Long-Term Care Insurance – can be expensive and confusing, hopefully this will make it a little easier to understand.
Someone with a physical illness, a disability or cognitive impairment (such as Alzheimer’s disease) often needs long-term care. Long-term care generally helps you live as you are instead of improving or correcting medical problems.
If you have a major illness or injury, such as a stroke, heart attack or broken hip and need assistance with daily living, such as bathing or dressing. You may need a nursing home or home care for a short time or you may need these services for several months, years or the rest of your life. It’s hard to know if you will need long-term care.
Depending on the policy options you select, long-term care insurance can help you pay for the care you need, whether you are living at home, in an assisted living facility, nursing home or hospice facility. The insurance might also pay expenses for home care or adult day care. Some policies will even help pay costs associated with modifying your home so you can keep living in it safely.
When you decide to shop for long-term care insurance seek out an independent agent who sells policies from multiple companies rather than a single insurer, making it easier to compare companies. Be sure the person you are working with has had additional training in long-term care insurance and check with Pennsylvania’s Insurance Department (www.insurance.pa.gov) or you can contact the Consumer Service Bureau toll-free at 1-877-881-6388 to confirm that the person is licensed to sell insurance in Pennsylvania.
Factors to consider:
Policies cost less if purchased when you’re younger and in good health.
Premiums often increase over time and your income may decrease. If you find yourself unable to afford the premiums, you could lose all the money you’ve invested in a policy. Premiums vary based on a variety of factors. These factors include your age, health when you buy a policy and the level of coverage, benefits, and options you choose.
A rule of thumb is that you may not be able to afford the policy if the premiums will be more than 7% of your income.
Most policies limit the total benefit they’ll pay over the life of the policy. Some policies state the maximum benefit limit in years while others may write the policy benefit limit in dollar amounts. Policies normally pay benefits by the day, week, or month.
When you buy a policy, insurance companies let you choose a benefit amount. It’s important to know how much-skilled nursing homes, assisted living facilities and home health care agencies charge for their services before you choose the benefit amounts in your policy.
“Benefit triggers” is the term usually used to describe the way insurance companies decide when to pay benefits. Benefit triggers are an important part of long-term care insurance policies. Look for a section called “Eligibility for the Payment of Benefits” or simply “Eligibility for Benefits” in the policy and outline of coverage.
Typically, a policy pays benefits when you can’t do a certain number of the ADL’s (bathing, dressing, toileting, eating, transferring and continence), such as two or three of the six. Some policies say that you must need someone to actually help you do the activities others may say you qualify if you only need someone nearby to help you if you need it. Some long-term care policies pay benefits only if your doctor orders or certifies that the care is medically necessary.
How many days you have to wait for benefits to start will depend on the “Elimination Period” (waiting period). During an elimination period, the policy won’t pay the cost of long-term care services you receive, it can be 20 days or up to 100 days after you start using long-term care or become disabled. You also might be able to choose a policy with a zero-day elimination period but expect it to cost more.
You can probably choose other policy features, but some insurers don’t offer all of them. Each may increase your policy’s cost:
Waiver of premium lets you stop paying the premium once you’re eligible and the insurance company starts to pay benefits.
Premium refund at death. This benefit pays to your estate any premiums you paid minus any benefits the company paid.
Downgrades – Some insurers will let you reduce your coverage if you have trouble paying the premium.
The “Free Look Period” allows a window of time to make sure the policy is right for you without the pressure of an insurance agent. If you decide to cancel within 30 days you most likely will be reimbursed for premiums you paid during the application process. During the free look period:
Review the policy in detail.
Be sure you understand how much coverage you’ll have and how the policy will cover the service you will receive.
Consider your financial situation.
Reach out to your insurance agent with any questions or if you decide to cancel the policy.
Clothesline of Love - will be hanging in front of Trinity with colorful hats, gloves and scarves generously donated by our parishioners to offer warmth to those needing them. Donations of new or gently used items will be appreciated.
CPR class will be held at Trinity on Saturday, January 12, 2019 at 9:00 AM.
For more information about Clothesline of Love or CPR call Kathy Burda at 570-621-3220.