Frequently Asked Questions
What Are The Most Important Planning Documents?
What Should We Share With Our Family/Loved
Ones About Our Long-term Plan?
What Are Some Facts and Figures Associated
With Long-term Health Care?
What is Long-Term Health Care?
Who Needs Long-Term Care?
Will My Health Insurance Pay for Long-Term Care?
Will Medicare Help With The Costs?
Will Medicaid Help With The Costs?
What Are My Options For Funding Long-Term Health
Care Expenses?
If I Am Considering Long-Term Care Insurance
- What Is The Best Time To Buy?
What Are The References For These Facts?
What Are The Most Important Planning
Documents?
Without a doubt the most important planning documents are a will
or trust and the associated directives. It is critical that these
documents give the authority to the family member or other individual
that you select to make health care decisions and handle various
types of business transactions for you if you become disabled or
incapacitated. If you do not have a power of attorney for health
care decisions, you may be subjected to treatments and procedures
you would not have wanted in the event that you are incapacitated
and cannot make these decisions for yourself.
If you do not have a properly executed durable power of attorney,
you may be unable to make or to have your desired agent make business
decisions such as selling property to fund extended health care
services. If you don't have a will, the state will dictate the distribution
of your estate. It does not have to be prohibitively expensive to
prepare these documents, and certain medical conditions can make
it impossible to execute legal documents once a medical diagnosis
has been made.
I WANT TO TAKE ACTION
What Should We Share With Our Family/Loved
Ones About Our Long-term Plan?
It is important to communicate your plan to family and loved ones
to enable them to follow your wishes if you become seriously ill
or pass away. It is especially important to share your plan with
any individuals that you want to act as your agents such as your
executor and powers of attorney. Be sure to address your plans for
financing long-term health care expenses. If you haven't
considered that in your plan, it is important to look at what resources
would be available to liquidate if you needed extended care. If
you are finding it difficult to initiate the discussion we offer
a complimentary one-hour planning analysis at no risk or obligation
and sometimes it helps to enlist the services of a planning professional
who can facilitate the discussion as a "disinterested third
party".
I WANT TO TAKE ACTION
What Are Some Facts and Figures
Associated With Long-term Health Care?
While the general population perceives the risk of needing
long-term care services to be less than 25%, the actual
risk for needing long-term care (either home care or nursing home
care) is greater than 50%.¹
For a couple turning 65, there is a 75% chance that
one of them will need long term care. ²
The average annual cost for nursing home care in Texas
may range from $30,000 to $50,000 per year. Depending on the services
needed and the costs in your area, average daily rates might range
from $90 per day to over $150. As the percentage of older Americans
rises, costs are projected to increase even further! ³
The average annual cost nationally for nursing home
care is about $57,000 or $157 per day for total costs, including
semi-private room and board, drugs and medical supplies.4
A recent study calculated the financial cost to caregivers - over
the course of a lifetime - as follows:5
- $566,000 in lost wages
- $67,000 in lost retirement contributions
- $25,000 in lost Social Security benefits
What Is Long-Term Care?
- Long-term care is the assistance needed to perform normal activities
of daily living (ADLs), such as; bathing, dressing, eating, continence,
toileting, and transferring (from bed to chair, etc.), due to
illness, injury, or cognitive impairment.
- Long-term care is the extended care you would receive at home,
in an assisted living or nursing facility, adult day care center
or hospice program.
Who Needs Long-Term Care?
- All ages need long-term care! 1/3 of the people who have a stroke
every year are under age 65 6
- Few people realize that regular health insurance will not pay
for a 32 year old who winds up in a coma with no progress after
an automobile accident."7
- Over 40% of Americans receiving long-term care are under 65
years old! 7
- 50% of Americans will need some sort of long-term health care,
either home care or institutional care 8
Will My Health Insurance Pay for Long-term
Care?
"…the major medical health insurance you may have at
work usually will not pay for long-term care." 9
Will Medicare Help With the Costs?
- Generally Medicare only covers medically necessary, skilled
care under Part A (Hospital Insurance) and Part B (Medical Insurance).
10
- Together, conventional health insurance and Medicare pay less
than a fourth of the nation's bill for home health care and nursing
home care. . . and mostly for short-term care that lasts less
than three months, not long-term care which can last several years.
11
I Understand Medicare Covers "Skilled Care" - What
Is Considered Skilled Care?
- Skilled care has nothing to do with how sick you are. A person
can be totally paralyzed or in a coma and still not be receiving
skilled care, in which case private insurance will not pay. Skilled
care is care to get you better-IVs, dressing bedsores, providing
physical and speech therapy after a stroke, etc. as long as you
are improving. Once progress stops, the care is "chronic,"
or "maintenance" and is no longer skilled. Daily cleaning
of a colostomy drain or a catheter, or even oxygen or respiratory
therapy needed regularly for an emphysema patient, are examples
of care that is not skilled.11
- Long-term care insurance should cover all levels of care although
some older policies may still have a skilled care requirement.
11
I WOULD LIKE A REVIEW OF MY LONG-TERM
CARE POLICY
Will Medicaid Help With the Costs?
- "You may have to spend down or use up most of your assets
on your health care before Medicaid is able to help." 9
- If you do not have long-term care insurance, you may want to
sit down with our planning professionals to evaluate your plan
and determine whether Medicaid will be an option for you if the
time comes you can not pay for long-term care expenses. Planning
ahead is always better.
I WOULD LIKE A COMPLIMENTARY ONE-HOUR
MEDICAID ANALYSIS
What Are My Options For Funding Long-Term
Health Care Expenses?
- Personal savings. It will probably take 25 years of saving to
provide you with as much coverage as a Long-Term Care insurance
policy. 12
- Assistance from family members or loved ones.
- Spend down to poverty level and apply for Medicaid
- Transfer all or part of the risk to Long-Term Care insurance.
If I Am Considering Long-Term Care
Insurance - What Is The Best Time To Buy?
- Whether you are considering group or individual long-term care
policies-don't wait to purchase a policy. American families desperately
need to prepare today for a long-term care need that could strike
at any time. 11
I WOULD LIKE A QUOTE FOR LONG-TERM CARE
INSURANCE
References
- Who Buys Long-term Care Insurance? Profiles and Innovations
in a Dynamic Market, Health Insurance
Association of American/Life Plans, Inc., p.2, January 2001
- Wall Street Journal, June 2000
- "What Texans Should Know About Long-Term Care Insurance",
TX Dept of Ins., Revised, June 2003
- "2000 Nursing Home Cost Survey", MetLife Mature Market
Institute, Released July 24, 2000
- 1999 Met Life Juggling Act study
- Helping Hands Special Report, Wall Street Journal, October 22,
2001
- Long-Term Care: Your Financial Planning Guide, Phyllis Shelton,
2003
- Cracks in the Nest Egg Special Report, Wall Street Journal,
October 22, 2001
- A Shopper's Guide to Long-Term Care Insurance, National Association
Insurance Commissioners, 1999
- 2002, Guide To Health Insurance for People with Medicare, Centers
for Medicare and Medicaid Svcs.
- Long-Term Care:Your Financial Planning Guide, Phyllis Shelton,
2003
- United Seniors Health Cooperative, 1995
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