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 18-85; 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 |
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Qualifying
for Tax Qualified and Non-Tax Qualified LTC Plans
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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