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Don't let your LTCi be a disappointment
"I have $100 a day for life," Gloria, one of my clients,
complained. "Why do they only give Carolyn $25.00 a day?"
Gloria owns several policies
with my company. However, her LTCi, which she is currently using,
is with a different company. Carolyn, her home health aid, receives
limited pay because Gloria's policy includes only 50% home care.
While Gloria would receive $100 a day indefinitely in a nursing
home, she can only get $50.00 a day for home-care. Furthermore,
since Carolyn does not work through an agency, she is considered
"non-professional" and will be paid no more than $5.00
an hour. To make matters worse, Gloria is still paying her full
monthly premium because her policy does not include a waiver
of premium unless she is in a nursing home! This situation could
have been avoided.
Take action to protect your
interests
Long Term Care insurance, a type of protection that pays the
bills when a person needs extended care either at home or in
a nursing home, should be part of senior planning for every adult
who owns property, investments or savings–or who simply
wants to protect freedom of choice, independence, and family
harmony. Nevertheless, 65% of adults over 40 admit to having
made no plans for long term care for either themselves or a spouse,
according to Genworth Financial. |
LTC Insurance: Compare the top companies, and
get the best quote for your needs.
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Put the excuses on the table
The first excuse for putting off the purchase of LTCi is money,
but the real reasons are usually a matter of denial–you
don’t really believe you will ever need it–and confusion
over the mountain of information. Numerous companies offer LTCi
insurance, and while the policies are similar, the language can
vary significantly from one company to another. Make one inquiry,
and multiple packets crammed with information will soon fill
your mail box. You don't know what to do, so you do nothing.
LTCi: Basic coverage and features
Fortunately, understanding LTCi is not as difficult as it seems.
However, it is not a one-size-fits-all program, so doing it on
your own or over the phone is not a good idea.
Basic coverage
All LTCi begins with the basic coverage–a maximum dollar
amount per day multiplied by the number of days of coverage.
The actual premium is then based on your age. For example, a
three year, $100 per day benefit would give you 1095 days times
$100, or a "pot of money" of $109,500 to spend. Even
though most nursing homes charge more than $100 a day, your pot
will last at least three years because you can't spend more than
$100 per day. Once the company has paid $109,500, your policy
is exhausted, and you will have to pay for additional care yourself.
The other part of your basic
coverage is the elimination period, a deductible consisting of
a set number of days that you must pay for care before your policy
will start paying. Some companies go strictly by the calendar,
others go by the actual days you received care. A longer elimination
period reduces your premium.
Feature 1: Home care
Features are benefits included with no extra cost. For example,
most companies can offer a choice of whether you want to include
care in your home. It may be included at a slightly higher premium,
or it could be a rider, depending on the company. You can also
choose 50% or 100% home care. If you choose 100%, you can spend
your maximum of $100 per day for care in your home. Furthermore,
while nursing home care has to be calculated on a daily basis,
most companies calculate home care by the month. You could thus
spend $50 one day and $200 another day, so long as you do not
go over $3100 per month (in our $100 per day example).
Feature 2: Waiver of premium
and discounts
Most companies will waive your premium when you have to start
using your coverage. Some waive the premium from day one while
others require you to be on claim for at least 90 days first.
If you should get well and go off of claim, your premium would
resume. Some companies waive the premium for both spouses if
just one goes on claim. However, nearly all companies give a
discount if husband and wife are on the same policy.
Feature 3: Restoration of
Benefits
The best companies include a restoration of benefits feature,
meaning that if you only need care for a few months and are able
to go off of claim, your entire pot of money is "restored,"
giving you the full policy to use again when you need it. However,
the pot can only be refilled if it has something left in it–even
as little as $50.00.
Feature 4: Home modification
Many companies will pay several times your monthly benefit to
modify your home with things like wheel chair ramps, widening
of bathroom doors, or rails in the bathtub or around the commode.
Feature 5: Caregiver training
Do you have a family member who is able and willing to participate
in your care? Some companies will pay several times your daily
benefit to train that person who will then take care of you at
their own expense, making your policy benefit last much longer.
Feature 6: Respite care
Respite care is simply a vacation for a family member who has
agreed to help take care of you. For a certain number of days
each year, a company will put you in a nursing home or find someone
else to take care of you, and the company will foot the bill
up to your maximum daily benefit.
Feature 7: Equipment rental
Equipment rental is simply the rental of hospital equipment–such
as a hospital bed–usually up to the purchase price of the
equipment.
Feature 8: Adult day care
The better companies include adult day care where you can get
therapy and interact with other seniors. Usually transportation,
meals, therapy, and help with activities of daily living are
included.
Feature 9: Prescription drugs
The inclusion of prescription drugs–of the type given in
a nursing home or hospital–is a very important feature,
but many companies only include drugs with a rider. Ask about
it.
Feature 10: Room reservation
What if you get sick while you are in the nursing home and have
to go to the hospital? The room reservation feature reserves
your bed for a certain number of days each year.
Feature 11: Hospice and ambulance
Medicare pays for the nursing needed during hospice as well as
for a certain number of ambulance trips per year. However, most
LTCi policies offer some additional ambulance dollars as well
as the home health aid and domestic services if you are on hospice.
Feature 12: Patient Care Coordinator
Companies have different names for this, and many don't offer
it at all. A patient care coordinator is a person who will work
with you to find the agencies in your area. The person will find
out what the agencies charge, and will help you choose the appropriate
agencies to meet your need. The coordinator can also help you
file claims by explaining how to correctly complete the paper
work.
Remember, features of a policy
are included without extra charge. It's worth paying a bit more
for a policy that includes a lot of features rather than buying
something cheap only to find out that benefits you would have
liked aren't included.
about the author:
Gary Stuart learned quickly that long term care insurance is
as much about education as it is about selling. People need to
understand what they are buying, why they need it—or don't
need it—and what it will do for them and their family. Every
family's needs are different, there is no such thing as one size
fits all either in LTC insurance or in educating people about
this relatively new kind of insurance. http://www.1sthealthinsurancequotes.com |
