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Long Term Care

From a presentation by: Paul W. Isenberg RHU, CLTC
                                         used with his permission

"if you read this, you will know more than most people who sell this product."

LONG TERM CARE is the continuum of services, housing and care individuals will need as they age.  The goal is to allow individuals to "age in place" - to let them be in familiar surroundings as they age, and to be able to have care for their needs throughout the process.

Long term care is the additional help needed during a long-term illness or disability such as Stroke, Cancer, Alzheimer's, Rheumatoid Arthritis or Osteoporosis.

LONG TERM CARE INSURANCE is a means to pay for this care, but we are not just talking about nursing homes.  LONG TERM CARE INSURANCE pays for home care, assisted living retirement communities, adult day care and respite care, in addition to nursing homes.

Less than 1 percent of nursing home care is paid for by health insurance such as Blue Cross or Medicare, and that care must be skilled care. (three day prior hospital stay, needing a nurse, recuperative care)

Most people (95%) need custodial care, which is help with day to day activities such as dressing, eating, bathing.  LONG TERM CARE INSURANCE covers custodial care.

At 65 years old your chances of someday needing long term care are about 2 in 5 or 40%.

In RI the average cost for a nursing home is $150/day or $55,000/year. CT is $200/day or $73,000/year. MA is $180/day or $66,000/year.

Home care in RI =$20/hour, CT=$30/hour, MA=$25/hour.  

Assisted living communities = $2800/month to $3500/month.  Florida rates are very similar to RI.

The average stay in a nursing home is only 2 to 3 years.  Alzheimer's could be 7 to 11 years, but that's in a nursing home.  There are many more people living at home for much longer periods.

Private health insurance pays for doctors, hospitals and prescription medications, but pays very little for long term care.

Medicare, for those over age 65, pays the first 20 days of skilled care, then co-pays the next 80 days.  Most people have a Medicare supplement such as Blue Cross 65, Blue Chip, AARP, that pays for the 100 days of skilled care, after 100 days you are on your own.

Medicaid of course is the welfare system.  One has to spend down their assets to poverty level before the state will pick up their tab.  The government wants people to be self sufficient and not go on state aid so incentives are in the form of tax considerations for individuals and especially businesses. (S Corp -60%, C Corp - 100%)

Long term care insurance protects:
                Your Assets
                Your Independence
                Your Family (physically,financially,emotionally)

 

WHAT IS LONG TERM CARE INSURANCE?

Simply put:  You give a premium to an insurance company and tell them how much benefit you want available to you if you should ever need care.  You can choose a pool of benefits, or lifetime/unlimited benefits.  You choose how and where you will spend the benefit money.

Inflation protection may be the most important part of the policy.  This feature assures you that the benefits in your plan will grow annually to keep pace with the rise in health costs.  Options are 5% compounded or 5% simple, CPI or none.

LONG TERM CARE INSURANCE covers Alzheimer's, Parkinson's, Cancer, Stroke, Debilitating Arthritis..................  You qualify to tap into your policy if you should need assistance with 2 out of 6 physical activities of daily living.  These activities of daily living are: eating, dressing, bathing, toileting, continence, and transferring.  A completely separate trigger is cognitive impairment.  If one should need supervision because they are a danger to themselves or to others (Alzheimer's, dementia, senility).

Most policies also include these standard features: Guaranteed Renewable, Waiver of Premium, Spousal Discount, Bed Hold Feature.

BALL PARK PREMIUMS

AGE 50- $150/DAY, 4 YEAR POOL ($219,000), 5% COMPOUND INFLATION
     COST IS APPROXIMATELY $950/YEAR

AGE 50- $150/DAY, LIFETIME/UNLIMITED, 5% COMPOUND INFLATION
     COST IS APPROXIMATELY $1,400/YEAR

AGE 65- $150/DAY, 4 YEAR POOL ($219,000), 5% COMPOUND INFLATION
     COST IS APPROXIMATELY $2,000/YEAR

AGE 72- $150/DAY, 4 YEAR POOL ($219,000), 5% SIMPLE INFLATION
     COST IS APPROXIMATELY $3,000/YEAR

AGE 79- $150/DAY, 4 YEAR POOL ($219,000), NO INFLATION
     COST IS APPROXIMATELY $4,400/YEAR

Example of how benefits compound over the years to increase the policy limits:
AGE 50- $150/DAY, 4 YEAR POOL ($219,000), 5% COMPOUND INFLATION
     Pool at age 50=$219,000               Daily benefit = $150/day
     Pool at age 71=$614,660               Daily benefit = $421/day
     Pool at age 86=$1,278,960            Daily benefit = $876/day

IN CONCLUSION

LONG TERM CARE INSURANCE gives people the option of "aging in place" by providing cash to pay for the services and housing discussed.  It does much more, however, it allows people to keep commitments to their spouses and children who may need special care after parents are gone.  In these and other ways, LONG TERM CARE INSURANCE is no different than life insurance.  It protects against unforeseen illnesses that can threaten one's life savings and choice of care.

The Insurance Center has access to several of the major LONG TERM CARE INSURANCE carriers and would be happy to talk to you about this valuable coverage.

Send mail to myronmitchell@cs.com with questions or comments about this web site.
Last modified: July 12, 2002