Long term health care insurance

[hpeer]

My Wife brought this topic up, long term health care insurance. She got some guy to come in and give us the pitch. But all his policies are limited to the U.S.

So what do ex-pats do?

Say, for sake of argument, you have permanent retired status in Belize (or Thailand, or where ever) and you go downhill. Do these kind of long term facilities even exist? What would they cost?

I've not a clue where to start thinking about this.

[Andy73]

Our company uses CIGNA to provide world wide health care coverage... not sure about individual policies through them, but it may be worth a look for you.

[JulieMac]

I'm familiar with these policies, having been a broker. Some policies exclude coverage outside the U.S., while others provide a percentage like 50%.

You can buy a regular stand alone LTC policy, or have one tied to a life insurance contract. In those policy contracts, either the claim is made for the LTC benefit when needed, or upon the death benefit. These Policies typically are not restricted to locational issues. People seemed to like them, as they are dual purpose.

Tax issues generally don't come into play, but not all policy types may qualify for a tax deduction. I'd start doing your research at industry wide, and not company specific websites. Good luck!

[SailFastTri]

Save your money. I've done a lot of research on this, and you're way better off if you've got the money in the bank. OTOH, if you don't have money in the bank, the LTC assistance will help but only in a limited way, and the premiums are very expensive if you want good coverage. If you don't use the LTC then of course, you're throwing that money out.


If you've got $100k plus to put into this -- you would be eligible to look into "hybrid" LTC polices that combine a life insurance component with the LTC. The LTC benefits won't be as good but typically you can cancel and get back about 80% of what you invested (or your beneficiaries will get the insurance payout).


LTC insurance doesn't cover in-home care. The first person to become ill is more likely to be able to receive in-home care, and a nursing home is a last resort only if the spouse is unable to provide the needed care. Think about it -- usually it's the surviving spouse that is more likely to need LTC. If you're an ex-pat and don't have a trusted family member (e.g. adult child or trusted close friend who has power of attorney) to act as an advocate you might me in a very bad situation, with our without LTC insurance.

[hpeer]

Thanks guys, lots to think about.

[chuckr]

When we were in Belize a few years ago we ran across a number of Americans who had decided to live there. Not sure what they do for insurance but if you really want to live there, go down and there was one place, i can not remember the name, where there is a charter base and check with the Americans who live there.

As for us we do not carry health insurance beyond Medicare part a and b that is worthless outside the USA.

We pay as we go as medical care outside the USA is good and inexpensive. In Colombia the Admiral had hand surgery that just the surgeron in the usa wanted $10k and everything in the Colombia was $1,500USD with a hand surgeron. In Trindad I had about 1/2 my nose replaced do to some non miligant cancer at about $1,500USD and people can not even tell I had it done. In Tunisia I ruptured a tendon in my left shoulder and had 2 very expensive screws inserted for the repair and it cost about $2kUSD. The Admiral just had here other hand operated on for the same condition and it cost about $700 USD.

Drugs are inexpensive as such things as physical therpy. So would insurance pay for itself??

[rourkeh]

There are several international healthcare companies out there. I have been cruising continuously since 2010 in the Caribbean and purchased a policy from a British A+ rated company called "Bupa". Great policy with worldwide coverage, and all the typical options available such as medical evacuation, U.S. coverage, etc. I did a lot of research before deciding on "Bupa" and met several people who had the company and made catastrophic claims, one was for cancer with a million $+ claim and they paid all his expenses including travel and his choice of treatment doctors and hospitals.

[Hudson Force]

We looked into the long term health care policies and, after some serious discussions with our children, we decided to invest the same money as the premiums would have bee into an account that could be managed for us. ....and then, keeping the money invested within the family, if we depart life quickly (stepping on a "land mine"), then the fund can put a grandchild or two through college.

[JulieMac]

Originally Posted by Hudson Force

We looked into the long term health care policies and, after some serious discussions with our children, we decided to invest the same money as the premiums would have bee into an account that could be managed for us. ....and then, keeping the money invested within the family, if we depart life quickly (stepping on a "land mine"), then the fund can put a grandchild or two through college.

Not a bad plan. However, insurance places a person into a large risk pool. This mitigates and spreads the risk across many lives. An insurance company wouldn't take the risk on one life the way many people do when they self insure.

I'm a proponent of policies which will pay a death benefit if the person either never claims, or partially claims their LTC pool of money. The rate of return at life expectancy or at average claim age can be in excess of 5-7%, tax free.

You only "lose", if you live past average life expectancy. Your rate of return on your legacy investment for your kids may then be closer to a CD, or Treasury bond. (1-3%)

[JulieMac]

Originally Posted by SailFastTri

Save your money. I've done a lot of research on this, and you're way better off if you've got the money in the bank. OTOH, if you don't have money in the bank, the LTC assistance will help but only in a limited way, and the premiums are very expensive if you want good coverage. If you don't use the LTC then of course, you're throwing that money out.


If you've got $100k plus to put into this -- you would be eligible to look into "hybrid" LTC polices that combine a life insurance component with the LTC. The LTC benefits won't be as good but typically you can cancel and get back about 80% of what you invested (or your beneficiaries will get the insurance payout).


LTC insurance doesn't cover in-home care. The first person to become ill is more likely to be able to receive in-home care, and a nursing home is a last resort only if the spouse is unable to provide the needed care. Think about it -- usually it's the surviving spouse that is more likely to need LTC. If you're an ex-pat and don't have a trusted family member (e.g. adult child or trusted close friend who has power of attorney) to act as an advocate you might me in a very bad situation, with our without LTC insurance.

Almost all US based policies offer the option of at home care. Comprehensive policies pay for nursing home coverage, as well as community and at home options.

Some plans only allow reimbursement if the person(s) giving the care are licensed nurses or aides.

Other policies will pay the family dollars up front upon claim, allowing the family to decide how to use the money. These are known as indemnity based plans.

Women are most likely to use these policies, as they live 5 years or so longer than men.