|
|
 |
 |
 |
 |
 |
 |
 |
|
 |
|||||
|
INSURANCE > LONG TERM CARE FAQ FREQUENTLY ASKED QUESTIONS What is Long Term Care? What are considered "Activities of Daily Life (ADL)?" What are the differences between Custodial, Intermediate, and Skilled Care? Will Medicare cover me? Who pays? Why buy a Long Term Care policy? Should I buy Long Term Care Insurance? How do I apply for one of the recommended policies? What is Long Term Care? Long Term Care is the kind of help you need if you are unable to care for yourself because of a prolonged illness or disability. It can range from help with "Activities of Daily Life" (ADL) to skilled nursing care in a nursing home. Long Term Care is provided by home care agencies, senior centers, adult day care centers, traditional nursing homes, and continuing care retirement communities. Family members often provide long term care as well. What are the differences between Custodial, Intermediate, and Skilled Care? Custodial Care is where 95% of us will go when we are somewhat ambulatory, but not fully able to care for ourselves. Intermediate Care is where 4.5% of us will go as our condition worsens. Skilled Care is where .5% of us will go at the end of our life. This is a hospital-like setting. Will Medicare cover me? Not for very long... For those that qualify, Medicare will pay up to 100 days of LTC. The average length of stay in 1996 was 27 days. Besides, do you want to rely on the government? Remember that Medicare covers the full amount for only the first 20 days. After that, you pay the first $81.50 per day. Who pays? More than half of all nursing home expenses are paid out-of-pocket by individuals and their families, and somewhat less than half are paid by state Medicaid programs. Neither Medicare, Medicare supplement insurance, nor the health insurance provided by your employer will pay for most long term care expenses. Medicare will cover the cost of some skilled nursing care in approved nursing homes or in your home, but only in certain situations. Medicare does not cover custodial or intermediate care or prolonged home health care. Medicare supplement insurance is private insurance designed to help pay for some of the gaps in Medicare coverage, such as hospital deductibles and excess physician's charges. These policies do not cover long term care expenses. However, of the standardized Medicare supplement policies, plans D, G, I, and J do contain an at-home recovery benefit that may pay up to $2,000 per year for short-term at-home assistance with activities of daily living for those recovering from an illness, injury or surgery. Medicaid pays for early half of all nursing home care. To receive Medicaid assistance, you must meet Federal poverty guidelines for income and assets and may have to "spend down" or use up most of your assets on health care. (Some assets, such as your home, are not counted when determining Medicaid eligibility.) When you have spent down your assets, you will then be eligible for Medicaid. Many people who begin paying for nursing home care out of their own pocket spend down their financial resources until they become eligible for Medicaid. They then turn to Medicaid to pay part or all of their nursing home expenses. State laws differ about how much money and how many assets you are allowed to keep once you become eligible for Medicaid. Contact your state Medicaid Office, Office On Aging, State Department of Social Services or local Social Security Office to learn about the rules in your state. Increasingly, insurance policies are used to pay for long term care. Why buy a Long Term Care policy? People with significant assets may wish to buy a Long Term Care policy if they want to save these assets for family members. Many people buy a Long Term Care policy because they want to maintain their independence and not burden their children with nursing home bills. Long Term Care can be expensive, depending on the amount and type of care needed and on the setting in which it is provided. In 1996, the cost of a year in a nursing home averaged about $40,000. If you received skilled nursing care in your home and were visited by a nurse three times a week for about two hours per visit for the entire year, the bill would have come to about $17,000. If you received personal care in your home from a home health aide three times a week for a year, with each visit lasting about two hours, the bill would have amounted to about $12,200. Should I buy Long Term Care Insurance? For some, a long term care policy is an attractive and affordable form of insurance. For others, the cost is too great and the benefits they can afford are insufficient. The need for long term care can arise gradually as a person needs more and more assistance with activities of daily living, such as walking and dressing. Or the need can surface suddenly following a major illness, such as a stroke or a heart attack. It is difficult to predict who will need long term care, but there are studies that help shed some light on the likelihood of needing such care. For example, one national study projects that some 50% of those who turned age 65 in 1996 will enter a nursing home at some time during their life. Whether you should buy a policy will depend on your age, health status, overall retirement objectives, and income. Keep in mind, in order to qualify for Long Term Care Insurance you must be in reasonably good health. An automobile insurance company will not insure your car after you have wrapped it around a tree, you cannot qualify for long term care coverage as you are knocking on the door of the nursing home! |
|
 CERTIFICATES OF INSURANCE If you need a certificate of insurance please contact one of the following: Condominium owners/Homeowners contact our San Diego Office at: Email: certs@havilandinsurance.com Phone: (619) 298-7292 Fax: (619) 298 7866 For all other requests: Email: crs@havilandinsurance.com Fax: (858) 225-0118 QUESTIONS? Toll Free: (800) 466-6902 |
|
|
|
HOME I INSURANCE I LOANS I CLAIMS I CONTACT |
|
|
||
 |
|
|
|
Haviland Insurance · 1155 Camino Del Mar #507, Del Mar, CA 92014 · Phone: 800.466.6902 · Email: csr@havilandinsurance.com Copyright © 2008 Tim Haviland and Haviland Insurance Agency. All rights reserved. |
|