Fewer Americans Plan For LTC

Fewer Americans Plan for Long Term Care

January 13, 2012

By Jenny Ivy

Many Americans are looking to Medicaid for meeting their long-term care needs, although most know more about long term care insurance than five years ago.
John Hancock Financial surveyed 1,000 people and found 60 percent believe they'll someday need long term care+. However, fewer have planned for the possibility in their own lives, and many said they'd rely on Medicaid despite admitting they did not understand how the program worked.
A majority of respondents answered seven out of 10 basic LTC quiz questions correctly compared to four out of 10 in 2006. Despite the increase in general LTC knowledge, fewer people today than in 2006 said they've made financial calculations for what they'll need in retirement (66 percent vs 72 percent). Of those who have calculated for retirement, only 41 percent included LTC needs in the equation, compared to 51 percent in 2006. Fewer still, 22 percent, said they've made plans specifically to finance potential LTC needs, compared to 31 percent in 2006.
While it is encouraging to see an increase in general knowledge," said Marianne Harrison, president of John Hancock LTC Insurance, "the survey's overall results are a cause for concern because most consumers appear to be making long-term care plans by default, thinking they'll rely on government programs, which already are showing signs of strain."
Planning and LTC Insurance Seen Positively
A large majority of respondents, 82 percent, agreed that it is irresponsible not to plan for the cost of LTC needs. Among a number of options, LTC insurance was cited as the best way to plan by the greatest number of respondents (61 percent). Additionally, a number of the benefits of LTC insurance were seen as important by vast majorities – with some growing by more than 10 percent since 2006:
  • LTC insurance helps individuals receive care where they choose (93 percent in 2011 from 79 percent in 2006)
  • LTC insurance ensures one receives high quality nursing home care (93 percent in 2011 from 74 percent in 2006)
  • LTC insurance ensures the individual is in control of overall care (92 percent in 2011 from 80 percent in 2006
Although most respondents said they thought LTC insurance would be the best way to cover long-term care needs (61 percent), only 11 percent reported having purchased it. More than half of those who hadn't bought LTC insurance (53 percent) said they plan to cover their LTC costs by qualifying for Medicaid.
However, more detailed survey questions about Medicaid revealed a lack of knowledge about how the program worked and a feeling that it would be cut back in the future. By their own admission, few Americans understand how Medicaid works – less than a third (30 percent) reported being knowledgeable about it in general. When asked specific questions about Medicaid, almost four in 10 respondents (37 percent) incorrectly thought that Medicaid covered LTC services received at home and nearly half (46 percent) didn't know that people generally needed to spend down almost all their assets to qualify.
In addition, three-quarter of all respondents (75 percent) said they believed Medicaid would be cut back in the next decade, with 44 percent believing it would be cut back a lot.
Economy Seen Affecting LTC Insurance Purchase
Roughly one-third of respondents (32 percent) say they have been less likely to purchase long term care insurance because of the economy. Consumers are more likely this year to say they agree that a long-term care policy is an extra cost they do not want to spend right now (92 percent vs. 80 percent in 2006) and that they simply cannot afford to pay for it (80 percent vs. 66 percent in 2006).
Americans Can't Afford Much Care
When asked how much they would be able to afford annually to pay for the cost of care (in today's dollars), the majority said between $1,000 and $14,000 (70 percent). Another one in five said they would be able to spend between $14,000 and $35,000 (20 percent). Very few feel they would be able to afford any more.
When given the approximate cost per year for a semi-private room in a nursing home, the majority of respondents said they do not think they could even afford to pay this amount for a full year (62 percent)
Lack of Planning May Cost Them High Quality Care They Desire
Not surprisingly, 96 percent of respondents expressed that if they ever needed care in a nursing home, it was important that they receive high quality care; 71 percent of respondents reported it was very important and 25 percent considered it somewhat important.
However, in the absence of buying LTC insurance, more than half (53 percent) said they planned to qualify for Medicaid, despite the fact only a quarter of respondents feel they'd receive care that was good or better on Medicaid.
"There is a disconnect between the care Americans would like to receive should they need it and the actions they would need to take to prepare for it," said Harrison. "Although the current economy may discourage individuals from planning ahead for their potential long-term care needs, the purchase of long-term care insurance can help ensure that they get the kind of care they would hope for in their future, while helping to protect their assets."
However, more detailed survey questions about Medicaid revealed a lack of knowledge about how the program worked and a feeling that it would be cut back in the future. By their own admission, few Americans understand how Medicaid works – less than a third (30 percent) reported being knowledgeable about it in general. When asked specific questions about Medicaid, almost four in 10 respondents (37 percent) incorrectly thought that Medicaid covered LTC services received at home and nearly half (46 percent) didn't know that people generally needed to spend down almost all their assets to qualify.
In addition, three-quarter of all respondents (75 percent) said they believed Medicaid would be cut back in the next decade, with 44 percent believing it would be cut back a lot.






 
[The following disagrees with the some of the points in the article above, posted by the moderator. Please understand that I am not taking issue with the moderator on a personal level, I'm not trying to pick a fight with him, and that I disagree with him on the issues, nothing else. Please don't delete this. It took me a while to compose and I think it adds to the dialectic of this section. In the past few weeks some posts that disagree with the position or viewpoint of some (not all) moderators sometimes will just vanish. We've had a lot of posts just "go away" in the past month or two. I hope this won't be one of them! Please?]

It would be interesting to learn how many insurance agents have LTC.

I would bet no more than 20% of all active agents who have a license to sell LTC in their state have LTC. (In CA you must have a health insurance license. We have "life-only" and "health/accident" licenses. Most agents have both.)

If I'm right and if agents who know the risks and needs won't/don't buy the product why would we expect the general public to be buying it?

The following is just a guess and based on zero research but I think people are looking to "government" to solve this issue for them: Pay a tax (payroll) and be eligible for LTC, similar to how some states have SDI.

Don't yell at me. It's only a gut feeling and I'm not advocating a government run system... but I think that is what we will eventually get... and what people want.

The perception of LTC I've received from a few people is that "I will pay my premiums but when I need LTC the company will find some way to screw me and not pay it... just like my house insurance and car insurance and health insurance." Again, I'm not saying this is "fact" or a wide-spread opinion... but I would not be surprised if it were.

One thing about life insurance. No one has ever told me a story about how they were cheated by the company. Dead... is dead. No "adjusting" here. No "fine print" or long list of exclusions. Show a death certificate and claim is paid. I've never had anyone say they distrust a life carrier to not pay up upon death.

I am 100% certain that if I made a major claim (say $100K+) against my house insurance (Travelers) if there was a fire or storm damage that I'll have to fight tooth and nail to settle it... and that the agent won't help me a whole lot... she reps the company, not me. (I'd call my family lawyer before I called my agent!)

People "know" they need and will use health insurance. But like house and car insurance, LTC is seen (by some... many?) as a "rat hole" you throw money at... down the drain. We need more LTC products where people don't lose the asset... life / annuity riders or some kind of ROP to survivors if LTC is never used. I used to recommend the John Hancock LifeCare rider, but they cancelled it.

I think the entire LTC sector of the industry is in disarray (Met leaving didn't help) and until they come out with products that are easier to understand and are more "value oriented" than what we have here (in CA) I don't see the sector having more than 10 million (if that) policy holders. What do we have now? Maybe 7 million out of how many "eligibles"... 200 million?

This piece from the New York Times is 18 months old, but much of it is still accurate.

YMMV.

Al
You can find me at this site.
 
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I wonder how many agents would advocate the government offering LTC or forcing everyone to buy it or face a penalty as with Obamney Care.

Let's face it. As long as the fed can print fiat money, the government will continue to take over all health related insurance, just as they have started to take over banking and auto manufacturing.

We can bitch all we want, but insurance agents will no longer be needed in the future except for P&C and maybe life.

Rick
 
I wonder how many agents would advocate the government offering LTC or forcing everyone to buy it or face a penalty as with Obamney Care.

Let's face it. As long as the fed can print fiat money, the government will continue to take over all health related insurance, just as they have started to take over banking and auto manufacturing.

We can bitch all we want, but insurance agents will no longer be needed in the future except for P&C and maybe life.

Rick

I've not heard of any agents in favor of a mandate to buy LTC. (And there are only a very few agents here (myself included) who back a mandate for health insurance.)

But I agree with Rick. It seems (and I'm surely no expert at LTC, but I read a lot) that the private sector has "failed" in that they have not come up with compelling LTC products for people to buy at a price they can afford (or are willing to pay!)

It's the chicken/egg. You need a large pool to keep rates down and you can't get a large pool without low rates.

Another failure of the industry is in creating an awareness of the LTC need. How many of us have seen a TV commercial for life insurance (i.e. "The company you keep".) I've never seen an adv. for LTC except in insurance magazines.

LTC Awarness Month is directed more toward agents than the general public.

Rick makes a good point in that governments (federal and state) are taking over the role of health care financing from the private sector. We probably disagree on my contention that I don't see a huge groundswell of resistance toward it. There is some, but at least in the current election season so far it has not been the issue of concern, like jobs, the economy, and whether President Obama is a US-born citizen or a Christian.

As for P&C, I'm seeing a movement to call-center distribution like that company with the lizard and the one with that irritating woman in the white uniform.

I agree with Rick that insurance agentry is a stagnant if not declining occupation (assuming that is what he meant above.)

When you look at the opportunities open to young men and women these days, I don't see the insurance industry offering much that the "best and brightest" will be attracted to. Wall Street brokerage, investment banking, and hedge-fund management, yes. Selling or managing an insurance portfolio? Not so much.

And those who do come into the industry do not come into it with anything less than dollar signs in their eyes... but few actually "make it." Matthew got it right...

"For many are called, but few are chosen." - Matthew 22:14 (American King James version.)
 
Both Al & Rick make some good points but it's very obvious that neither are LTC Specialists. By "Specialist" I mean someone who earns a minimum of 90% of their income selling LTCi.
Now, that doesn't make either a bad person. Rick knows more about Medicare Supplementals & Final Expense than I can ever hope to know.
And AL..................................
Well, I'm not sure what you specialize in Al, but whatever it is, I'm sure you've very good at it. (That's a joke Al)
This will most likely be somewhat of a lengthy response to both of your posts, because there are so many issues that you bring up. (Who ever thought that AL & Rick would be on the same page on ANY topic? This has to be a first)
You list a number of common misconceptions which are typical for those who get their LTCi information from public venues, such as the newspapers, magazines, and news reports, such as the one 2 weeks ago on a CBS prime time TV segment, about Bankers Life, for giving a 94 year old policyholder a terrible time in filing a claim. Bankers Life has a storied reputation for being a bad apple. They own 6% of the business and are responsible for 30%+ of all complaints. They are not representative of the other carriers in the business.
Hey, s**t happens! It happens in the world of LTC and it also happens with other insurance products, which Al confirms by saying he fears his homeowners policy won't be there if he needs it.
Personally, in the 16 years I'm selling LTCi, I have had dozens & dozens of policyholders file claims. I truthfully say that NOT ONE policyholder who qualified for benefits under the terms of the contract was ever denied access to benefits.
Al, understand the article that was posted was not written by me. It was an article that I pulled out of Producer's Web. I only posted it for LTC agents to be aware of up-to-date information.
I'm not sure if a survey exists, but I don't agree with you that only 20% of agents own LTC policies. If I had to guess, the number of specialists owning policies is about 80%. Agents in their 20s or 30s, may not feel it necessary to buy a policy, but it's certainly in their best interests to do so. How do you promote something without having enough conviction to own the product yourself? Many times I'm asked by prospects "And what LTC company is your policy with?" I know many agents who carry their policy with them when on appointments for just that reason.
Rick, if you're familiar with CLASS Act, you'd know that part of Obamacare included a national LTC offering. It wasn't mandated like health insurance was and because of that, the government could not put together a program that was deemed financially sound for 75 years, which the law stipulated. There's a long thread on the forum on CLASS Act. You will never hear agents hoping for a federally mandated LTC program. Why would they? If everyone had to buy a federal LTCi policy, every LTC agent would be out of work and looking for a job.
You're correct about "industry awareness". I've been complaining about that for years. It just doesn't exist. The industry feels the way to go is to make financial advisors aware of LTCi and that's why the only ads you see is in industry publications. I've been advocating with every carrier for years to spend some money and hire a spokesperson. My first choice years ago was Moses (I mean Charlton Heston), but he was taken by the NRA. I yelled for them to speak with Betty White. They just can't seem to get their act together and promote the product to the consumer. Don't get me started because that could be a thread by itself.
I'm not denying that the LTC industry has had and is presently having some major problems. Companies leaving the market, exorbitant rate increases and also consumers perception that the benefits may not be there if I file a claim in 25 years.
You need to understand that in the scheme of things, the LTC industry is relatively new. How long has life insurance been around, 150 years? The actuaries have a pretty good handle on mortality. LTCi started out in the early 1980s and if I had to guess, 90% of all policies were sold post 1994. In the begining the actuaries didn't have valid numbers to price the product correctly. Now, 15-20 years later, claims are starting to come in and rates are being increased to reflect the actual claim numbers. In reality, LTCi will eventually wind up being for the upper middle class, those that have assets to protect and enough income to comfortable afford the premiums.
I can go on (and on), but I think I addressed most (if not all) of your points. This post may go down as one on the longest on the forum but you'll learn that I am very passionate about the LTC industry and will defend it if I feel it's unfairly represented.
So...... In addition to responding to your comments, at the end of the day I hope that Al & Rick can use this post to unite, and start dating. You have proved that you both have some common interests you should put the past behind you and take a long weeked vacation together.
The only potential problem is that most likely only one of you will return.................
If nothing else, I hope I have given you and other members some insight on the LTCi industry.
 
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As an outsider looking it, is there ever any good news in LTC land?

I mean LTC makes life look like a beach party. People think the life insurance agent is a lower form of life than cockroaches, but at least they'll buy it. Seems like very few buy LTCi, and then the news is full of bad news about it to boot.
 
"I mean LTC makes life look like a beach party."

I am kind of slow. Can you please explain what that statement means???, in relation to what you said??????????
 
"I mean LTC makes life look like a beach party."

I am kind of slow. Can you please explain what that statement means???, in relation to what you said??????????

The average person doesn't want to buy life insurance either. But at least it is not a parade of bad news.

Both are great products and both have to be sold. Life insurance seems to be a no news industry and LTCi seems to be a "publish only the bad news" industry.
 
As an outsider looking.............

That's the point I was trying to make. You ARE an outsider looking in and that places you into the group of "uninformed consumers". We deal with that group every day.

How does one leave that outsider group? Most of our business today is done with baby boomers. There are 10,000 people everyday turning 65. A good many of those 65 year olds are seeing their own parents getting old (and frail) and start to require LTC services. Maybe it's a friend helping out, maybe it's a licensed home health aide or maybe it's a mother caring for the father. Maybe it's Alzheimer's and the parent has to enter a nursing home.

The boomer is watching their parents cut a check to the nursing home for $5,000, $6,000 or $7,000 every single month. In the NY metro area, those checks run $10,000 to $13,000 per month.

So, that 65 year old, who was "on the outrside looking in" now get a dose of reality and decides he doesn't want to see his own children have to deal with the same thing.

He then calls up Arthur who meets with them and he sells them a very expensive LTC policy and goes home happy because he made a lot of money!

Does that help you understand the situation a little better?
:yes:

The LTC industry paid out almost $9,000,000,000 (as in 9 BILLION) in claims last year. I think that says it all.
 
The obstacle I see is that the benefit need for LTC is fairly static. The local costs determine how much benefit you need. With life, your need and thus your premium has a strong relation to your income. With LTCi, if the local costs are $150 a day, it is $150 whether you make $50,000 or $500,000. It seems like the people who would benefit most, the middle class, are often priced out.
 
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