Long Term Care FAQ

Frequently Asked Questions

Q: What is long term care?
A: Long-term care is the care you need when you are no longer able to care for yourself. It is personal care, such as help with bathing, eating or dressing required over a lengthy period of time.

It can range from simple assistance in your own home to assistance required in a residential care facility, or it can be highly skilled care in a nursing facility. Cognitive impairments such as Alzheimer's and other diseases may also trigger the need for long term care, even though physically the person appears to be fine.

Over 90% of long term care is "custodial care" and typically custodial care is not covered by health insurance, HMO's, Medicaid, Medicare or supplemental policies. These are for short-term not long-term care.

Q: Who needs long term care insurance?
A: Anyone concerned about providing for their future needs while protecting their life savings and assets.

Often people think they might need long term care insurance sometime in the future, but not now, not today. Then one day they fall in the shower or are on their way to the store they get rear-ended and end up needing a few months or a lifetime of care. Then they learn that their health insurance or Medicare only covers a few weeks. Reality has a way of overcoming denial.

The need for long-term care can be caused by such things as motor vehicle accidents, falls, sports injuries, strokes, heart attacks, surgery, and later by old age and frailty. Healthy, active people of any age can suddenly find themselves a the situation where their lives are changed. Christopher Reeve at age 42 became paralyzed following an equestrian accident and required 9 years of long term care.

We all have experienced a change of health. We go to bed feeling fine and wake up sick. Most of the time it's a minor illness. Changes of health are sudden, we're fine then we're not. We probably won't have enough warning to insure before we have a sudden health change, and it doesn't have to be a disabling change to make us uninsurable.

In America 40 percent of all those receiving long term care are not elderly but between the ages of 18 and 64. If you are not insured today but plan on insuring later it is recommend you do it at least two months before your health changes, it takes that long to see if you qualify and not everyone does.

If you are uninsured you are exposed to a huge financial risk. One way or another Americans are going to pay for their long term care -- savings or insurance. Purchasing long term care insurance now keeps the cost down over time while avoiding becoming uninsurable later.

People argue that if they have this insurance then die they would have wasted their money. True enough, but over half of us will need long term care before we die, that's greater than 1 in 2. Are you willing to risk your life savings on the chance you'll be the lucky one and die without needing long term care?

What are you insuring now that you hope to collect on? A car accident, catastrophic health or home insurance, surely not life insurance! No one wants to collect on insurance. Your choice with long term care is pay now (insurance) or risk paying much more later (savings).

Q: How much does it cost to stay in a nursing home?
A: According to a 2006 Survey the average cost of nursing home care nationally is $70,900 a year. This is about $194 per day. The cost of care is different in different regions. A nursing home private room in New York City averages $385 a day ($140,000+ per year).

Nursing home care is reserved for those who need medical attention yet most long term care is not medical care but custodial care, which is not covered by health insurance, Medicare, or Medicaid.

When family and friends provide the custodial care there is no bill presented for the care provided, but the toll to the family and friends can be very high. An option to home care is assisted living. Since this level of care is custodial and not considered medically necessary you pay out-of-pocket or with insurance.

Q: Doesn't Medicaid pay for long term care?
A: Medicaid is welfare health care and has always been for people who are at the low end of the economic scale. The Medicaid system is somewhat complex and if someone has questions they should contact their local state welfare office. Each state may have their own names for the program. Examples include "Medi-Cal" in California, "MassHealth" in Massachusetts, and "TennCare" in Tennessee.

Medicaid allows a person to keep up to $2,000 in cash assets, not counting a home, a car and some personal items. Even if they can qualify for long term care under Medicaid when they pass on, their estate is subject to recovery by the state. That means the house can be sold to reimburse the taxpayers for what Medicaid spent. For example if the Medicaid reimbursement rate is $150 a day and they spent 3 years on Medicaid their estate (family) would have to reimburse the state $164,250.

Some people may look to legal ways to keep their assets and still qualify for Medicaid. The state can "look back" 5 years to assess any transferred assets. It is a federal crime to try to defraud Medicaid. Even if you had a legal angle you would be on welfare and is that really how you want to live?

Q: Who should you buy long term care insurance from?
A: Like most businesses there are a few companies that stand out. These companies differ only slightly on their rates and underwriting requirements.

The better companies also have tougher underwriting. They want healthy people and you do to. That insures against future rate increases and that the money will be there when you need it.

Other companies, in order to have future financial viability, must charge higher premiums or if needed raise policyholder rates. These companies also may take higher risk people.

Based on your profile when you submit a Pre-Qualify Quote a long-term care insurance specialist will match you with the best company with the best rate for your age and health. If you want to Apply for insurance we send you by email or mail all the necessary forms to submit to see if you health qualify. If you health qualify you will be insured for long term care based on the benefits you choose. You have about 2 months from your application date to decide if insurance is right for you.

Q: Why don't people insure for long term care?
A: They are not sure they will ever need it. But that is a question that will only be answered when they either die without needing long term care or when they need long term care. The fact that it cannot be answered in advance is why they should insure.

If you knew for certain that you were going to need long term care would you insure? If you are uninsured you are deciding to carry the entire risk yourself which could be very costly.

People also don't think they can afford it. A policy could cost anywhere from $100-$1000 per month depending on your age and the benefits chosen. For many people they can use their return on investments to pay the premium, which would protect their entire nest egg.

Q: Who should not buy long term care insurance?
A: For those with no assets to protect or who cannot afford insurance. Long-term care insurance shouldn't put a heavy strain on your finances.

A single person with no family may not think they need coverage but if they have assets and are in an accident, they may need care. Without coverage they may find themselves physically recovered later but their assets drained. A policy would provide care and potentially leave their assets intact.

Some people assume they can't obtain coverage because of their current health when they might qualify. The only way to find out if you qualify is to apply. There is no obligation to see if you qualify.

Q: Who are average buyers of long term care insurance?
A: We have clients at both ends of the financial spectrum and most are in the middle. On one end are fixed income retirees with high-end policies who say they don't want their children or friends to ever have to spend money on them. On the other end are those who can easily afford expensive policies but buy a low benefit plan which will buffer the cost of care yet provides access to all the non-financial benefits like care coordination.

Most people are in the middle and buy enough insurance to guard against depleting their savings and burdening their families. Our qualified long term care insurance specialists will work with you to help you determine just the right coverage for you.

No one wants to make a mistake.
.	Your Action	Your Outcome	Your Result
1.	You Insure for LTC	You Need LTC	No Mistake
2.	You Don't Insure for LTC	You Don't Need LTC	No Mistake
3.	You Insure for LTC	You Don't Need LTC	Yes Mistake
4.	You Don't Insure for LTC	You Need LTC	Yes Mistake
Which mistake would you rather make?

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