Understanding Long-term Care Insurance

What is long-term care?

Long-term care applies to people of any age who require help performing the activities of daily living (ADLs), such as bathing, dressing or eating. They may need care because of age, illness, injury or cognitive disorder. Care may be provided by private homes, assisted-living facilities, adult day-care centers, hospices, or nursing homes.

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Why do I need long-term care insurance (LTCI)?

You may never need long-term care but, if you do, you will want to be prepared. The average annual cost of nursing home care is approximately $56 000 and growing (Source: AARP, 2001.) Medicaid does cover some costs but has strict financial eligibility requirements. In order to be eligible you would have to exhaust a large amount of your savings. HMOs, Medicare and Medigap won't cover most long-term care expenses, so you may want to find alternate ways to pay for care and an LTCI policy is one option.

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How does LTCI work?

You pay a premium and when benefits are triggered your policy pays a specified dollar amount per day for the type of care outlined in the policy.

Most policies provide that certain physical or mental impairments trigger benefits. The most common method for determining when benefits are payable is based on your inability to perform certain ADLs. Benefits are payable when you're unable to perform a certain number of ADLs.

Some policies will begin paying benefits only if your doctor certifies that long-term care is necessary. Others will offer benefits for cognitive or mental incapacity, based on your inability to pass certain tests.

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What should I consider before buying a LTCI policy?

• Are you between the ages of 40 and 84?
• Do you have significant assets that you would like to protect?
• Can you afford to pay the premiums, now and in the future?
• Are you insurable, good health?
  
  
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How do I compare different LTCI policies?

Read the Outline of Coverage portion of each policy carefully, and make sure you understand all of the benefits, exclusions, and provisions. Once you find a policy you like, check that company's ratings from services such as A. M. Best, Moody's or Standard & Poor's to make sure the company is financially stable.

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What features and provisions should I pay attention to?

When comparing LTCI policies, you may wish to consult a financial professional or attorney for more information, but the following are some features you should look at.

Elimination or waiting period

How long before the insurance policy will begin paying benefits?

Duration of benefits

What limits are placed on the benefits you can receive? This will be either a dollar amount or a time limit.

Daily benefit

How much can you select for your daily benefit?

Optional inflation rider

Does the policy offer protection against inflation?

Range of care

What coverage is offered for different levels of care in different settings, such as home care or a nursing home?

Pre-existing conditions

How long will it be before coverage goes into effect for treatment of pre-existing conditions?

Other exclusions

Are certain conditions such as Alzheimer's or Parkinson's disease covered?

Premium increases

Will premiums increase during the policy period?

Guaranteed renew ability

Will you have the opportunity to renew the policy and maintain coverage despite any changes to your health?

Grace period for late payment

How long will the policy remain in effect if you are late paying the premium?

Return of premium

Will the premium be returned to you if you cancel your policy after paying for a number of years?

Prior hospitalization

Is a hospital stay required before you can qualify for LTCI benefits?

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What's it going to cost?

LTCI is often expensive. The cost depends on many factors.

• What is the type of policy?
• What is the size of the benefit?
• What is the length of benefit period?
• What care options are outlined?
• Are there any optional riders?

Premium cost is also based on your age when you purchase the policy. The younger you are the lower your premiums will be.

If you have more questions about the information provided or about your retirement situation please contact your local Safe Money Representative or ask the experts.

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