Long-Term Care Insurance with Diabetes

I misposted this in a discussion and am reposted it here. Long-Term Care (LTC) insurance provides benefits when you are no longer able to take care of yourself either physically or mentally. Some people look to LTC so that they can be taken care of, so that they don’t deplete all their savings (particularly if you are married and one of you ends up in LTC) and so that you are not a financial and emotional burden on your family.

Long-term care (LTC) insurance, like life insurance, is often stacked against those with diabetes. Poorly controlled diabetes is a high risk factor and insurance companies use retrospective information to assess risk. So even though new evidence suggests that when you are well controlled your risk profile is much reduced, it doesn’t matter to these companies.

One underwriting guide says that you cannot get LTC if you have any of the following diabetes criteria:

  • Insulin has been used in the past 12 months
  • There is a history of CVD issues
  • There is a history of Congestive Heart Failure (CHF) within 5 years
  • There has been a hospitalization for diabetic complications within 24 mos
  • Any skin complications have occurred (skin breakdown, ulcers)
  • An amputation or blindness have resulted from Diabetes
  • There is any associated kidney disease
  • Obesity is evident (see chart below) (BMI > 34)
  • A1C level exceeds 8 or no A1C or blood sugar levels have been determined within the past 12 months

Despite this poor view many of us have LTC available through group offerings, particularly through our employers. In many cases typical restrictions can be waived. And if so you might find that you can obtain LTC and it is not an unreasonable deal (compared to someone who doesn’t have diabetes). But your experience may vary.

But my opinion is that LTC is not a great deal. While one third of people turning 65 will need LTC at some point, the chances of needing LTC between the ages of 50 to 70 is tiny. And most LTC claims are due to Alzheimer’s and really apply when you get over 85 when the chances of needing LTC rise to 7-10%. And in general if you put the money you pay for LTC into savings by the time you get to 85 you will have accumulated essentially the same amount as the benefit max.

The real problem with LTC is that the premiums are high compared to the relative benefit and you have to pay forever. If you stop paying your don’t have any cash value. And you are tied to the insurance company forever even if they turn out to be bad.

At this time I have not elected to get LTC through my work. I’ll just take that money and invest it.

ps. Some of the information comes from the book “The Essential Retirement Guide

pps. I do not wish to live out the end of my life in a nursing home with no quality of life so I refuse to plan for that outcome.

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For those in the US, LTC is essentially asset protection. Purchasing a locked in offered by an employer may make sense, provided the lock in is less than the cost the market is offering as an individual and in particular if one has a spouse who might be subject to spenddown in order to satisfy Medicare coverage or who may wish a different level of care than might be specified by Medicare. Typically LTC ihas a nice provision for extended at home care which pays a family member for maintenance of care.

As one gets older the cost of insurance usually goes up substantially (that makes sense) but the benefit for a single person or a person who has limited assets is dubious at best.

my 2 cents.


If I was in the position to require long term care, after sorting out my estate etc (whatever that may be), I fully intend to commit suicide with a syringe full of fast acting insulin.

I am very sure that the existing health care system is not set up to deal with the huge burden that may arise from seriously disabled persons who no longer have family members available, willing, or available to take care of them.

I have no medical insurance that would take care of me nor access to such likely in the conceivable future. For now, I am saving as much as possible - though that is mainly to get my kids educated and fully independent. After that any left over I’ll use to live if I’m no l,onger working, and after that…ce la vie.

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Sad, but (as a fellow single mother who holds little faith in the health-care system due to the completely effed-up health insurance industry) quite pragmatic…

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Thanks Brian–I was the one who started the other thread on a rather confused note because LTC is what I was really interested in but Long Term “Disability” is what I posted, not really thinking about the difference.

Would this just apply to T2’s do you know? The responses have made me skeptical about LTC insurance anyway, but if this guideline is universal I can stop worrying about it entirely.

I suspect this is about anyone with diabetes on insulin. This would mean that LTC would be more expensive because you would need someone qualified (like a nurse) to take care of your insulin. This is instead of just a health aide.

Hadn’t thought of that–makes sense.

Although, from an actuarial perspective, someone in that situation isn’t likely to live as long or require end-of-life care for as long of a period— perhaps their premiums should therefore be cheaper instead

well as an example, My wife and I had the opportunity several years ago to purchase LTC insurance. We purchased a plan that pays up to 6K per month but is annually inflation adjusted *today it is worth 7.5 K per month in care costs for LTC.

The policy will pay individually meaning both are covered and for 3 years. It wwoudl also pay up to 2K per year for up to 6 years if we stay in the home. The payment can be made to a fmaily member if needed.

The premimum never increases and is fully paid at 80. Our cost is $112/month.

Now the reason I did this is of course I have a hihg likelyhood of ending up in a facilitiy. Folks with RA tend to find this more than others. Second of course i am type 1 at 42 years now.

Our assests are not great more than some less than most i fear but both of us saw the herific spend down that occured when one of our parents went into a nursing home. being forced to do that woudl cripple the remaining partner.

THis was an amployer sponsored plan that coudl be taken with me at no additioanl vcost when i left. I am delighted to pay the cost for peice of mind. But if it were double or the assessts were less, than no in todays situation nursing home coverage is paid for by medicare which ar ento necessarily nice places.

this gives more options and it prolongs assessts. if it is being considered you shoudl look at it as assest protection