Tag Archives: Qualified Long Term Care

Surprising Long Term Care Insurance Statistic

Surprising Long Term Care Insurance Statistic

In a recent report from the American Association for Long Term Care insurance, it states that in 2011 $6.6 billion (6,600,000,000.00) were paid out in claims to 200,000 people.

If all the claims were equal (which we know were not) that would be $33,000.00 per person on claim.

Now not everyone goes on to long term care claim (just like not everyone has a car accident), but if you do go into a facility whether nursing home or assisted living, or you need someone to come to the house, how do you plan on paying that?  Let’s use the number of $33,000 per year (some are higher some will be lower), what will that do to your savings account, your retirement, do your kids have enough to pay for it?

I know it’s a lot of questions, but something that you should at least think about. You should contact me for a quote specific for your situation.

Also did you know when it comes to purchasing long term care insurance that you can write off a portion of it?  I have copied this directly from the IRS website.

Qualified long-term care premiums up to the amounts shown below.
Age 40 or under – $340.00
Age 41 to 50 – $640.00
Age 51 to 60 – $1,270.00
Age 61 to 70 – $3,390.00
Age 71 or over – $4,240.00

Again Contact me with questions.

Long-Term Care Partnership Program Makes Policy Purchases More Attractive to Consumers

Long-Term Care Partnership Program Makes Policy Purchases More Attractive to Consumers

Few expenses can deplete a lifetime of savings as rapidly as the need for long-term care. The Long-Term Care (LTC) Partnership Program, a federally supported, state-operated initiative, helps individuals protect themselves against this possibility by encouraging them to purchase long-term care insurance policies.

Basically, the program works like this: An LTC Partnership Program-qualified policy will cover the cost of long-term care initially, after which time the policy owner will be able to apply for Medicaid to pay for additional long-term care services-but without having to spend down personal assets as would normally be required. By permitting individuals to protect a portion of their personal assets, the program is intended to provide an incentive to purchase a qualified long-term care insurance policy, a result that would benefit individual consumers and insurance companies, too, by creating a more active market for long-term care insurance.

At the same time, states participating in the program hope to save dollars by having more individuals pay at least a portion of long-term care expenses with policy benefits, thereby delaying the point in time at which Medicaid kicks in. Medicaid currently accounts for close to 49% of overall long-term care funding, while private health and long-term care insurance pay just over 7%, according to information from the National Conference of State Legislatures.

The LTC Partnership Program began in the mid-1980s. Currently, qualified policies are available for sale in 23 states, according to the Long-Term Care Partnership Program Technical Assistance Website. Most other states have programs in various stages of development or approval.

Program specifics will vary state to state. For example, some use a dollar-for-dollar model: If an individual purchasing a qualified long-term care insurance policy worth $150,000 exhausts policy benefits, he or she can qualify for Medicaid to pay for additional long-term care expenses without having to spend down $150,000 worth of personal assets. Other states use a total assets model: Individuals who purchase qualified coverage of at least a set dollar amount can protect all individual assets after they have exhausted policy benefits.

States set the requirements for qualified long-term care policy provisions. These may include whether qualified policies must be comprehensive or facility-only, and minimum daily benefit amounts.

Statistics on the ever-rising cost of long-term care services make it clear how great the need is for long-term care planning. According to Genworth Financial’s 2009 Cost of Care Survey, individuals needing long-term care services will see the following national averages:

• $183 per day for a semi-private room ($203 for a private room) in a nursing home that provides 24-hour-a-day skilled care.

• $2,825 per month for a private room in an assisted living facility providing assistance with personal care, as well as some medical care.

• $18 per hour for home health aid services provided by a non-Medicare-certified but state-licensed agency (for example, assistance with bathing, dressing, transferring, etc.).

• $46 per hour for home health aid services, sometimes including skilled care, when provided by a Medicare-certified agency.

• $10 per hour for adult day care services in a community-based setting.

Companies exploring adding a long-term care benefit to their voluntary benefits offerings should check to see whether partnership program plans are available in their states. The advantages of such policies-in a time when the need for long-term care services is on the rise, along with the cost of such services-can help make long-term care a voluntary benefit that employees truly welcome.

Long Term Care Terms

Long Term Care Terms

You will find definitions of terms commonly used terms in Long-Term Care Policy

Activities of Daily Living
The following functions for personal independence in every day living and are used as the measurement standard to determine your functioning capacity. These ADLs are a national standard for tax-qualified long-term care plans.

These are the Activities of Daily Living:

  • Bathing: Your ability to wash yourself, including a sponge bath, or in a tub or shower, including the task of getting into and out of the tub or shower.
  • Continence: Your ability to control bowel and bladder function; or when unable to maintain control of bowel and bladder function, your ability to perform associated personal hygiene (including caring for catheter or colostomy bag).
  • Dressing: Your ability to put on and take off all items of clothing and any necessary braces or artificial limbs usually worn, and to fasten and unfasten them.
  • Eating: Your ability to feed yourself by getting food into your body from a receptacle (such as a plate, cup or table) or by a feeding tube intravenously.
  • Toileting: Your ability to go to and from the toilet and maintain a reasonable level of personal hygiene. This includes getting on and off the toilet and caring for clothing.
  • Transferring: Your ability to move in and out of a bed, chair or wheelchair.

The certification by a licensed health care practitioner must be made at least annually.

Adult Day Care
A program for six or more individuals of social and health-related services provided during the day in a community group setting for the purpose of supporting frail, impaired, elderly or other adults with a disability who can benefit from care in a group setting outside the home.

Cost of Waiting
Definition: The total cost of premiums paid at one age versus the cost of premiums paid if purchased at a later age.

Cognitive Impairment*
A deficiency in a person’s short or long-term memory, orientation as to person, place and time, deductive or abstract reasoning, or judgment as it relates to safety awareness.
*see Severe Cognitive Impairment

Custodial Care
Care given primarily for the purpose of assisting another with Activities of Daily Living (ADLs).  Custodial Care is not intended to restore health or the ability to function. It can be provided by a non-medically trained professional.

Daily Benefit Amount
The maximum amount of money you will be reimbursed for services during each day you are eligible for qualified long-term care benefits.

Elimination Period

The number of days (waiting period) before LTC will pay covered benefits under your policy. You need only satisfy this elimination period once in your lifetime.

Standard elimination period options are 30, 60 and 90 days. These days need not be consecutive and may be accumulated until your elimination period has been met.

Home Care
Care provided to a person in his or her home primarily to assist with Activities of Daily Living (ADLs).

Home Health Care
A program of professional, paraprofessional or skilled care provided through a home health care agency to an insured in his or her home.

Inflation Protection
If you choose to add Inflation Protection to your contract, you can increase your Maximum
Monthly Benefit to protect against the anticipated increases in the cost of
long term care.

Nonforfeiture
With these riders, you can add a contract feature that returns at least part of the premiums you paid if you cancel your contract or let it lapse:

  • Contingent Nonforfeiture (included in base) or
  • Shortened Benefit Period Continued coverage equal to premiums you have paid if your contract has been in force for three years and lapses.
  • Full Return of Premium* If you die while the contract is in force, we will refund all premiums you have paid for the contract and riders. Available only to enrollees age 65 and under.
  • Return of Premium*  The same protection as Full Return of Premium except any benefits paid or payable are deducted. Available only to enrollees age 75 and under.


Respite Care

Temporary relief from caregiving duties from a member of the immediate family or other person who is the unpaid primary caregiver. This “time off” helps the primary caregiver maintain his or her health and mental well-being.

Restoration of Benefits
Whenever a period of 180 days elapses in which you were not chronically ill, we will restore your Lifetime Maximum to what it would have been had no benefits been paid under your contract. Not available with Unlimited Lifetime Maximum. Not available in conjunction with the Shared Care Rider.

Severe Cognitive Impairment
The deterioration or loss in intellectual capacity that requires Substantial Supervision to assure the insured’s and others’ safety. The deterioration or loss is established by clinical evidence and standardized tests that reliably measure:

  • Short-term or long-term memory
  • Orientation as to people, place, or time
  • Deductive or abstract reasoning; and judgment as it relates to safety awareness.

Skilled Nursing
A level of care that is provided by a registered nurse and is prescribed by a doctor for the medical care of the individual.

Spending Down
Spending down is when you, or your family, spend all your assets to reach the level where Medicaid will cover your LTC expenses. Not only will this action deeply effect your surviving spouse, but it can also take away your freedom of choice. Most facilities have a limited number of Medicaid beds, if they accept Medicaid at all. Medicaid has a significant number of restrictions on Home and Facility care, approved caregivers and the location of that care.