| Long Term Care
Age is not a determining factor in needing long-term care. About 60 percent of individuals over age 65 will require at least some type of long-term care services during their lifetime. About 40% of those receiving long-term care today are between 18 and 64. Once a change of health occurs long-term care insurance may not be available. Long-term care insurance rates are determined by six main factors: the person's age, the daily (or monthly) benefit, how long the benefits pay, the elimination period, inflation protection, and the health rating (preferred, standard, sub-standard). Most companies will give couple's and multi-life discounts on individual policies. Some companies define “couples” not only to spouses, but also to two people who meet criteria for living together in a committed relationship and sharing basic living expenses. The average age of purchasers has dropped from 68 years in 1990 to 61 years in 2005, and the number of purchasers who are under age 65 has increased significantly. Most companies offer multiple premium payment modes: annual, semi-annual, quarterly, and monthly. Companies add a percentage for more frequent payment than annual. Options such as spousal survivorship, non-forfeiture, restoration of benefits and return of premium are available with most plans. Medicare primarily focuses on hospital stays and physician visits. Medicare is not designed nor intended to cover long term care. It will not cover more than a few days of skilled nursing home care. Will Medicaid pay for long term care? Medicaid is a government “welfare” health care program from indigent persons established by the federal government, but administered by the states and funded by both federal and state governments. Benefit levels and eligibility requirements vary with the states. When a person requires long term care and does not have private insurance, funding for the care must first come from the individual’s own income, savings and assets. Only when the person has “spent down” or exhausted his or her income, savings and most assets to a minimal amount, will Medicaid funding become available. In addition, Medicaid limits your choice of facilities and often pays too little to cover the high-quality care. Who should consider buying long term insurance? People who: • Don’t want to burden their children or family; • Want to protect their assets; • Want to avoid going on Medicaid; • Want to have peace of mind • Want to have control of their care; or • Want to maintain their independence. How do you become eligible for benefits? You must be certified as a chronically ill individual by a licensed health care practitioner. Chronically ill means you are unable to perform two or more of the six activities of daily living for an expected period of at least 90 days or you require substantial supervision to protect yourself from threats to your health and safety due to severe cognitive impairment. The six activities of daily living include: bathing, dressing, toileting, the ability to move in and out of bed, chair or wheelchair, eating and continence. Written certifications must be renewed or updated at least every 12 months.
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