> they each paid about $14,000 in annual premiums for 10 years, and the daily benefit started at $200 per day.
Insurance companies have to make money, but that's not that good of a deal, and the payout isn't that high ($73k annually) considering you won't be doing much else.
Consider also that by the time you need a nursing home or some other form of continual skilled care you are probably going to die within that year.
"Long-Term" is sort of a scare tactic that is used to get you imagining that you're going to be needing expensive skilled care for years. That can happen, but isn't normal.
Severe dementia id exactly when it does happen, though. Most patients die within months of moving into a nursing home. Dementia patients average ten years.
“That can happen but isn’t normal” is exactly the kind of thing that insurance should be for. Unfortunately, US health insurance is more oriented towards covering everything rather than spreading out the risk of rare high-cost events.
If you get the PPO, you have an in-network annual benefit cap of $2,500. So you're paying your insurance company to pay your dentist for you? And as soon as the bill gets large enough that you'd actually need insurance, they tap out?
What's the problem? 2500 is enough to get a cleaning and a couple fillings per year. If dental insurance covered everything you need, now, at no extra cost, people would simply get coverage for a year, get their mouth fixed, and cancel it.
The studies I’ve seen that say months or a small number of years specially look at older adult admissions, so may exclude a lot of dementia patients.
US study:
> The mean age of decedents was 83.3 (SD 9.0) and the majority were female (59.12%), and White (81.5%). Median and mean length of stay prior to death were 5 months (IQR 1-20) and 13.7 months (SD 18.4), respectively. Fifty-three percent died within 6 months of placement. Large differences in median length of stay were observed by gender (men, 3 months vs. women, 8 months) and net worth (highest quartile, 3 months vs. lowest quartile, 9 months) (all p<.001). These differences persisted after adjustment for age, sex, marital status, net worth, geographic region, and diagnosed chronic conditions (cancer, hypertension, diabetes, lung disease, heart disease, and stroke).
It has been a terrible deal. These policies have been a disaster for the industry. They're very expensive and they've raised premiums to cover rising costs, which causes people to drop the policy unless they're sure they'll need it. And then those people often require care for many years, generating massive losses.
Insurance is wonderful when it works, but the conditions for it to work can be quite fragile.
Or perfect pricing. When insurance pricing is perfect, it’s never worth it.
“It appears you’re slipping on ice and about to hit a tree with your automobile, to continue your insurance, please deposit $27k within the next 6 seconds”
The basic bargain of insurance is supposed to be: the insured buys it before they foresee needing it, and the insurance company keeps premiums level. If either side defects from this protocol, things fall apart.
No the basic bargain of insurance is a community paying their surplus into a pool that pays out for random unfortunate events that are uncorrelated and could happen to any member of the community.
Adversarial for profit insurance does not make sense as it creates perverse incentives.
A lot of people think of insurance like a savings account rather than something like a sequence of options being rolled over so when they experience the reality of what they've been spending money on they tend to get very upset.
Insurance companies have to make money, but that's not that good of a deal, and the payout isn't that high ($73k annually) considering you won't be doing much else.