Posted on Friday, 29th September 2023 by

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Long Term Partners, LLC sent their 2023 enrollee decision period offer letter on September 11. We have until November 9, 2023 to either accept the offer listed under Option 1 or submit a selection form changing coverage to option 2, 3 or 4. If Long Term partners doesn’t receive an election from by this date, your premium increase for Option 1 will increase effective January 1, 2024.

The acronyms they frequently use are confusing, the first time a new acronym is mentioned I highlight it in bold so you can easily refer back to it as you progress through the article. Maybe it’s my age, I find it difficult reading anything laced with so many abbreviations.

Then and Now

I applied for Long Term care insurance when it was first offered as a benefit in December of 2002. Our combined initial premium for the Future Purchase Option (FPO) was $73.57. I was 52 at the time and our 5 years of coverage provided a total benefit of $228,125, $125 per day.

Currently our premiums are $222.08 monthly, $115.05 for me and $107.03 for my wife, over a 200% increase from our initial 2003 premiums. Our Daily Benefit Amount (DBA) is $228.21 with a $249,889 Maximum Lifetime Benefit (MLB). Still not enough to fully cover nursing home care we may need.

In 2016 premiums increased dramatically, we opted to retain our lower FPO premiums and agreed to a reduction in the daily rate and reduced our coverage from five to three years. We could have changed to the Automatic Compounded Inflation Option (ACIO), the cost was almost 4 times what we were paying at the time! Many were enticed to switch to an ACIO plan and can’t revert back to the FPO option after making that election.




Coverage

Under my FLTCIP 1.0 plan, nursing home care, assisted living care, and hospice care in a facility is covered up to 100% of your daily benefit amount (DBA).

In addition, comprehensive coverage also includes hospice care at home covered up to 100% of your DBA or weekly benefit amount (WBA) and home care and adult day care covered up to 75% of your DBA or WBA.

Informal care provided by friends and family members is covered up to 75% of your DBA or WBA, limited to 365 days for family members. Informal caregivers are covered as long as they did not live with you at the time you became eligible for benefits.

Enrollees are entered into one of three programs, FLTCIP 1.0, 2.0 or 3.0, depending on the date they enrolled.

Benefit Booklets:

2024 LTC Rates

This year, under the FPO plan, I received a letter offering the following four options:

  1. Accept FPO offer and pay premium increase
  2. Decline the offer and pay premium increase
  3. Reduce benefit amount to help keep premium at or near its current level
  4. Choose paid-up, limited benefit; no future premiums due

Option one’s benefit amount for my wife and I would be $237.84 daily for 3 years with a maximum benefit of $260,434. My premium would be $163.06 per month and Mary’s $153.23 for a total of $316.29, a 42% increase!  This change only provides a 4.22% increase in benefits above what we currently have.

Seems like a lot for a small MBA increase of just $10,000 and DBA increase of less than $10!

With the previous January of 2022 increase, Option 2 allowed you to decline the FPO with a small DBA decrease and the premium was slightly reduced. For 2024, if I decline the FPO offer, my premium increases 30% and my DBA amount and MLB benefit decreases!

Option 3 reduces the benefit amount and Maximum lifetime benefit to retain close to the premiums I’m currently paying. We did this in 2016 and if we did it again, I’m not sure it is worth keeping, knowing full well that additional increases will further erode our benefits.

Option 4 reduces our coverage to $228.21 daily with a maximum lifetime benefit of only $15,847.

The Automatic Compounded Inflation Option (ACIO) Election

With this option, your DBA and remaining portion of your MLB will automatically increase by 3% compounded every year. The increases under this option are made even if you are eligible for benefits, without regard to your age, claim status, claim history, or the length of time your coverage has been in effect.

Your premium does not increase annually as a result of this annual increase in benefits. However, premiums are not guaranteed. With long term care costs continuing to rise almost every year, you may want to consider the automatic compound inflation option (ACIO). The initial premiums are higher than the future purchase option because you are prefunding automatic future benefit increases that are designed to help keep pace with inflation.

If you have the Future Purchase Option (FPO), you can opt for the ACIO inflation adjusted rates without providing evidence of your good health. This is considered a coverage increase and is more expensive than the FPO option. The additional premium for the increase in coverage will be calculated using your age as of January 1, 2024 and will no longer receive FPO offers.

Long Term Care Average Costs

The cost of long-term care varies based on several factors including the care setting, location, level of care required, among other things. You can use Nationwide’s Long Term Care national calculator to determine average costs in your state.

National annual median long-term care costs: (Excerpted from aplaceformom.com)

  • In Home Care $60,000 ($5,148/month, $169/day, $27/hour)
  • Assisted Living $57,912 ($4,500/month, $148/day)
  • Adult Day Care $20,280, $1,690/month, $78/day)
  • Nursing Home
    • Semi-Private Room $94,900 ($7,908/month, $260/day)
    • Private Room $108,405 ($9,034/month, $287/day)

The duration and level of long-term care according to LongTermCare.gov varies from person to person and often changes over time. They list the following average need:

  • Someone turning age 65 today has almost a 70% chance of needing some type of long-term care services and support in their remaining years
  • Women need care longer (3.7 years) than men (2.2 years)
  • One-third of today’s 65-year-olds may never need long-term care support, but 20 percent will need it for longer than 5 years

Contacting Our Long-term Care Provider

Call 1-800-582-3337 for clarifications and to change your coverage or visit their online site at www.LTCFEDS.com .

Many insurers have dramatically increased premiums for Long Term Care and others are no longer offering this coverage.

Other Options & Resources

  • Some private sector providers are combining insurance policies with a long-term care rider and others offer deferred-income annuities if appropriate for your situation. Lincoln Financial offers a Money Guard policy that combines both.  According to Lincoln Financial, “Unlike traditional long-term care insurance, your policy costs are set at issue and will never increase. Your policy provides benefits, even if you never need care, provided all planned premiums are paid.”
  • Money.com recently featured the Best Long-Term Care Insurance Companies of September 2023 on their site. They cover traditional LTC and hybrid policies with LTC riders for you to explore.
  • Research senior living facilities in your area at https://www.aplaceformom.com/.

The 90-day waiting period

If you enter a nursing home the average cost of a semi private room is $7,908 a month today, the first three months are on you. You will need $23,724 to cover this waiting period. After that, your long-term insurance will pay the bills up to your insured daily amount.

You will have to pick up the tab for any charges above your coverage limits. You only need to satisfy the 90-day waiting period once during your lifetime. If you stay at an assisted living facility first for 30 days and then enter a nursing home, you would only have to wait 60 days since you already had 30 days at an assisted living facility according to the FLTCIP customer service representative that I talked to.

Medicare Misconception

Many believe that Medicare and your FEHB plan will cover long-term care costs. Medicare states on page 55 of their 2024 guide, “Medicare and most health insurance plans, including Medicare Supplement Insurance (Medigap) policies, don’t pay for this type of care.”

Suspension Period for FLTCIP Applicants

As of December 19, 2022, individuals not currently enrolled may not apply for coverage, and current enrollees may not apply to increase their coverage. The suspension will remain in effect for 24 months, unless OPM issues a subsequent notice to end or extend the suspension period.

Current enrollees’ coverage status will not change as long as they continue to pay premium. For those in a claim status, there is no change to coverage or the claims reimbursement process as long as benefits have not been exhausted.

Summary

Personally, my concerns are twofold. I want my wife and I to have dignified care in a professional, clean, and caring facility and at the same time I don’t want to bankrupt our estate in the process. These high costs can easily drain your bank accounts, and investments.

A long-term care policy helps to reduce the financial stress to a manageable level. Your family won’t have to worry about where the money is coming from.

Federal employees and annuitants that are confronted with large premium increases should contact FLTCIP to discuss their options for reducing costs. Research other long-term care options NOW.

If I was younger, and hadn’t already spent tens of thousands of dollars on LTC premiums, I would seriously consider a hybrid policy with a LTC rider. These policies weren’t available when I first signed up for coverage.

When you consider that 30% of those over 65 may never need this care, it makes sense to explore insurance programs that offer something back for all the years you paid premiums.

The younger you are when you apply the lower your monthly premium, start early to research your options. My premiums are lower because I took out our policy when I was 52.

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change.

The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

 

Last 5 posts by Dennis Damp

Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION | Comments (0)


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