Long Term
Care Insurance
| |
Florida
Agency Takes Pain Out Of Shopping For
Insurance Since 1953
|
Get A Free
Insurance Quote,
Fill
Out the Request A Quote Form and
Start Saving Today! |
|
|
|
Long -term
care insurance (LTCI)
is a contractual arrangement that pays a selected dollar
amount per day for a selected period of time for skilled,
intermediate, or custodial care in
nursing homes and other settings (such as home health care).
Because Medicare and other forms of health insurance do
not pay for custodial care,
many nursing home residents have only three alternatives for
paying their nursing home bills: their own assets (cash,
investments), Medicaid, and LTCI. For information about
Medicare and other government programs that cover only a
limited amount of long-term
care expenses,
see Coordination
with Government Benefits.
For details about Medicaid, see Long-term
Care Insurance (LTCI)
as a Medicaid Planning Tool.
In general, long-term
care refers
to a broad range of medical and personal services designed
to provide ongoing care for
people with chronic disabilities who have lost the ability
to function independently. The need for this care arises
when physical or mental impairments prevent one from
performing certain basic activities, such as feeding,
bathing, dressing, transferring, and toileting--activities
known as ADLs ("activities of daily living"). For more
information about these activities, see Long-term
Care Insurance (LTCI)
Provisions.
For details about places where you might receive long-term
care, see Types
of Long-term
Care.
For information about different kinds of LTCI policies and
places where you might purchase them, see Types
of Long-term
Care
Policies.
Long-term
care may
be divided into three levels:
-
Skilled care--continuous
"around-the-clock" care designed
to treat a medical condition. Thiscare is
ordered by a physician and performed by skilled medical
personnel, such as registered nurses or professional
therapists. A treatment plan is created, and it is
usually contemplated that the patient will recover at
some point.
- Intermediate care--intermittent
nursing and rehabilitative care provided
by registered nurses, licensed practical nurses, and
nurse's aides under the supervision of a physician.
- Custodial care--care designed
to help one perform the activities of daily living (such
as bathing, eating, and dressing). It can be provided by
someone without professional medical skills, but is
supervised by a physician.
The
risk of contracting a chronic debilitating illness (and the
resulting catastrophic medical bills incurred) is considered
by many to be one type of risk best passed on to an insurance company
through the purchase of a LTCI policy.
A
number of factors can increase your risk of requiring long-term
care in
the future. Naturally, your health status affects your
likelihood of incurring a long stay
in a nursing home. Indeed, people with chronic or
degenerative medical conditions (such as rheumatoid
arthritis, Alzheimer's disease, or Parkinson's disease) are
more likely than the average person to require long-term
nursing
home care.
And because women usually outlive the men in their lives,
women stand a greater chance of requiring long-term nursing
home care.
However, if you already have a primary caregiver (like a
spouse or child), your likelihood of needing a long stay
in a nursing home will be less, particularly if you're a
man. Because the cost of long-term
care can
be astronomical and may exhaust your life savings,
purchasing LTCI should be considered as part of your overall
asset protection strategy.
Example(s): Sue
is a 75-year-old widow with two children, John and Jill.
Sue owns her condominium apartment and has $200,000 in
liquid assets. After enjoying independence much of her
life, Sue suffered a stroke and now needs help with such
things as bathing, dressing, and eating. John and Jill
look into home health care and
discover that it will cost $1,500 per week (or $78,000
per year). The money that Sue had hoped to pass on to
her children will instead be spent on expenses that may
otherwise have been covered by an LTCI policy.
Although purchasing LTCI seems to be the easy answer to the
problem of escalating long-term
care costs,
the premiums for LTCI can be, depending on benefit levels
selected, quite expensive.
Your yearly premium for an LTCI
policy depends on a number of considerations, including your
age when you purchase the policy, your health, the length of
the coverage period (for instance, three years, five years,
or lifetime benefits), the amount of the daily benefit
provided, and whether you purchase inflation protection.
When buying an LTCI policy, you must also consider not only
whether you can afford to pay the premiums now but also
whether you'll be able to continue paying premiums in the
future, when your income may be substantially decreased. For
more information about the cost of LTCI and examples
regarding how Medicare and Medigap may help defray some of
the costs, see Coordination
with Government Benefits.
During the "golden years," when income
typically declines, the purchase of LTCI should becarefully considered.
People with significant discretionary income and substantial
resources to protect for spouses, children, and other loved
ones should seriously consider purchasing LTCI. Individuals
with modest resources (e.g., less than $50,000 net worth)
may find the premiums unaffordable, and may qualify for
Medicaid by spending down their assets and/or engaging in a
little Medicaid planning.
Insurance protects
against an event that might happen in the future. Therefore,
buying enough protection is important, but affordability
must also be considered. In terms of
cost, you need to consider the amount of the daily benefit
you want to purchase and also the length of the benefit
period.
-
Daily benefit--Most policies will let you choose your
amount of coverage, typically running anywhere from $40
to $150 or more per day. Of course, the greater the
daily benefit and thelonger the
benefit period, the more the policy will cost. Also,
note that the cost of nursing home care varies
greatly from one metropolitan area to another, so you
need to know where you'll be living out the remainder of
your years. Certainly, it wouldn't make sense to
purchase a policy with a daily benefit of $40 if the
average daily cost of nursing homes in your area is $250
per day--unless, of course, you have substantial
resources and plan to use some of your own income to pay
for care.
Consumers should generally buy enough coverage to cover
50 to 100 percent of nursing home costs. If you don't
plan on using your own income to supplement, you should
buy enough insurance to
cover 100 percent of the nursing home costs.
-
Length of benefit
period--When purchasing LTCI, you'll be asked to select
a benefit period. Benefit periods generally range from
one to six years, with some policies offering a lifetime
benefit. You'll want to choose the longest benefit
period you can afford. If you can't afford a lifetime
benefit, consider choosing a benefit period that
coordinates with the look-back period for Medicaid (five
years). For more information about ineligibility
periods, see Look-Back
Period for Medicaid.
Tip: The
Deficit Reduction Act of 2005 gave all states the option
of enacting
long-term
care partnership
programs that combine private LTCI with Medicaid
coverage. Partnership programs enable individuals to pay
for long-term
care and
preserve some of their wealth. Although state programs
vary, individuals who purchase partnership-approved LTCI
policies, then exhaust policy benefits on
long-term
care services,
will generally qualify for Medicaid without having to
first spend down all or part of their assets (assuming
they meet income and other eligibility requirements).
Although partnership programs are currently available in
just a few states, it's likely that many more states
will offer them in the future.
Unfortunately, LTCI policies are not standardized.
Provisions contained in policies vary greatly, and premiums
charged vary as well. Therefore, you should compare policies
to obtain the best amount and combination of benefits for
your premium dollars.
-
To compare
policies, you should obtain sample policies and
"Outlines of Coverage" from each carrier you are
considering. The Outline of Coverage summarizes the
policy's benefits and highlights the policy's important
features. You need to read the policies carefully,
ensuring that you understand each provision. There are a
number of factors you should be concerned about, such as
inflation protection, a full range of care (including
home healthcare),
exclusions for pre-existing conditions, and the amount
of the daily benefit provided.
- To compare
providers, you should check out the financial strength
of the companies by reviewing their A. M. Best Company's
ratings along with the opinions of other rating
services. You can also review the company's financial
statements.
If you purchase a
"qualified" LTCI policy, part (or all) of the premiums you
pay pursuant to the contract may be deductible on your
federal income tax return. LTCI polices issued after January
1, 1997, must meet certain federal standards to be
considered qualified. However, LTCI policies issued prior to
January 1, 1997, that met the long-term
care insurance requirements
of the state in which the contract was issued are
automatically considered qualified. For more information,
see Taxation
and Long-term
Care Insurance (LTCI).
|
|
|
|
About Us |
Privacy Policies |
511 E Ocean Avenue Boynton Beach, FL 33435 Phone:561-732-9305
Fax:561-364-9848 email:
info@oyerinsurance.com |
|
Copyright © Harvey E. Oyer Jr., Inc., 2010.
All Rights Reserved

|
 |
|