[USER]

I’m a 45 years old single male with a NW of about $10mm. Still employed but planning to “retire” from full-time employment within 2-3 years.

No heirs/dependents as of now. Do I need long-term care insurance?

I don’t know much about it, what do other people with an equivalent NW do in that regard?

Thanks.

[Grant]

We are in a similar position and use Christian Health Network. Happy with it.

[Bill]

Unfortunately, the ltc market is broken. With a high net worth, you should self insure.

The only semi- reasonable alternative is a ltc rider on a whole life policy, but that has all the negatives of whole life and you should avoid it if possible.

[Joel]

Doubtful. You can easily cover the cost of LTC out of pocket with that much wealth.

[Eric]

Woah 10m? I couldn’t even imagine. I use marketplace for insurance.

Once you don’t make income the policies are fantastic

[Rick]

Can you describe in 60 seconds or less to a complete novice on ltc why you feel you need it and how you believe it would cover those whys?

This is a recipe for fear based buying and/or being sold insurance. Neither of which is a good idea for anyone.

[Jennifer]

My. Mom’s been paying for long term care for at least 10 years. She’s 87.

Now she has multiple Myeloma for 5 years and is declining and we can’t get them to cover care without jumping through a bunch of hoops.

[Mona]

I think most would like to think money gets passed on to their kids but in fact it gets used for your elder care.

With no heirs, and ltc being unreliable, id plan on using your money for assisted living.

Medicaid wouldn’t even cover you until your assets are depleted anyway and it seems ltc only covers a fraction of cost… perhaps 2k a month out of say 8-10k month depending on your condition.

[Juliett]

You just cash pay.
$10M is enough that you could cash pay for 30 years for you and spouse and be ok.

[Cody]

No. At the 4 percent rule, you would have $400k a year. That is likely enough to pay for round the clock in home care.

[Maria]

How about establish residency in a European country that has very affordable healthcare? Contrary to popular belief, it is not free.

But it is very very affordable.

I lived in Amsterdam for 15.5 years. And I paid something like $100 per month for full health insurance.

As for long term care, just get a very young wife and a good prenup.

[Keith]

Understand that if you go into Long Term Care, someone else is making your critical decisions for you. Spell everything out as to your wishes as clearly as possible.

Find a reputable estate planning attorney and discuss with them in detail how things are to be handled if you are no longer able to voice your thoughts.

I have had to be this person for two members of my family. It can be Hell on earth for that person.

Plan for worse case scenarios.

[Tikvah]

Self insure. But I’d suggest you focus more on getting the right “vehicles” in place to manage the money like a trust or living will/advanced directive so someone managing knows how you would like your money spent regarding your care if you are unable to communicate/make those decisions.

[Amy]

A generation ago good policies were available but insurance companies realized those good policies weren’t profitable. Now they sell only mediocre policies.

With a high NW you can likely afford to pay for your own care.

Decide how much you might need or research what a LTC policy would pay out then earmark that amount in your liquid investments.

[Gretchen]

You are so much better off self-insuring. You can afford far better care than ltc would cover. You will have complete control over your care versus being confined by the limits of insurance.

Plus, in my limited experience, it will be up to your heir to do all the paperwork of getting the final payments from ltc.

Save them that work and get better care – win win win.

[Jennifer]

no, you just have a trust set up with someone to pay out any LTC costs that arise but more people with means just pay for 24/7 caregivers in their homes for as long as possible

[Alan]

I think a bigger question is if it can’t be you – who is going to handle the money if you need LTC – a lawyer for a trust… you can self insure (average ltc before death is 300k I believe I read somewhere) but the money management is what matters.

You do not want a court appointed guardian.

[Car]

Or move to Europe haha just kidding, I can say having lived in Europe and just moved here in the US, I’m actually regretting my decision based on this fact lol healthcare system in Europe is much better especially the long term care, and you get to live your life fully, I was born and raised in Asia and have also lived in Europe, and as a healthcare worker myself I know the difference of long term care across continents and how affordable and better quality of life living outside of US, so definitely consider that and also your money will go a long way outside of US, just a thought for you to ponder there is a work / life balance outside US

[Ryan]

Self insure. Do you have any tax deferred retirement accounts? Allocate some of that money for LTC, since medical expenses over 7.5% AGI are deductible.

You would just have to make sure the care is medically necessary when the time comes.

[Emily]

You would do better paying cash for the care you want.
Grandmother lived to be 99 years old and she had LTC insurance- it would pay a portion of her care base on certain needs of care but not the full cost of the facility she chose to live in.

She was wealthy enough that having the insurance didn’t matter and she could pay out of pocket for the total cost.

She was paying ~$11k a month for the nursing home she wanted 3 years ago.

I don’t think the cost of the LTC insurance paid off in the long run for her.

I work as PT in a rehab hospital – the people who chose to self pay for a rehab stay when insurance denies it/or doesn’t pay for as long as the patient or family want definitely have a better quality of life return home after acute care stays when they need the intense therapy to recover function.

I don’t think longer term care insurance will cover that – when it’s your choice to stay somewhere insurance says you don’t need.

You mentioned nieces/nephews live in another country. Have you considered relocating in your older years?

Round the clock private in home care – not nursing home style – is much more affordable in countries other than the US.

So not relying on them for care, but perhaps being closer to them for better options in care for yourself.

[Stephanie]

First off, congrats! You’re doing great! It’s more about how you want to pay for care later. Dollar for dollar out of pocket (the most expensive way to pay for care) or leverage your dollars for a less expensive way to pay for care that’s also tax advantaged (LTCi).

I can help you with different LTCi options. I personally like a hybrid solution.

[Author]

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