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| Insurance & Financial Services >> Personal >> Long Term Care |
Long Term Care Overview
 Long-term care is the assistance provided when you are unable to provide for yourself as the result of disability or a prolonged illness. Long-term care is offered through home care agencies, senior centers, traditional nursing homes, adult day care centers, and retirement communities that provide ongoing care.
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Who Should Buy Long Term Care Insurance?
A long-term care insurance policy is not for everyone, but it does make sense as an affordable and worthwhile form of insurance for some people. Decision factors depend on your age, health status, income and wealth. Whether long-term care insurance is appropriate really requires a full financial analysis and discussions to learn and review what is important to you as you age and potentially become dependant on others to care for you.
Your Odds of Needing Long Term Care
Studies have shown that 43% of those who turned age 65 in 1990 will enter a nursing home at some time during their life. Of those who live to age 65, nearly 1 in 3 will spend three months or more in a nursing home and 1 in 4 will spend one year or more in a nursing home. Only 1 in 11 will spend five years or more in a nursing home.
Women outnumber men in nursing homes according to studies. 13% of women as compared to 4% of men, were projected to spend five or more years in a nursing home.
Understanding the Product
Always read the details and fine print of a Long Term Care policy. Below,you're your review, are some commonly used types of policies and the generally accepted meanings.
Skilled nursing care... is needed for medical conditions that require care by specially trained, and usually state-licensed nurse or therapist. It is given either during or just after the severest level of an illness, and is usually required around the clock, 24 hours a day.
Intermediate nursing care... is associated with stable conditions that require daily supervision, but not around the clock care. It is less specialized than skilled nursing care, often involves much personal care, and is supervised by registered nurses. Intermediate care is often needed for many months or years.
Custodial care... is intended to assist with daily living, which includes bathing, eating, dressing, and other routine activities. Special training or medical skills are not required. Custodial care is provided by unskilled nursing assistants in nursing homes, day care centers, and at home. It is also occasionally referred to as personal care.
The Cost of Long Term Care
Long-term care is expensive, depending on the severity of a disability, the degree of care needed and where it is to be provided. In 1992, the cost of a year in a nursing home averaged $32,000 across the United States. Skilled nursing care at home with two hour visits by a nurse three times a week over a year might cost about $12,500. Personal care at home from an aide three times a week for two hours would cost about $8,400 a year.
In major cities, the cost can be expected to reach $60,000 a year and as much as $100,000. With an average nursing home stay of 19 months, seniors living in major metropolitan areas, can expect to pay $100,000 on long-term care in addition to medical bills and prescriptions.
Who Pays For Long Term Care?
The answer is simple:It comes from your cash and your assets, your family's assets. For those without assets, it is paid by Medicaid programs administered by state government. More than half of nursing home bills are paid out-of-pocket by individuals and their families, and somewhat less than half are paid by state Medicaid programs.
Group insurance does not pay for most long-term care expenses, and Medicare does not offer long-term care as a benefit. Only in certain cases will Medicare cover the cost of some skilled nursing care in approved nursing homes or in your home, but there is no coverage for custodial or intermediate care or prolonged home health care.
Here are some guidelines and tips when shopping for a Long Term Care policy
Check with several companies
Contact several companies (and agents) before you sign the dotted line. Be sure to compare benefits, the types of facilities you have to be in to receive coverage, the limitations of coverage, the exclusions, and, or course, the premiums.
Take your time and compare coverages
Never let anyone pressure or scare you into making a quick decision. Don't buy a policy the first time an agent comes calling. One suggestion would be to ask the agent to give you a simple easy to understand outline of the coverage they are proposing. The outline of coverage should summarize the policy's benefits and highlights important features. Compare outlines of coverage for several policies.
 Understand the policiesMake sure you know what the policy covers and what it does not. If you have any questions, ask the agent or call the insurance company's home office before you sign the ole dotted line.
If the agent gives you answers that are vague or differ from information in the company literature, or if you have doubts about the policy, tell the agent you will get back to him or her later and don't hesitate to call or write to the company and ask your questions. Beware of an agent who claims the policy can be offered only once.
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Download Now
 Here is a sample you can download and use for estimating your Long Term Care needs:
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A few Do's & Don'ts
- Never pay the agent in cash
- Write a check and make it payable to the insurance company.
- If you don't receive your policy within 60 days, contact the company or agent
- Read the policy again and make sure it provides the coverage you want
- Reread the application you signed, it becomes part of the policy. If it's not filled out correctly, notify the insurance company immediately.
- Keep the policy in a convenient place where you or anyone else readily can find it, and tell a trusted friend or relative where it is.
Your medical history is important!
Accurately disclosing your medical history is extremely important. This is not the time to hide the minor heart attack or stroke you suffered last week. Make sure you fill out the application completely and accurately. If an agent fills out the application for you, don't sign it unless you have read it and made sure that all of the medical information is correct.
If information about the state of your health is misstated, incomplete, or wrong, the company will refuse to pay your claims and cancel your policy. For that reason you should always fully and completely explain the full extent of your medical condition. If you are unsure about any particular item be sure to state "do not recall." And as a catchall to protect yourself, always refer the carrier to your doctors' records of the care provided to you and list the names and address of your doctors.
Contact CRC for Free Information on Long Term Health Care
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