Why do people fail to activate their long-term insurance (LTCi) policy when they should, and how to avoid these pitfalls?
You Have Long-Term Care Insurance, but you are afraid to activate your policy.
Too little too late: a lot of people have been afraid to activate their long-term policy, and activate their policy too long to get the benefits of a policy they paid into for years and decades.
In this blog, we will explore the 3 main misconceptions around LTCi and how they could be costing you the care you deserve.
LTCi Misconception #1: I am in bad shape, but I have time to activate my policy; I should wait until I get worse.
You may think that you need to be in really poor health to initiate your policy. And, in your head, you may be thinking “my health is not so bad right now, I am probably not eligible”.
Truth: You do not have to be about to pass away to activate your long-term care insurance policy. Simply put, “long-term care insurance” is to pay for “long-term care”. Based on your health, this could mean several months or years of care.
Let’s review the typical long-term care policy triggers. While these will vary from policy to policy, these are rather standard.
To be able to take advantage of your long-term care policy, you will need either help with 2 to 3 ADLs (Activities of Daily Living) or cognitive impairment.
What are ADLs?
These are “activities of daily living”, understood to be the essential needs for independent, healthy, safe living. There are 6 commonly understood.
- Personal Care (Hygiene/Grooming): Bathing, showering, brushing teeth, and shaving.
- Dressing: Selecting clothing and putting it on/taking it off.
- Toileting: Using the restroom and maintaining hygiene.
- Eating: Feeding oneself, not necessarily the preparation of food.
- Functional Mobility/Transferring: Moving in/out of bed or a chair and walking.
- Continence: Managing bowel and bladder function.
If you have issues with 2 of them, you are likely eligible to activate your long-term care insurance (some policies may require 3 ADLs, but the state of Utah prohibits the requirement of more than 3 ADLs).
Secondly, if you have no ADL needs but have a cognitive impairment, then you may be eligible to activate your long-term care insurance as well.
Let’s say that you are experiencing difficulties getting out of bed and moving around your house safely. These are 2 ADLs that could be sufficient triggers to activate your long-term care insurance.
Just remember that you have been paying premiums for years, often decades, for the purpose of financing the care you will need. If you have a need, it is time to delve into your policy details and see if it is the right time to activate it.
LTCi Misconception #2: What if I activate my policy too early, and I outlive my benefits?
Outliving your benefits is scary, and is absolutely worth calculating before you activate your policy.
Your policy will have several maximums that we will help you review.
First, a “maximum benefit limit”, aka a “maximum lifetime benefit,” over your lifetime. This will be an amount to carefully watch for and assess.
Further, your policy will also have a daily (or weekly or monthly) limit.
It may also have a one-time limit from the installation of a home alert system or a ramp.
Very importantly, your policy may also include an inflation rider. This means that the benefits listed could be indexed to inflation. Having an inflation rider came at a price for your premiums, but you could reap significant advantages today.
Keep in mind that statistically, 50% of policyholders will die before ever using any benefits, and among the 50% of policies that are activated, 70% of the people die before the policy runs out of money. This means that statistically, 15% of the policyholders will “run out of money”. A careful policy review will ensure that you are in the 35% of people who activate their long-term insurance policy and do not run out of money.
LTCi Misconception #3: You can stop paying premiums when you activate your policy
Premium – getting it suspended or waived.
Very often, when you activate your long-term care insurance policy, your premiums get suspended or waived. This is a great benefit, as your premiums have likely increased over time, and are probably a few hundred dollars a month to pay.
This suspension of premium is particularly useful as you enter the elimination period.
Having an in-depth understanding of your policy is critical to managing your cash flows optimally.
FAQ
What is the main reason people do not buy long-term care insurance?
There are a few reasons why people do not buy long-term care insurance. The most obvious of them is that not everyone knows about long-term care insurance. We all know about car insurance, house insurance, life insurance, and health insurance. But long-term care insurance is down to the bottom of the list, and it is easy to not be aware of what it covers. Another reason people do not buy long-term care insurance is the cost. Long-term care insurance, especially when indexed for inflation, can be a significant portion of someone’s budget. With people juggling paying a mortgage, sometimes paying for their kids’ education, and still saving for retirement, putting away several hundred dollars for long-term care insurance feels like a daunty and unnecessary expense. People can put it off or simply think that they will pay for the expenses when they arise (aka self-insure).
What is the biggest drawback of long-term care insurance?
As appealing as long-term care insurance is when you need it, it comes with drawbacks worth considering. First, the cost. Is it worth expending cash for years and decades in exchange for a hypothetical long-term care need? What if the premiums increase and you have spent all this money, but are unable to continue paying the premiums? Another drawback is either forgetting about your policy or activating it too late, negating the benefits you would have derived if you had used it faster.
What happens if I never use my long-term care insurance?
If you never use your long-term care insurance, you will sadly be in the company of many policyholders. You will have spent significant sums of money, in exchange for the comfort and feeling of safety, but without its actual realization.
You may ask yourself: how different is long-term care insurance from other types of insurance? You pay car insurance premiums year after year, hoping that, if you have an accident, your car will be replaced. Your health insurance premiums cover your doctor’s visits, hospital stays, and medications. In both cases, you would never forget to use your insurance.
Similarly, it’d be silly to forget the long-term care insurance you paid for for so long when you actually need it.
What is a good alternative to long-term care insurance?
Self-insurance, i.e., the bet that your own funds will pay for long-term care, is the de facto alternative to long-term care insurance: without insurance, you are on the hook for all long-term costs that may arise. You could decide to hold specific assets (real estate, stocks etc…) dedicated to your long-term care, or you could simply plan to use retirement funds to pay for care as needs arise. If you have small means, you may never have had the purchasing power and the need to purchase long-term care. In this case, Medicaid will cover your long-term care. Of course, it comes with strings attached, such as the relinquishment of your social security income, but you will have a social safety net to rely on.
What percentage of people actually use long-term care insurance?
About 50% of the policyholders will activate and use some (70%) or all (30%) of their benefits. The sweet spot is evidently to use most of your policy’s allotted funds (maximum lifetime benefits), not just a fraction of them, but not run out of funds before you pass away. Contemplate statistics as it pertains to your case: 50% of the policyholders will die before activating their policy.
What age is too late for long-term care insurance?
Long-term care insurance is commonly purchased while people are still in their fifties, but more often sixties and even seventies. The longer you wait, the higher the premiums will be, making the trade-off starker, and insurance companies will have a hard cutoff after which you can no longer purchase long-term care insurance (often age 79, but will vary between insurance companies).
Is walking considered ADL?
ADLs stand for Activities of Daily Living. These are activities that are fundamental to people’s functioning and well-being. There are commonly 6 basic ADLs, of which walking (mobility) is a part. The Cleveland Clinic has an excellent review of these here. Bathing, Personal hygiene and grooming, Toileting and continence, Eating and feeding, Dressing, Moving/transferring.
ADL: What it involves
- Bathing: Using soap, water, towels, and other supplies to wash, rinse, and dry your skin. Standing, sitting, or moving in ways that allow you to bathe every part of your body.
- Personal hygiene and grooming: Cleaning your teeth, including dental orthotics and prosthetics. Washing, drying, and styling your hair. Using supplies like cosmetics, deodorant, tweezers, scissors, and nail clippers for grooming.
- Toileting and continence: Moving to the toilet and getting into the proper position. Using supplies like toilet paper and menstrual products. Managing devices like a catheter or colostomy. Controlling when you pee (bladder function) and poop (bowel function).
- Eating and feeding: Chewing and swallowing food so it can reach your stomach. Using utensils to bring food from the plate to your mouth.
- Dressing: Getting clothes from closets or drawers and putting them on your body in the right order. Using zippers, buttons, snaps, and Velcro as needed. Putting on or removing prosthetic devices or splints.
- Moving/transferring: Moving from one spot to another to complete your daily routine (for example, from your bed to the bathroom, or from your couch to the kitchen).
Get Support with Long-Term Care Insurance in Murray, UT
If you have long-term care insurance and are unsure whether it is time to activate your policy, you do not have to figure it out alone. At Assisting Hands, we work with families every day to help them understand their coverage, identify their eligibility, and access the care they have already paid for. Do not wait until your needs become more severe to explore your options. Start working with our team by following these simple steps:
- Contact us for a free consultation.
- Meet with a member of our team.
- Start making the most of your long-term care insurance!
Other Services Offered with Assisting Hands Home Care
At Assisting Hands Home Care in Greater Murray, we offer other forms of support in addition to long-term care insurance advocacy. We also provide a full range of professional, compassionate in-home care services designed to help seniors live with greater comfort, safety, and peace of mind in the place they call home.
In addition to LTCi advocacy, we offer Alzheimer’s and Dementia Care, Parkinson’s Home Care, Stroke Recovery Home Care, and Orthopedic Home Care Services. We also provide Personal Care & Grooming, Meal Preparation, Light Housekeeping, and Grocery Shopping & Errands to support the day-to-day needs of seniors aging in place.
For families navigating life transitions, our Transitional Care, Hospice Support Services, and Coordination of Care services can also provide support. We also proudly serve Veterans through our Veterans Aid & Assistance program, and offer Companionship and Fall Prevention services. Whatever your family’s needs look like, Assisting Hands is here to help. Explore our full list of services or contact us today for more helpful information!
