Long Term Care

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Long Term Care Insurance (LTCI)

 

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Long-term care can include a broad range of services, provided in any setting outside a hospital. It might be help with simple daily tasks like bathing or dressing. It may also include skilled care in your home, an assisted living facility, some other community resources or a nursing facility.

It is the kind of care people need when they are no longer able to handle Activities of Daily Living (ADLs) including bathing, dressing, eating, toileting, continence, and transferring. 

 

Accessing Your Benefits

LTCI policy owner is eligible to receive benefits when a licensed health care practitioner indicates that he/she will need either of the following:

  • Substantial assistance with at least two out  of six activities of daily living(ADLs) (bathing, dressing, eating, toileting, continence, transferring) for at least 90 days
  • Substantial supervision due to Alzheimer's disease, stroke, brain injury, or other types of cognitive impairment.

 

Types of Care Covered

This care is provided whether it is needed early on due to an accident or illness, or later in life.

  • Skilled care - includes nursing care, occupational, physical, occupational, speech therapy and respiratory from licensed professionals.
  • Intermediate care - represents skilled care services that are not received on daily basis. (see above)
  • Custodial care - includes help with day-to-day activities such as eating, dressing, transferring, etc.

 

Care Setting

The LTCI owners ability to receive care in the preferred is a valuable benefit

  • Home care - Owners receive skilled services in the owners residence from a professional care provider such as a nurse, therapist, home health aide, informal caregiver, or home health care provider.
  • Adult day care - Owners may receive care in their local community, which will be covered for social and health-related services in an adult day care center.
  • Assisted living facilities -  Owners may receive care in secure, home-like environment, where people live independently.
  • Nursing homes - Owners will be covered for custodial and skilled care in nursing homes. 
  • Hospice care - Owners will be covered for terminal care situations, including support for family members, in your home, or preferred facility.

 

Benefit Amount

  • Daily Benefit Options - $50 - $500 per day ($10 dollar increments
  • Monthly Benefit Options - $1,500 - $15,000 per month ($100 dollar increments)

 

Benefit Period

The Benefit Period represents the minimum period of years the coverage will last.Contact Us

Choices:

  • Three Years
  • Five Years
  • Five Years Plus $1 Million Dollars**                                                      

** Enables owner to access up to $1 Million of additional coverage to pay for care after the initial five year period is exhausted. 

 

Total Benefit Calculation

Daily Benefit:     $150 X 5 years (1,825 days)   =  $273,750 (Total Money Pool)

Monthly Benefit: $4,500 X 5 years (60 months) =  $270,000 (Total Money Pool)

 

Elimination Period

An Elimination Period on a LTCI policy is similar to standard deductible. The owner pays the care costs for 60 - 100 days before coverage begins.

The Elimination Period only needs to be satisfied once during the lifetime of the policy.  Each day care is received will count toward satisfying the Elimination Period.

 

Inflation Option

It is important to factor inflation or anticipated rising costs into any financial plan.  The coverage selected for today's long term care costs must meet the owners future need 10, 20, 30, years from now.

Automatic Inflation Coverage:

  • Typically each year the daily/monthly benefit and money pool will be adjusted on a compounding basis linked to the Consumer Price Index (CPI).**
  • The potential amount of CPI is unlimited, even in high inflationary environments.  The benefits will not be reduced if the CPI decreases.

**Consumer Price Index (CPI) - an index that tracks the price of an average of a group of goods and services included such items as housing, medical care, etc.  It is typically used to measure inflation, or the CPI is also used to track the current cost of living wage adjustments to millions of American workers.  The net result is that CPI is strongly associated with labor costs and housing, two key variables of long term care costs today and in the future. 

The annual average increase of CPI over the last 30 years ending 12/08 was 4.1%. (U.S Dept. of Labor, Bureau of Labor Statistics)

Guaranteed Purchase Option (GPO):

  • This option is available to the owners who do not select the automatic inflation option.  An offer is presented with in a multiple year time frame with an option to increase the daily/monthly benefit amount of the money pool by 5% or so on an annual compound basis without any exams or health questions.Contact Us

 

Optional Features

Joint Benefits:

  • Especially designed for couples, which enables the owners to maximize the coverage value by linking two individual policies to reduce overall premiums by sharing benefits.
  • This allows one partner to access the others money pool when his/her own benefits are exhausted.
  • If one partner dies, then the survivor's money pool will increase by the departed partner's remaining money, while the survivor's premium is reduced.
  • Typically, in the event that on spouse taps into the others benefits until exhausted, an option to purchase a new policy with a three year Benefit Period with no underwriting.*

* Owner must not have been eligible for benefits in the prior three years, and must be 90 or younger.

Qualified Partners for Joint Benefits:

  • Married
  • Family member of the same generation(sibling or cousin) that have lived together for at least three years.
  • Partner of the same or opposite sex that have lived together for at least three years.

 

Free Look Period

  • Owners typically have 30 days upon delivery date to review the new LTCI policy.  This option allows the return of the policy for a 100% refund.

 

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Disclaimer

**The feature icons displayed are a summary for informational purposes only. Review the evidence of coverage and insurance policy (plan contract) for a detailed description of coverage benefits, limitations, and exclusions.**