Anonymous wrote:

Anonymous wrote:My parents have a federal long term care policy under John Hancock (the long term policy under FLTCP). They are soon going to be ready for needing to use this policy. However, I am not certain how to determine when they are eligible exactly. Should I ask the insurance company for eligibilty determination? Or should I hire someone (like a geriatric care manager) for an outside assessment? To qualify, they have to be unable to carry out two activities of daily living. I am worried about personal care (nails long, uncut) and that they may not be taking their medications. Eating is also an issue for one but the other is providing that service.

Thoughts/advice on the use of long term care insurance?

My suggestion would be this:

- Find a place that lets you come in at some level as self-pay, then transition to Medicaid after a certain period.

- If at all possible, set enough insurance benefits aside to pay for care for one parent during that transition period.

- Use the rest of the funds to pay for homemaker services.

- Use home equity (maybe by simply selling the home) to pay for home care and facility care for the healthier parent. If the sick and parent dies without needing to touch the facility care money, and the parent can use the leftover benefits, then the second parent can use that money, too.

- If some of the benefits go unused, that’s wonderful. That means one or both parents stayed reasonably able-bodied till the end. The last thing people should want is need their long-term care benefits.

PP, helpful comments here though am confused by the one above set in bold - how does one set aside enough insurance benefits? A little more substance here may help.

And in a more general comment, I really appreciate posters who come on here like PP and spell out possible steps to consider with eldercare. DCUM at its best!

Anonymous wrote:

Anonymous wrote:My parents have a federal long term care policy under John Hancock (the long term policy under FLTCP). They are soon going to be ready for needing to use this policy. However, I am not certain how to determine when they are eligible exactly. Should I ask the insurance company for eligibilty determination? Or should I hire someone (like a geriatric care manager) for an outside assessment? To qualify, they have to be unable to carry out two activities of daily living. I am worried about personal care (nails long, uncut) and that they may not be taking their medications. Eating is also an issue for one but the other is providing that service.

Thoughts/advice on the use of long term care insurance?

My suggestion would be this:

- Find a place that lets you come in at some level as self-pay, then transition to Medicaid after a certain period.

- If at all possible, set enough insurance benefits aside to pay for care for one parent during that transition period.

- Use the rest of the funds to pay for homemaker services.

- Use home equity (maybe by simply selling the home) to pay for home care and facility care for the healthier parent. If the sick and parent dies without needing to touch the facility care money, and the parent can use the leftover benefits, then the second parent can use that money, too.

- If some of the benefits go unused, that’s wonderful. That means one or both parents stayed reasonably able-bodied till the end. The last thing people should want is need their long-term care benefits.

Thanks for this advice. Unfortunately, all of this requires significant wealth that they don't have. Can't come in as self-pay because no $ to do so. Insurance benefits are the available option. No home equity to draw from. And I'm not sure what the 'rest of the funds' you refer to are?

Anonymous wrote:My parents have a federal long term care policy under John Hancock (the long term policy under FLTCP). They are soon going to be ready for needing to use this policy. However, I am not certain how to determine when they are eligible exactly. Should I ask the insurance company for eligibilty determination? Or should I hire someone (like a geriatric care manager) for an outside assessment? To qualify, they have to be unable to carry out two activities of daily living. I am worried about personal care (nails long, uncut) and that they may not be taking their medications. Eating is also an issue for one but the other is providing that service.

Thoughts/advice on the use of long term care insurance?

My suggestion would be this:

- Find a place that lets you come in at some level as self-pay, then transition to Medicaid after a certain period.

- If at all possible, set enough insurance benefits aside to pay for care for one parent during that transition period.

- Use the rest of the funds to pay for homemaker services.

- Use home equity (maybe by simply selling the home) to pay for home care and facility care for the healthier parent. If the sick and parent dies without needing to touch the facility care money, and the parent can use the leftover benefits, then the second parent can use that money, too.

- If some of the benefits go unused, that’s wonderful. That means one or both parents stayed reasonably able-bodied till the end. The last thing people should want is need their long-term care benefits.

Not sure about a "Federal" policy (I don't even know what that is) but with my mom's policy (Mass Mutual) when we wanted to put her in the facility, the medical director at the facility had to certify to Mass Mutual that she was incapable of carrying out a certain number of activities of daily living. The facility had to re-certify every year that she was eligible, and furthermore had to tell Mass Mutual every month how many days she'd spent there. The good news is that these facilities want tenants so they have every incentive to find your parent eligible.

The more activities of daily living your parent can't do, the more they get to charge for a higher "level of care". I did have an argument with my mom's facility at one point - they wanted to raise her "level of care" and charge her more. After a certain amount of hassle where we documented everything mom needed and how much time it took, they backed off.

Anonymous wrote:I would advise using the benefits when they are truly needed for daily care, otherwise you will burn them up before your parents reach a stage where they more desperately need hands-on help.

There are other ways/things which are not that costly to do medication reminders or some grooming.

In any case, you should look over their benefit information to find out what they are eligible for and what the lifetime cap is.

Yes, this. You do NOT want to burn through then find your parents requiring more intensive - and expensive - care.

My MiL started using their LTC policy to watch her husband (FiL) as he cannot be alone due to cognitive issues. She immediately started booking 5 days of care as she wants to continue to keep up her busy social life. I get that, especially as caregiving can be very draining, though perhaps 2-3 days may have been more financially prudent. Even DH said the other day that their resources are not endless.

I would advise using the benefits when they are truly needed for daily care, otherwise you will burn them up before your parents reach a stage where they more desperately need hands-on help.

There are other ways/things which are not that costly to do medication reminders or some grooming.

In any case, you should look over their benefit information to find out what they are eligible for and what the lifetime cap is.

My parents have a federal long term care policy under John Hancock (the long term policy under FLTCP). They are soon going to be ready for needing to use this policy. However, I am not certain how to determine when they are eligible exactly. Should I ask the insurance company for eligibilty determination? Or should I hire someone (like a geriatric care manager) for an outside assessment? To qualify, they have to be unable to carry out two activities of daily living. I am worried about personal care (nails long, uncut) and that they may not be taking their medications. Eating is also an issue for one but the other is providing that service.

Thoughts/advice on the use of long term care insurance?