Home Health & Long Term Care Insurance

Long Term Care Insurance  pays for help both in your home and nursing home, when you  can no longer care for yourself, that is you are not able to fully do 2 or more of seven Activities of daily living” which include eating, bathing, dressing, ambulating, transferring, toileting, and continence.  

The money from your policy are not taxable as income and the premium can be deductible.   

What are your Costs of Long Term Care and chances of needing Long Term Care?

Medicare does NOT pay for Long Term Care.   Medicare may pay for 90 days in a nursing home after 3 days in a hospital.  Click here for our Medicare Webpage on Skilled Nursing  to learn more above coverage in skilled nursing, when you need medical care and not just maintenance,  7 activities of daily living

More…

Long Term Care includes a wide range of mostly non-medical services that are designed to help people maintain the maximum level of independence.  Care can be custodial, intermediate or skilled in nature and can be provided in the home, (most claims are for in home care) community or institutional setting. Long term care can be provided in a formal (nursing home) or informal manner (home care, family & friends).

The Three main types of coverage are:

  • nursing facility,
  • home care  – here’s what Medicare covers publication # 10969 32 Pages
  • comprehensive, which includes both nursing and home care coverage. BJFIM.com

Might COVID 19 Raise Costs?

 

Insurance Journal.com 8.3.2020  

Questions to ask yourself to figure out what you might need?

 

Financial Resources Questionnaire

to get the right coverage for your situation

Cut & Paste these questions into an email and send to us at [email protected]

1. Seven percent of my annual income is approximately $_______________.  (This is the maximum amount of annual income experts advise spending  on a premium.)

2. The cash value of my non-housing assets* is $____________.  (This is the amount you would otherwise have to spend for long-term care.)

3. My non-housing assets would last _____________ years if I needed care today.  (This is the approximate number of years of coverage you might consider buying.)

4. I can afford to pay $____________ a day towards the cost of my own care.  The difference between the amount I can afford and the cost of care today is $_________. (This is the approximate amount of daily benefit you will need.)

5. I can afford to pay a total of $____________ for the first days of care in a nursing home. Therefore, I will need a waiting period no longer than:

30 days $__________ 60 days $__________ 90 days $____________.

(To determine the amount you would pay, multiply the daily nursing home cost times the number of days in the waiting period.) Copied from Taking Care of Tomorrow *

The California Partnership for Long-Term Care

 

The California Partnership for Long-Term Care (Partnership) is dedicated to educating Californians on the need to plan ahead for their future long-term care and to consider private insurance as a vehicle to fund that care. The California Partnership for Long-Term Care is an innovative program of the State of California, Department of Health Care Services in cooperation with a select number of private insurance companies. These companies have agreed to offer high quality policies that must meet stringent requirements set by the Partnership and the State of California. These special policies are commonly called “Partnership policies”. Partnership policies take the guesswork out of ensuring you purchased a quality policy. In addition to many other consumer protection features, Partnership policies offer the special benefit of Medi-Cal Asset Protection.

 

WHAT’S NEW!

 

The Partnership has launched www.RUReadyCA.org an independent, easy-to-use website that offers a host of tools, information and calculators to help each Californian plan for their individually unique long-term care needs. ​​​​​​​​​​​​

Learn more about the California Partnership for Long-Term Care on Facebook

Miscellaneous Information

Children can pay the premium on their parents policy.

Double check that your Long Term Carrier remains solvent and can hold their prices & promises  Cal Broker Magazine *

Husband & Wife Planning – 2 page brochure

Benefits are generally income tax free, see the Taking Care of Tomorrow brochure for more details.

Premium Tax deduction if medical expenses exceed 10% or 7.5%  if over 65 Mutual of Omaha 

If your employer pays, it’s no income to you and the employer gets a deduction.

Medi-cal (Medicaid)  Welfare, might pay, however if you have $$$ or Property, they might put a lien on your home.

The average cost for a private room in a nursing home in Los Angeles is $175/day.  Average hourly home heath care is

$15.

Genworth Calculator

Please email us [email protected] for more details.

 

FAQ’s
More and ask your own question 

 

Can I be denied because of genetic testing?

No.

The Genetic Information Nondiscrimination Act of 2008 (Pub.L. 110–233, 122 Stat. 881, prohibits the use of genetic information in health insurance and employment. The Act prohibits group health plans and health insurers from denying coverage to a healthy individual or charging that person higher premiums based solely on a genetic predisposition to developing a disease in the future. The legislation also bars employers from using individuals’ genetic information when making hiringfiring, job placement, or promotion decisions.[1] The Act contains amendments to the Employee Retirement Income Security Act of 1974[3] and the Internal Revenue Code of 1986.[4]

CA Law – genomics law report.com * SB 559 – 2011 Padilla

1 in 2: Needing long term care

Almost 70% of those over age 65 will require some form of long term care during their lives.

Source: 2015 Medicare & You, page 63 Center for Medicare & Medicaid Services

The odds of winning the PowerBall jackpot are 1 in 292 Million. 

1 in 20,000,000: Dying in a terrorist attack  

1 in 3,748,067: Dying from a shark attack

1 in 3,000: Having a residential fire

1 in 84: Being in a car accident

Medicare & Home Health Care # 10969

Medicare & Home Health CareCheck out

TRUE FREEDOM - Home Health Care 

No health questions asked

Video on Home Health Care

Video Medicare & Home Health Care

Baby Boomers - Long Term Care Costs are Rising

baby boomers long term costs are rising

Smartphone?

Try turning it sideways to read pdfs and screen shots better

#Low Budget – Premium Resistance –
Can’t Qualify Health Issues?

Questions to ask yourself to figure out what you might need?

 

Other Options & Ideas?

Medi-Cal  Medicaid

Social Security or Pension

IRA

Veteran’s Aid & Attendance

Forgotten Assets & Life Policies Sell home or Reverse Mortgage Charity – Faith Community Low amount of Long Term Care to fill gaps

Medicare.Gov other long term care choices

 

Bibliography

next avenue.org/pay-long-term-care-without-long-term-care-insurance/

can-self-insure-long-term-care/

nia.nih.gov/paying-care pbs.org/paying-long-term-care

Rob Lowe - Maria Shriver Video

Rob Low - Maria Shriver  video  long term care

Long Term Care 101
Video

long term care 101

Suze Orman – Long Term Care
Video

Suze Orman on Long Term Care coverage   video

How much does Long Term Care Run?

•The median cost of a private room in a nursing home is about $104,000 in California,

•The median cost of a semi-private room in a nursing home is about $86,800 in California,

•The median cost of a single-occupancy room in an assisted living facility is $45,000 in California,

•Adult day health care, with a median cost of $76 per hour in California,

Homemakers services, with a median cost of $22 per hour in California,

•Home health aide services, with a median cost of $23 per hour in California, the median annual cost of a private or semi-private room in a nursing home in Sacramento is about $116,000 and $92,500, respectively

Cost of Care Tool – Nationwide – Genworth
Cost of Care Tool - Nationwide - Genworth

 

Genworth Cost of Long Term Care – Survey
Genworth Cost of Long Term Care - Survey

Pages on our website related to topics mentioned in Taking Care of Tomorrow

preventative-care Medicare Wellness Check Up Advance Directives 

20 comments on “Long Term Care Nursing & Home Health Care

  1. I was recently talking to friend who said that her mom had paid for years & when it came time to use policy, the Insurance company REQUIRED THAT she PROVE INCAPACITY for ONE YEAR, before payment started.

    But by then she was dead.

    • The proposal we showed you has a 90 day wait for reimbursement. Cash benefits don’t have a waiting period. If you want a lower premium, you can have a longer wait.

      Calendar Day Elimination Period –

      Your policy has a waiting period before policy benefits begin. The elimination period starts on the first day you are chronically ill and you receive a covered service. Once the elimination period has been satisfied, benefits for covered services are paid to you each month, up to the maximum monthly benefit you select. Your options include:

      90, 180 or 365 calendar days

      On LTC policies, you only have to show you can’t do two of these 7 things (Activities of Daily Living). https://life.healthreformquotes.com/ltc/adl/

      What Is Long-Term Care?

      Long-term care is the kind of personal care needed for tasks like bathing, dressing, eating, continence, toileting, and transferring (getting in or out of a bed or chair). These six basic needs are commonly referred to as Activities of Daily Living or ADLs. You might need help with one or more of these tasks because of a chronic medical or physical condition, or for an injury like Martha had. Frequently, people with Alzheimer’s disease or other dementias, also referred to as a cognitive impairment, need ongoing supervision. People who can no longer drive, manage their medications, or their finances need help with these tasks, which are referred to as Instrumental Activities of Daily Living or IADLs. These needs often occur first, before someone needs formal long-term care services.

      Long-term care covers a broad range of needs and related services people receive in several
      types of places. Services may include care at home or in a community program like adult day care, as well as care in an Assisted Living Facility (also known as a Residential Care Facility) or in a nursing home (also known as a Skilled Nursing Facility). Because long-term care is provided through a wide variety of services, it is also known as long-term services and supports, or LTSS. Taking Care of Tomorrow

      Benefit Eligibility Triggers

      Eligibility for accessing the benefits of a longterm care insurance policy depends on your inability to perform two “activities of daily living” (ADLs) out of a list of six, or when your cognitive ability is impaired. These are referred to as “benefit eligibility triggers.”

      To be eligible for benefits you generally have to meet one of the two benefit eligibility triggers listed below. In addition, your doctor or other health care professional must draw up a Plan of Care, and certify that you are expected to need care for 90 days or more.

      ADL’s – See above

      Impairment of Cognitive Ability This is another benefit eligibility trigger that causes a person to need substantial supervision because of a severe cognitive impairment. People with Alzheimer’s disease or other types of dementia often need substantial supervision to protect themselves or others around them. Taking Care of Tomorrow

      View the actual State of CA law on Long Term Care https://life.healthreformquotes.com/ltc/adl/ca-law/

    1. Anonymous says:
      What are some of the Long Term Care facilities in my area and how much to they cost? 

    2. Anonymous says:
      What does tax qualified mean? 

    3. Anonymous says:
      If I were to find an inexpensive Nursing Home that only charged say $3k/month, would able to get the benefit until the claim reached $216k or would it end at 3 years? 

    • You’re 64 years old, right?

      Did you know that Medicare doesn’t cover Long Term Care? https://www.medicare.gov/coverage/long-term-care

      Did you come to my website to just find the cheapest price for ObamaCare or for someone that can help you plan and review all the financial risks that might cause problems in your life?

      Do you really want to have to rely on Medi-Cal, if you need Long Term Care?

      Did you read the actual brochure, besides my video introduction?

      Here’s some graphic highlights from the Government Brochure.

      In the next 10 years you’re looking at say a 1 in 20 chance that you won’t be able to do all the ADL’s Normal Activities of Daily Living https://life.healthreformquotes.com/ltc/adl/

      percent by age of people in nursing homes

      Almost 20% of people in nursing homes are within 10 years of your age
      percent by age in nursing homes

      Even if you don’t buy Long Term Care – don’t you think it would be wise to read the pamphlet and do what planning you can?

    • Here’s a short term highly liquid MYGA Multi Year Guaranteed Annuity for those who prefer to pay out of pocket instead of going with a lifetime income solution to pay for care at point of need. For someone already diagnosed as impaired a pre-planning solution like the FG isn’t an option really, so I thought you may like to see this.

      It has an optional ROP rider, pays full account value at death, and has a 15% annual penalty free withdrawal available yr one. So, as an alternative to a bank account this is much more attractive as they client can get more interest on their funds while maintaining a high level of access and an exit strategy via the ROP feature. We would typically make the impaired the annuitant so at their death, the funds are 100% payable to the bene including interest.
      Preferred Series Annuity (Principal) – This is a super liquid fixed rate deferred annuity for those who opt to continue taking regular withdrawals from a lump sum they have set aside to pay for care)

      I’ve also included links to other solutions for your convenience.

      Point of Need Care Funding Solutions:
      Income Assurance (Genworth) – Underwritten SPIA to maximize income for the impaired
      • LifecareXchange (GWG) – Turn Life insurance into cash even if the policy has no cash value
      Reliable Living Plan (Legacy/Americo) – 1st ever guaranteed issue single premium LTCi

    • Let’s take a look at Taking Care of Tomorrow (see above) by CA Department of Aging for definitions and explanations. I think once we get that, we can answer the question for ourselves. What is the “most popular” doesn’t necessarily apply to our or your situation. In fact, we are not allowed to say best in Medicare Advantage.

      How Much Does Long-Term Care Insurance Cost?

      The cost of long-term care policies varies according to the type of policy, the coverage provided, and the choices you make when you buy the policy. Some of the factors that can influence the cost of long-term care insurance include:

      • Your age and your health at the time you apply for coverage;
      Inflation protection and what kind you buy;
      • The deductible, waiting period, or elimination period you choose before the policy begins paying benefits;
      • The combination of the benefits you want included in the policy;
      • The daily or monthly benefit amount you want the company to pay when you need care; and
      • The number of years or total dollar amount you want the company to pay in benefits.

      How Much Will A Policy Pay?

      That depends on the benefits you choose. Most policies pay daily amounts (sometimes
      times called “daily benefits” or “daily benefit maximums”) from $80 a day to more than $300 a day for the covered services described in the policy.

      For Example:

      If you choose a daily maximum of $150 per day and your nursing home expenses are $200 per day, you will be responsible for the difference, $50 per day, or $1,500 a month. (This is your co-payment.)

      While you may have the income to pay this co-payment today, you need to be sure that you can pay it in the future too. Nursing home costs have increased 5.4 percent annually since 1980 and will continue to increase each year due to inflationary increases in the cost of providing care (refer to Chart #6 in taking care of tomorrow brochure above

      This means that the co-payment you choose will also increase. Once you qualify for benefits, many companies will pay your benefits on a monthly or weekly basis, which allows you or your caregiver to organize your care more efficiently.

      NOTE:

      Some companies pay you for the cost of your covered expenses only “up to” the daily benefit
      amount that you chose when you bought your policy. In that case you will be responsible for any amounts greater than the daily benefit.

      In Another Example:

      If you choose a daily maximum of $200 and your nursing home expenses are $275, you will be responsible for the difference ($75).

      Conversely, if you choose a daily benefit of $200 and your nursing home expenses are only $150, a company that reimburses for covered expenses will only pay $150, the actual cost of your care.

      NOTE – more modern plans use the concept of a “Pool of Money

      Inflation Protection I think is pretty much self explanatory. Learn more

      inflation protection

      See these webpages also:
      https://life.healthreformquotes.com/long-term-care/costs-long-term-care/

      https://www.mylifesite.net/blog/post/so-ill-probably-need-long-term-care-but-for-how-long/

        • We can reduce the premium/benefits. If we cut the benefits – potential payout to half that will still provide half the monthly LTC Long Term Care benefit and in in some policies 1/2 the death benefit.

          Even a small LTC benefit is still a huge value due to the leverage

          One has 70% chance they will need LTC services in their lifetime… That’s a greater risk than car accident, home damage, or pretty much anything else they already are paying insurance premium for.

          How about instead of self-insuring and paying dollar for dollar for care if needed, use the monthly pay AssetcareIV which has guaranteed premium and unlimited claim period. That way one might pay for example $1,208/mo click here for a specific quote for you – now which will provide them with 10,000/month combined LTC benefits (5k/mo each). That is leverage of 827% on the dollar. And if you never need care and both the husband and wife passed away their beneficiary(ies) get the $166,667 tax free death benefit. OR, if they want to cash out one day for some reason, the policy builds cash value which they could tap for any reason.

          More Clarification of Leverage

          When you pay a premium and it is buying you coverage worth more than you paid, that is leverage on your dollar. For example, paying $500/month in LTC premium for a monthly benefit of $5,000 for LTC is leverage of 10 times your premium

          See also https://www.investopedia.com/terms/l/leverage.asp

          If 1208/mo is too high for them to budget, reduce the premium/benefits. Half that will provide half the monthly LTC benefit and death benefit. Even a small LTC benefit is still a huge vaule due to the leverage.

          OR, though Mutual of Omaha LTCi is not guaranteed premium, it may better fit their budget at 942/mo premium for 10k/mo(5k each) LTC protection which is 1061% leverage on their dollar. Or reduce premium/benefits to fit budget.

          Need to relay the severity of the risk, and the power of the leverage, so it’s a no brainer versus self-insuring. Then it’s just, finding the premium to fit their budget and refining the coverage to maximize the benefits they can afford on their budget.

          • severity of the risk, and the power of the leverage, so it’s a no brainer versus self-insuring

            finding the premium to fit their budget and refining the coverage to maximize the benefits they can afford on their budget.

            We will research and update this….

  2. I am saving this web page URL (in my LTC folder) to keep its links to the State of California info regarding LTC.

    Even if affordability is questionable today, if a family member were to die and leave me enough money, I might be able to swing the deal. — As morbid a thought that is!

    Money can suddenly come from more than one source. — A lucky lawsuit, perhaps?

    • Sorry, No. Here’s an explanation from the 2005 Medicare & You Publication

      Long-term care includes non-medical care for people who have a chronic illness or disability. This includes non-skilled personal care assistance, like help with everyday activities, including dressing, bathing, and using the bathroom. At least 70% of people over 65 will need long-term care services and support at some point. Medicare and most health insurance plans, including Medicare Supplement Insurance (Medigap) policies, don’t pay for this type of care, sometimes called “custodial care.” Long-term care can be provided at home, in the community, in an assisted living facility, or in a nursing home. It’s important to start planning for long-term care now to maintain your independence and to make sure you get the care you may need, in the setting
      you want, in the future.

      Here are some of the different ways to pay for long-term care:

      https://longtermcare.acl.gov/

      https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf#page=60

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