What Senior Citizens Need To Know About Private Long Term Care
Insurance
Long term care is a major concern of American senior citizens
and their families. Studies have shown that Americans rank long
term care second, behind saving for retirement, when
prioritizing financial needs. Unfortunately, many Americans do
not want to think about needing long term care and, therefore,
fail to plan for it. Others 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 best time to plan for long term care is before it is needed.
Start thinking about long term care when you plan for
retirement. If you are already retired, it is not too late to
begin planning for potential long term care needs.
Private long term care insurance is an excellent way to finance
long term care. This brochure will guide you through the
important process of selecting the right long term care
insurance policy. This booklet provides information on long term
care services, what to look for in a long term care insurance
policy, and a glossary of terms.
Finding a good policy will take some effort, but the effort will
be worthwhile. Here are some steps to take when considering the
decision to purchase a long term care insurance policy:
1. Talk to your financial planner or insurance agent about
whether long term care insurance makes sense for you. 2. Ask
your financial advisor to recommend a company and a policy.
3. Check with insurance rating services to make sure the
insurance company you are considering is financially secure. 4.
Call your state insurance department and ask about the company
and its record in your state. 5. Make sure your insurance agent
is licensed to sell long term care insurance in your state. 6.
Review all the details and options of the policy. Do not rely
just on the marketing materials or outline of coverage. 7. Make
sure you understand all the provisions before you purchase any
policy. 8. 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.
The decision to purchase long term care insurance is not a
simple one, but thorough investigation and thoughtful planning
now can offer you and your family financial protection for the
future, and, most importantly, peace of mind.
Defining Long Term Care
Long term care includes a range of nursing, social, and
rehabilitative services for people who need ongoing assistance.
Most people in long term care facilities are older, but many
young people need long term care during an extended illness or
after an accident.
Assistance with routine personal needs such as bathing,
dressing, eating, toileting, and taking medicine is the most
common long term care service. Long term care facilities also
provide skilled nursing and rehabilitative care, which is
ordered by a physician and supervised by skilled medical
personnel such as a nurse or licensed therapist.
Long Term Care Is Offered In A Variety Of Settings
Nursing facilities are the primary settings for people who
require medical care daily or intermittently. You must have a
physician specify needed services in a written treatment plan
for admission to a nursing facility. Many nursing facility stays
are short periods of recuperation from an acute medical episode
such as a hip fracture or surgery.
Assisted living facilities or residential care facilities
provide general supervision, housekeeping services, medical
monitoring, and planned social, recreational, and spiritual
activities for people who are still independent and ambulatory.
Assisted living facilities do not provide medical care.
Facility care services include skilled nursing care, speech,
physical, or occupational therapy, facility health aides, or
help from facilitymakers. Sometimes, family members, or
caregivers, provide most of the care with the help of facility
aides and skilled professionals.
Adult day care services are available in many communities,
providing personal care, skilled care, and recreational services.
Financial Issues And Long Term Care
The cost of long term care varies by the level of care needed,
the setting where the care is provided, and geographic location.
Nursing facilities, assisted living facilities, and facility
care services provide different levels of care to different
resident populations; therefore, costs are not comparable.
On average, round-the-clock long term care services in a nursing
facility cost $40,000 per year, or $112 per day.
Assisted living costs vary dramatically--anywhere from $900 to
$3000 per month depending on room size, amenities provided, and
services required.
Facility care, if needed daily, also can be quite expensive. In
1996, an average facility care visit from a registered nurse
(RN) cost $99. RN visits for facility care typically do not
exceed 2-4 hours per day, so care is not round-the-clock.
Eight hours of adult day care can cost an average of $45 per day.
Nursing Facility Care: About one third of the costs of nursing
facility care are paid directly by individuals and their
families. Two government programs may pay for some of your care.
Medicare, a health insurance program for people age 65 or older,
only covers skilled facility care and up to 100 days of skilled
care in a nursing facility if you are admitted after a three-day
hospitalization (not required if you are an HMO member) and your
physician prescribes skilled care in your treatment plan. Many
people think that Medicare is the primary payor of nursing
facility stays, but Medicare accounts for only 9 percent of
nursing facility expenditures.
Medicaid, a program for the poor, pays for approximately 52
percent of the nation's nursing facility care, but only for
people who have spent almost all their assets and become
impoverished. Due to lack of planning for long term care,
Medicaid is the source of payment for nearly 70 percent of
people in nursing facilities!
Unless you have long term care insurance, qualify under limited
conditions for Medicare coverage, or become poor, you will pay
out of your savings for nursing facility services.
Assisted Living: About 90 percent of the nation's assisted
living services are paid for with private funds. The
Supplemental Security Income, Older Americans Act, and Social
Services Block Grant programs pay for some assisted living
services, while about one-fifth of the states allow the federal
Medicaid program to pay for some service components.
Facility Care: Private funds pay for about 46 percent of
facility care costs; Medicare covers 32 percent; Medicaid, 22
percent.
Adult Day Care: There are some out-of-pocket expenses for adult
day care; however, the majority of funding comes from public
sources either the state exclusively, or, in some states,
Medicare and Medicaid. Private donations from corporations and
charitable groups such as the United Way also supplement the
costs of adult day care.
When To Buy Long Term Care Insurance
Because long term care insurance premiums are based on age at
the time of purchase, the younger you are when you purchase a
policy, the less expensive the annual premium. These premiums
for most policies stay level each year as you age. If you buy at
age 55 a policy that cost $800 per year, you will continue to
pay the same premium. However, if you wait until you are 65, the
same policy will cost you $1,700 per year.
What To Look For In A Policy
The best policy for you depends on several factors, including
your family arrangement, your financial situation, your
preferences regarding long term care choices, and the level of
risk you are willing to accept. There is no one best company or
one best policy for everyone. You should select a policy that
meets your needs.
Before you buy a policy, make sure you know the product you are
buying and from whom you are buying it. Be sure your agent is
licensed to sell insurance in your state and has received
specific training on long term care insurance. Consult friends,
consumer guides, and information from your state's insurance
counseling program or local agency on aging.
For the complete article click on
What Senior Citizens Need To Know About Private Long Term Care
Insurance.