LONG TERM CARE INSURANCE

“Ladies, I’d like to make a motion that we face reality.”

The AARP released findings that show that four out of five of us believe that Medicare will pay for our basic nursing care needs when we get old. This is not true – Medicare pays about 8% of those expenses. The Medicare requirements for benefits to trigger are so rigid & extensive; most people do not qualify and if you do qualify, chances are you qualify for 20 days of coverage. To qualify for Medicaid, you must be almost destitute. If you do qualify for a Medicare or Medicaid bed, you do not get the choice of where you go – you must go to where they send you. You have no choice.

Statistics show that 1 in 3 Americans will need Long Term Care insurance [LTC]. That figure translates into 1 in 2 American women will need it – 50% chance. So this is a type of insurance that is worth looking into and discussing at length.

As Americans and as women, this is what we know…

Today, 22% of Americans are under age 16, 76 million baby boomers were born between 1946 and 1964 and the average life expectancy today is 80+. The 65+ group has grown by 10 times over the last 150 years.

The fastest growing segment of our population is 80+. We will live 1/3 of our life past retirement. (US General Accounting Office). The average age of widowhood in the US is 56 and 90% of women will be responsible for their care either by choice, divorce or widowhood. There has been a shift in economic and political power from young to old because we refuse to act old, we value our independence and we have more disposable income than at any time in history.

So we are older, we live longer, as women, we live longer alone and we are helping change the world. We don’t want to be victims anymore.

Now for some statistics: Nursing home costs range from $90 to $200+ per day, $30,000 to $70,000 annually; $50,000 per year is the average. The average stay in a nursing home is 3 years and 70% of homecare consumers are women.

Our risk as women: Women are 60% of the population over 65. If we live to be 65, odds are we will live another 19 years and if we make it to 84 odds are we’ll make it to 91. 60% of women over 65 are not married (only 25% of men over 65 are not married) and women are 150% more likely to enter a nursing home than a man.

70% of us baby boomer women are what’s referred to as the “sandwich” generation – taking care of parents and kids at the same time. Research shows that we will spend 17 years raising children & 18 years caring for parents (AARP & Public Policy Institute). It also shows that a married couple is more likely to spend more years caring for an elderly parent than raising their own child (The National Center for Women & Retirement Research) and that 40% of working caregivers lose promotions, pay raises or training opportunities due to caring for a family member (U. S. Department of Labor).

So take a close look at this insurance and here are some things to consider when looking at LTC insurance. Do you have assets to cover long term care expenses? How is your health? What is your family history? Who would/could help take care of you?

What to look for in a LTC policy:

  • Daily Benefit – how much the policly will pay per day when you need it.
  • Inflation Protection [especially if you buy it when you are relatively young]
  • Home Health Care provision should be 100%
  • Benefit Period – how long will the policy pay you benefits for?
  • Elimination Period – how long do you have to wait before the benefits begin?
  • Premium waiver – is the premium waived while you are receiving benefits?

All these are variables that directly affect the bottom line – they affect how much the premium is [how much it costs].

Benefits are triggered by the inability to perform two of the six ADL’s [Activities of Daily Living]:
1. Bathing
2. Continence
3. Dressing
4. Eating
5. Toileting
6. Transferring [mobility]

The decision of whether benefits are triggered should be made by your doctors, not the insurance company’s doctors. Check also what benefits are payable if you remain home, or if you go to an Adult Day Care Center, an Adult Family Home, a Nursing Home or an Assisted Living Facility.

Be careful whom you buy from. If you buy the policy today (say you are 50) but you do not need the benefits until you’re 80, you want to be sure that the Company you have chosen to do business with is still around and financially strong, 30 years from now. Be very picky and do the footwork and find a competent agent to help you make the right choices.