What is Long-Term Care? Click here to: REVIEW POLICY OPTIONS AND BENEFITS REQUEST A LTC QUOTE It is expected that 40% to 50% of us will require some type of long term care in our lifetime, either at home, in a nursing home or some other care facility. Individuals require long-term care when a chronic condition, serious injury, stroke, or illness limits their ability to carry out basic daily care tasks and household chores, which are frequently referred to as "activities of daily living." An estimated 12.8 million Americans of all ages need assistance from others to carry out everyday activities. Approximately 57% are persons aged 65 and older, 40% are adults aged 18 to 64 and 3% are children under age 18. Of the 12.8 million, only about 2.4 million live in nursing homes and like institutions. Of those receiving assistance from others, most are helped by family and friends, and a much smaller number receives assistance from government programs. In several studies conducted in 2002 the average annual cost of a nursing facility nationwide depending upon the study is $168.00 or up to $181.00 per day ($140.00 - 160.00 in Michigan) and the annual tab for a private room averaged $66,000 - $70,000. One study shows that nursing home prices have increased faster than inflation. These costs can quickly wipe out a family’s assets. The national average wage of a home health-care worker has increased 2.9 % over a 16-month period to $18.00 an hour. At these rates home care can sometimes greatly exceed the cost of nursing home care. Currently approximately 83% of the people receiving long term care benefits choose to receive their care at home. The costs illustrated here are averages...and are based on data from 2002. Costs greatly vary depending upon where you live, thus some rates will be lower and others will be higher. There are several reasons for rising costs the largest factor being the steady increase in medical costs and medical liability costs. Nursing homes tend to have difficulty in attracting and keeping quality staff and to do so must pay better wages and benefits. Additonally persons enter nursing homes today are in poorer health and have less stamina than patients in the past...and people are living longer, but as a result many need assistance or medical treatment. The U.S. Census Bureau shows that the fourth fastest growing poplulation in the U.S. are those age 90 to 94. This group has increased by 44.6% since 1990. Most nursing home stays are of short duration, the average being 2 1/2 years. 91% of nursing home stays are less than 5 years. Keep in mind that these averages are based on actual stays in a long-term care facility and do not take into account how long an individual may have been hospitalized or cared for at home. The average monthly base price for assisted living facilities in the U.S. (based upon the results of 21 states surveyed) was $2,159.00. Depending upon the level of care needed some facilities monthly cost could be as high as $6,800.00 per month.

Medicare And Medicaid (keep in mind that Medicare and Medicaid rules can change) Medicare Medicare covers skilled care only if ALL of the following are true: 1. You have Medicare Part A (Hospital Insurance) and there are days remaining in your benefit period available for use. 2.You must have been hospitalized for three consecutive days (not including the day you are discharged) prior to entering a Medicare certified facility and must enter it within 30 days of leaving the hospital. You also must be expected to recover. 3. Your doctor has directed that you need daily skilled care which must be under the direct supervision of a skilled nursing or rehabilitation staff. 4. The skilled services must be for a medical condition that was treated during your qualifying 3-day hospital confinement or the condition occurred while you were already receiving Medicare covered skilled care in a facility. If the above are all true then Medicare pays for up to 100 days of medically necessary skilled care. However , while Medicare "may" cover up to 100 days of skilled nursing home care per benefit period when all required conditions are met, after 20 days beneficiaries must pay a coinsurance fee. In 2002 that coinsurance fee was $101.50 per day and it can change each year. And while Medicare "may" pay for nursing home care sometimes...it doesn't cover the costs of care in assisted living facilities. If you have a Medigap, Original Medicare Plan, Medicare Managed Care Plan, or Private Fee-For-Service Plan your costs may be different or you may have more coverage. The coverage is for professional care only in a skilled nursing facility. For more information visit http://www.medicare.gov as there may be other requirements and limitations on this coverage or changes made to how you qualify or the extent of coverage afforded. You may also request the guide book "Choosing a Medigap Policy: A guide to Health Insurance for People With Medicare" developed by the Centers For Medicare & Medicaid Services. Most long-term care insurance insurers have this guide book available free of charge. Medicaid Medicaid pays for nursing home care and may also pay for some community based services. However, to receive Medicaid assistance, you must meet federal poverty guidelines for income and assets and may have to "spend down" or use up most of your assets on health care. State laws differ about how much money and assets you are allowed to keep once you become eligible for Medicaid. Many nursing homes have dropped out of the Medicaid program leaving long waiting lists and limited choices at those remaining.

Why You Should Consider Long-term Care Insurance To protect your life savings and maintain control of your retirement money. So you may maintain your independence and freedom through choice of where you want to live when the need for long-term care arises. Long-term care insurance can relieve the burden from family so you and they won't have to worry that they do not possess the training and skills necessary to help you with your long-term care needs. Most individuals prefer to receive long-term care at home for as long as possible or to reside in an assisted living arrangement rather than going into a nursing home. A policy with a home care and assisted living benefit can pay for services received in these environments, such as, assistance with the "Activities of Daily Living," or if eligible, services like cooking, cleaning and shopping. Additionally, if it is determined that you require services provided by a licensed professional nurse or therapist, you could also receive benefits for help to improve your mobility and strength as well as hearing and speech therapy. Purchasing a long-term care insurance policy is not something you do just for yourself. It involves family…giving those you love the financial support, choice and peace of mind when long-term care is needed. Researchers agree that the number of non-elderly persons with long-term care needs has grown in recent decades and that this is likely to continue and that the cost of long-term care will continue to escalate and to at least triple within the next 20 years. Therefore it's not expected that nursing home costs will decline or even stabilize.

Selecting A Long-Term Care Insurance Company The right policy for you is a policy where the benefit you may receive and the premium you are paying fits your financial plan. · Most persons consider a nursing home a last resort. If this is your view, then make certain the policy you are considering includes home, assisted living and adult day care and select coverage at least equal to and no less than 80% of the nursing home care benefit. · Daily benefit plans can range from $50 to $500 per day and monthly benefit plans up to $15,000 per month. Be certain to purchase an inflation protection rider. The 5% compound rider will work best at keeping your benefits in line with rising costs. However, if you are age 75 or older when purchasing long-term care insurance the inflation rider is not recommended. · If you intend to finance part of your long term care and do not have prescription drug coverage, be sure to factor this and other care related cost into your overall expenditure. · You should purchase a policy that provides benefits for a minimum of two years. Longer terms provide more security, but purchase only what you can afford. · Elimination periods can save premium dollars, but be certain to factor this cost into your budget, as you will be responsible for costs during this period. The policy should provide that you need only satisfy the elimination period once in your lifetime. · Make certain the insurance company you are considering is financially sound. Check the rating services for A- or better rated companies. · Check with your state's insurance department for any complaint history or history of rate increases.

When To Buy Premiums vary depending upon your age and health status when you apply for coverage. Other factors that affect cost include what you decide on for a daily or monthly benefit and if you select any of the riders that are available that enhance or broaden the coverage. As you must be in generally good health when applying in order to pass the company of choice's underwriting, it may be wise to purchase long-term care insurance at a younger age when health may be better and premiums are lower.

Educate Yourself You will find a plethora of information on the Internet on all aspects of long term care. Information from providers, insurance companies, information published by special interest groups and from government entities. You will also learn about future plans of special interest groups that lobby to make a difference in the availabilty, cost and quality of long-term care and long-term care insurance. Although studies have shown that Americans rank long term care second, behind saving for retirement when prioritizing financial needs, unfortunately many Americans do not take action as they find it unpleasant to think about needing long term care. Therefore, most fail to plan for it or wrongly assume that Medicare or standard health insurance policies will cover the costs of long term care services. As a result of this failure to plan, tens of thousands of Americans are impoverished each year by the costs of long term care. The time to plan for long term care is before it is needed. Private long term care insurance is an excellent way to finance long term care. · Talk to your insurance agent or financial planner about whether long term care insurance makes sense for you. · Ask your insurance agent or financial advisor to recommend a company and a policy. · Check with insurance rating services to be certain the insurance company you are considering is financially secure. · Call your state insurance department and ask about the company and its record in your state. · Make sure your insurance agent is licensed to sell long term care insurance in your state. · Review all the details and options of the policy. Do not rely just on the marketing materials or outline of coverage. · Make sure you understand all the provisions before you purchase any policy. Ask your insurance agent questions. Seek guidance from the state insurance commission office, the Area Agency on Aging, or local senior centers. Discuss policies with friends, family, and others whose opinions you respect. Take time when choosing a policy, and don't allow yourself to be pressured into making quick decisions. And remember: never pay cash.