

Cleo,
I can't agree more with your concern. I am just starting the search for such insurance, so anything of value that can be contributed here will be of great value, no doubt.

I work for a company that does not provide either disability insurance nor retirement benefits (insurance), so this is particularly important to my family. I was fortunate enough to have signed up for disability insurance 2 years ago, and was diagnosed just 3 months ago.

Now I just need to find a long term answer along with you. I'll let you know if I find anything workable here!

SlowI