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What is Long Term Care
Insurance? A long physical illness, a disability, or a cognitive impairment that requires skilled
care, intermediate care or custodial care which requires help with activities of daily living, that are provided in the home,
assisted living facilities, nursing homes and adult day care centers. Long Term Care Insurance is designed to
pay for costs associated with skilled care, intermediate care and custodial care for individuals in the home, assisted living
facilities, nursing homes and adult day care centers.
| Eligibility
Requirements Applicants age 18-99; No evidence of any cognitive impairment (Memory, Orientation,
Reasoning); Must be able to independently perform all activities of daily living; instrumental activities of daily living
and meet medical underwriting requirements.
Activities of Daily Living Bathing,
dressing, toileting, eating, transferring and continence.
Instrumental Activities
of Daily Living Using the telephone, doing laundry,taking medication, managing finances, shopping,
housework, and meal preparation.
Uninsurable Conditions AIDS
or AIDS related complex, alzheimer’s disease, chronic memory loss, dementia, senility, organic brain syndrome Systemic
lupus, cirrhosis of the liver, amputation due to disease parkinson’s disease, multiple sclerosis, muscular dystrophy,
amyotrophic lateral sclerosis (ALS) metastatic cancer, receiving Medicaid, or within the past 12 months have received home
health care; used an adult day care facility, been confined or advised to enter a nursing home, assisted living facility,
or any other similar facility.
An individual cannot be bedridden, have paraplegia or use of a wheelchair, walker,
multi-pronged cane, electric stair lift, motorized cart or hospital bed. Currently receiving physical therapy or rehabilitation
services Use of medical appliances such as as catheter, oxygen equipment, respirator, a dialysis machine or any other assistive
medical device.
Medical Underwriting In addition,
medical underwriting departments take the following into consideration when reviewing applications for LTC insurance:
Your Family Health History; Your Individual Health History; Whether you have been previously declined for LTC?; Had tests,
x-rays or diagnostic studies for which a diagnosis has not yet been made? On a LTC application you must list all conditions
in the past 5 years that you have been treated for and list all medications currently being taken. Your height and weight
must be within build scale requirements.
| Qualifying
for Long Term Care Insurance Benefits
Tax Qualified Plans Certification by a licensed health care practitioner that you are chronically ill and unable to perform two of six
activities of daily living for an anticipated duration of 90 days; or Supervision to protect yourself from threats to your
health and safety due to serve cognitive impairment.
Non-Tax Qualified Plans Inability to perform two of the six activities of daily living; or Cognitive impairment; or Medical necessity, as determined
by a physician (nursing home care only).
| Reasons
why people buy Long Term Care Insurance policies Maintain and control independence in their lives. Avoid being a burden to their families. Gain access to quality long term care facilities. Protect their assest
from depletion. Avoid having to go on welfare. Achieve and sustain peace of mind.
Application
Timeline To apply for a LTC insurance plan you must submit an application with an initial premium,
usually a minimum of two months. It takes 6-8 weeks for medical underwriting to be completed. This will include a review of
your medical records, a telephone and/or personal interview and para-med examination. A decision will than be made by the
insurance carrier to accept or decline your application. If your application is approved you will have 30-days to decide if
you want to keep the policy or make any changes.
| Plan Design To design and price a Long Term Care insurance plan the following must be determined.
Determine the
Applicants Risk Factor
Select a Daily
Benefit between $50 and $500 in $10 increments.
Select an Elimination
Period of 0, 20, 60, 90, 100, 180 or 365 days.
Select an Inflation
Factor - No Interest, Simple, Compounded or Guaranteed Purchase
Select a Benefit
Period - 2, 3, 4, 5, 6, 10 year or Lifetime. Insurance carriers include: Allianz, Genworth, John Hancock,
Med America and Met Life.
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If you have questions regarding Long
Term Care Insurance or would like to get a quote call (520) 575-8387
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