It's a fact: people today are living
longer. Although that's good news, the odds of requiring some sort of long-term
care increase as you get older. And as the costs of home care, nursing homes,
and assisted living escalate, you probably wonder how you're ever going to be
able to afford long-term care. One solution that is gaining in popularity is
long-term care insurance (LTCI).
What
is long-term care?
Most people associate long-term care
with the elderly. But it applies to the ongoing care of individuals of all ages
who can no longer independently perform basic activities of daily living
(ADLs)--such as bathing, dressing, or eating--due to an illness, injury, or
cognitive disorder. This care can be provided in a number of settings,
including private homes, assisted-living facilities, adult day-care centers,
hospices, and nursing homes.
Why
you need long-term care insurance (LTCI)
Even though you may never need long-term
care, you'll want to be prepared in case you ever do, because long-term care is
often very expensive. Although Medicaid does cover some of the costs of
long-term care, it has strict financial eligibility requirements--you would
have to exhaust a large portion of your life savings to become eligible for it.
And since HMOs, Medicare, and Medigap don't pay for most long-term care
expenses, you're going to need to find alternative ways to pay for long-term
care. One option you have is to purchase an LTCI policy.
However, LTCI is not for everyone.
Whether or not you should buy it depends on a number of factors, such as your
age and financial circumstances. Consider purchasing an LTCI policy if some or
all of the following apply:
·
You
are between the ages of 40 and 84
·
You
have significant assets that you would like to protect
·
You
can afford to pay the premiums now and in the future
·
You
are in good health and are insurable
How
does LTCI work?
Typically, an LTCI policy works like
this: You pay a premium, and when benefits2 are
triggered, the policy pays a selected dollar amount per day (for a set period
of time) for the type of long-term care outlined in the policy.
Most policies provide that certain
physical and/or mental impairments trigger benefits. The most common method for
determining when benefits are payable is based on your inability to perform
certain activities of daily living (ADLs), such as eating, bathing, dressing,
continence, toileting (moving on and off the toilet), and transferring (moving
in and out of bed). Typically, benefits are payable when you're unable to
perform a certain number of ADLs (e.g., two or three).
Some policies, however, will begin
paying benefits only if your doctor certifies that the care is medically
necessary. Others will also offer benefits for cognitive or mental incapacity,
demonstrated by your inability to pass certain tests.
Comparing
LTCI policies
Before you buy LTCI, it's important to
shop around and compare several policies. Read the Outline of Coverage portion
of each policy carefully, and make sure you understand all of the benefits,
exclusions, and provisions. Once you find a policy you like, be sure to check
insurance company ratings from services such as A. M. Best, Moody's, and
Standard & Poor's to make sure that the company is financially stable.
When comparing policies, you'll want to
pay close attention to these common features and provisions:
·
Elimination
period: The period of time before the insurance policy will begin paying
benefits (typical options range from 20 to 100 days). Also known as the waiting
period.
·
Duration
of benefits: The limitations placed on the benefits you can receive (e.g., a
dollar amount such as $150,000 or a time limit such as two years).
·
Daily
benefit: The amount of coverage you select as your daily benefit (typical
options range from $50 to $350).
·
Optional
inflation rider: Protection against inflation.
·
Range
of care: Coverage for different levels of care (skilled, intermediate, and/or
custodial) in care settings specified in policy (e.g., nursing home, assisted
living facility, at home).
·
Pre-existing
conditions: The waiting period (e.g., six months) imposed before coverage will
go into effect regarding treatment for pre-existing conditions.
·
Other
exclusions: Whether or not certain conditions are covered (e.g., Alzheimer's or
Parkinson's disease).
·
Premium
increases: Whether or not your premiums will increase during the policy period.
·
Guaranteed
renewability: The opportunity for you to renew the policy and maintain your
coverage despite any changes in your health.
·
Grace
period for late payment: The period during which the policy will remain in
effect if you are late paying the premium.
·
Return
of premium: Return of premium or nonforfeiture benefits if you cancel your
policy after paying premiums for a number of years.
·
Prior
hospitalization: Whether or not a hospital stay is required before you can
qualify for LTCI benefits.
When comparing LTCI policies, you may
wish to seek assistance. Consult a financial professional, attorney, or
accountant for more information.
What's
it going to cost?
There's no doubt about it: LTCI is often
expensive. Still, the cost of LTCI depends on many factors, including the type
of policy that you purchase (e.g., size of benefit, length of benefit period,
care options, optional riders). Premium cost is also based in large part on
your age at the time you purchase the policy. The younger you are when you
purchase a policy, the lower your premiums will be.