WHAT IS LONG-TERM CARE?

Long Term Care (LTC) is different from medical care.  Typically, it is not provided by doctors and is not designed to cure you of an illness.  Instead it refers to a wide range of supportive personal and social services needed by people who are unable to care for themselves for an extended period of time. This may be caused by accident, illness or frailty. It is the kind of help you need when you are not able to perform activities of daily living such as eating, bathing and dressing yourself, or because of cognitive impairment.  Care may be needed to help with household cleaning, preparing meals, shopping, paying bills, or taking medications.

Long-term care requires a healthy person to provide support for the disabled person. This support can be offered at home or in an institution. As a rule, those who cannot fully care for themselves prefer to stay at home. Most of the time, so-called informal care givers (family and friends) prefer the home for their loved one as well. The deciding factor of where to receive help ultimately centers on the nature of the care needed.

WHERE CAN I RECEIVE CARE?

Most policies today are comprehensive in nature. This means they cover approved care in the following places:

  1. • Home Care
  2. • Assisted Living Facility
  3. • Adult Day Health Care
  4. • Nursing Home Care
 

Who can provide the care can differ from policy to policy. All policies allow for care to be received through a licensed agency or facility. Some allow for care to be provided through a private licensed or certified caregiver, while others will allow family members to provide care. It’s important to know who can provide care when needed.

DOES MEDICARE PROVIDE LONG-TERM CARE?

No it does not and may be the most misunderstood subject in Medicare benefits. What Medicare provides is up to 100 days for Skilled Care following a 3-day hospital stay. This is considered short-term care. Coverage is only covered in full for the first 20-days. After that, there are co-pays that must be paid. A Medicare Supplement or Medicare Advantage plan will typically cover these co-pays. Be sure to check your policy.

WHY CONSIDER THIS COVERAGE?

The nature of long-term care in our society is changing. Medical science is keeping us alive longer and there are fewer early sudden deaths. Fewer deaths mean more prolonged health problems requiring long-term care. In addition the population of those over age 65 is increasing while the younger population is stagnating. This trend will continue to put pressure on aging services including long term care. But, that's not all.

Care traditionally provided by government agencies is diminishing as well. An aging population over the next 20 years will cause a huge drain on state Medicaid programs and Congress is sending a clear message it has no intent to create a new government-sponsored, long-term care entitlement program. Government programs like Medicaid cannot continue to spend at current levels and remaining self-insured is costly should you need care. 

With a little planning, you can buy long-term care insurance for yourself or as a gift for now-healthy parents. Although this is a product that catches the attention of seniors, the ideal time to buy it is actually when you are young and in good health. This is the time when premiums are lower and you’re less likely to have a pre-existing condition that prevents you from having coverage.

Many people consider purchasing a policy for the reasons below:
  1. •To avoid being a burden on family members
  2. •To preserve independence by using their policy to stay home as long as possible
  3. •To preserve freedom of choice in choosing where to receive care
  4. •To protect assets, keeping their estate intact for their spouse or children
  5. •To avoid welfare – Medicaid provides care once your estate has been spent down

WHAT DOES A POLICY COST?

Policies vary in cost so it is best to contact me to provide you with more specific information. Below are some policy features which will determine final cost:

Elimination Period: Think of this like a deductible. It is the number of days you pay for your own care, once you qualify to be on claim. The elimination period can be 0 days clear up to 365 days or longer. Most clients choose 0 days, 30-days, 60-days or 90-days. The more days you are willing to pay for your own care, the lower your premium will be.

Monthly Benefit Amount: This is the amount you want your insurance policy to pay for care if you have to file a claim. The higher this amount, the higher your premium will be. Most people choose to have a policy pay for a large portion of their care, and plan to use personal assets only if needed.

Benefit Duration: This is how long the policy will pay for your care once you are on claim. Most policies will cover a year to 5 or 6 years of care. Again, the length of time your policy covers you while on claim will affect the premium.

Inflation Protection: This is a “must have” feature for long-term care policy owners. It is a rider that inflates the amount of coverage you have annually. This keeps the benefit amount in your policy up to date with increasing costs of care. Policies have really become more flexible in this area, allowing inflation protection options that help your policy keep pace with inflation, while keeping premium more affordable.

Other Optional Riders: Depending on the insurance company, many policies offer other various riders. These do affect the cost of the coverage and should be discussed.

HOW DO I GO ON CLAIM?

Policies sold today are tax-qualified policies. This means that government standardized the “triggers” for qualifying to go on claim.

You must lose the ability to perform at least 2 out of 6 activities of daily living, with confirmation by your doctor that he or she thinks the need for care will last at least 90 days or if you are diagnosed with a cognitive impairment. The activities of daily living are: Bathing, dressing, eating, toileting, transferring, and continence.

I am committed to helping my clients through the claims process. It can be overwhelming for family members who are helping. I will walk with you and your family during this process to be sure you understand your policy and the claims process.

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Coverage

LONG-TERM CARE

Long Term Care (LTC) is different from medical care. It refers to a wide range of supportive personal and social services needed by people who are unable to care for themselves for an extended period of time. This may be caused by accident, illness or frailty.

Medicare Supplement

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and those with End-Stage Renal Disease. Medicare covers many health care services and supplies, but there are many "gaps" it doesn't cover

 

Contact

1127 W. 18th Avenue
Spokane, WA 99203
mail
danaengdahl@gmail.com