Sudden Insurance

There are different types Long Term Care Insurance Policies. “Indemnity” or “Expense Incurred” policies are most common. When you buy an expense incurred policy, you choose the benefit amount. Regardless of what you spend an “indemnity” or “per diem” policy pays up to a fixed benefit amount. An “indemnity” or “per diem” policy reimburses for the actual expenses for services received up to a fixed dollar amount per day, week, or month.

“Integrated Policies” or policies with “Pooled Benefits” pay a total dollar amount which may be used for different kinds of long term care services used. There is usually a daily, weekly, or monthly dollar limit for long term care expenses covered by this kind of policy. For example you buy a policy with a maximum benefit amount of $300,000 of pooled benefits. You will have, with this policy a maximum daily benefit of $300 that would last for 1,000 days if you spend the maximum daily amount on care. If your care costs less than the maximum daily amount of $300 you will receive benefits for more than 1,000 days.

Long Care Insurance Policies can be divided into three broad categories according to where benefits are paid – Home Care Only, Nursing Home and Residential Care Facility Only and Comprehensive. Care in your own home or a community setting is covered by Home Care Only policies. This kind of policy pays for expenses rising out of home health, adult day health care, hospice, respite care, personal care and homemaker services.

Costs rising out of care in a nursing home or any place that provides assisted living care as long as this place is licensed as a Residential Care Facility for the Elderly (RCFE) is covered by Nursing Home and Residential Care Facility Only policies. This policy pays for more than just room and board in these facilities. The costs of all long term care services you receive in either of these facilities is paid by this policy up to the policy’s maximum daily benefit amount.

Small neighborhood homes also called board and care facilities, retirement homes and specialized community facilities providing care for patients with cognitive impairment (dementia) from Alzheimer are some of the RCFE. The assisted living benefits must equal to at least 70% of the nursing home care benefit with this kind of policy.

The Comprehensive Long Term Care Insurance Policies cover costs rising out of care in a nursing home, assisted living facility, home care and community care (adult day care). LTC Comprehensive policies sold by different companies require different criteria to be met before benefits can be paid. When you are unable to perform two activities of daily living (such as bathing, using the bathroom, dressing eating etc.) or you have a cognitive condition that requires supervision, Comprehensive Long Term Care Insurance Policy will pay you the benefits. Whether care is provided in a nursing home, at your own home or in an assisted living facility the criteria required for the benefits remains as described above.

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Long Term Care Insurance Policy Premiums are determined by the type of policy chosen, daily benefit amount to be paid, your age, number of years the policy will pay benefits, choice of inflation protection and the number of days after you qualify for the benefits before the company will start to pay benefits. If you have a pre-existing condition some companies will insure you for a higher premium. The combination of these factors decides your LTCI premium.

The costs of benefits you choose are calculated differently by different LTCI companies. The significant difference you see between premiums for similar benefits is the result of the above. To illustrate the above, a company may calculate the premium based on every $10 of the daily benefit you choose. If the company charged $95 for each $10 of daily benefit, the premium would be $950 per year for a daily benefit of $100. If the cost was $150 for a similar package of benefits, the annual premium would rise to $1,500 with another company.

The type and amount of inflation protection chosen will also influence your LTCI policy premium. The makes the cost nearly double for those in 40s and 50s and not expecting to need care for several years. As you age your ability to change LTCI policy diminishes but probability of developing health conditions which make you ineligible to apply for new benefits increases.

Over the years your LTCI premiums can increase. At the time of buying a LTCI policy your agent provides you with a personal worksheet which explains the rate increases the company has had since 1990. The California Department of Insurance website lists the rate increases for every company that sells LTCI. Increasing future premiums became difficult for LTCI companies when California passed legislation in 2000.

When it became mandatory in 2006 for all companies filing for premium increases over a certain amount to offer a choice, policy holders got to choose between stop paying their premium and keep the benefits equal to the total amount of premiums already paid. The sum of premiums that has already been paid will finance only a small amount of care. If you were unable to pay because of a premium increase, you will not lose all your benefits.

Lower premiums can be negotiated with your company by reducing some of your policy benefits. If you need to lower your premium or you have received a premium increase notice contact your local Health Insurance Counseling and Advocacy Program (HICAP) office.

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Chronic illness and disabilities force people to seek Long Term Care services. Help with daily activities such as eating, bathing, using the bathroom, dressing, moving from bed to chair etc. is termed as long term care. Medicare covers only skilled care and does not pay for help with dailiy activities as it is not skilled care. Help in your own home or in an assisted living centre is not covered by Medicare. Medicaid comes into effect only after all of a person’s assetts, savings and dignity are wiped out.

Long Term Care Insurance pays for expenses resulting from long term care. The need for this kind of care increases with increasing life expectancy. When the last of the baby boomers reach 65 by 2030, 40% of them will live to be 90. 70 percent of people over age 65 will require some kind of help with daily activities at some point in their lives. Any one can have an injury or an accident at anytime and be forced to seek this kind of help.

Working adults between the ages of 18 and 64 form 40% of people receiving assistance with their daily activities. Buying long term care insurance at a young age locks in rates that can not be found as you grow older. You can not buy this kind of insurance only at the time you need it or at a time of crisis.

Many a time children or family would want to help. But most always children will have their young family to take care of or can not quit their jobs to help care for their parents. The financial freedom to choose the kind of services you want and where you want to receive it comes with maximum coverage long term care insurance.

Many desire to leave their life savings to their family instead of spending it on hospital and nursing home bills. Long Term Care Insurance not only protects your assets but should you overcome the need for help with daily living activities you will still have your savings to enjoy when you recover.

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