As baby boomers are now approaching the pre-retirement and retirement years, they should be considering the purchase of long-term care insurance.
Long-term care insurance is a significant benefit where an insurance company will assume the risk and pay the facility instead the insured having to spend up to five years’ worth of costs at a nursing home for their own care or that of their spouse. In addition, it provides your elder law attorney with a window of opportunity to preserve assets so that when the five-year period is expired and the policy benefits are extinguished, no further payments will have to be made once.
This planning opportunity prevents you from having to spend or transferred your funds prior to institutionalization, giving you the comfort and security of knowing that you will have sufficient funds to spend, gift, use as assets in your retirement years or spend down on non-essential medical expenses or any other purpose.
Another benefit of long term care insurance is its ability to pay for home care. Most policies provide for the same benefit per day at an assisted-living facility or at home, thus alleviating the need for you to become institutionalized. Some policies require a licensed caregiver to make a claim on the policy, while other policies permit a family member to be reimbursed as long as he/she attends a course on caregiving.
It is important to review the terms of the policy to be sure that the plan actually is what you intend. Pay attention to how the insurance company determines how the policy is sprung. This is related to your inability to independently perform specific activities of daily living. How many of them must be met in order to make a claim on the policy? These activities include toileting, transferring, eating, dressing and bathing. If you can’t independently perform two of these activities, then most policies will permit payment to be made, but some policies may require three or four of these activities to be met in order to qualify. It is important that you thoroughly understand your policy’s parameters.
There are also some “bells and whistles” that may be available to purchase for additional premium dollars, but for which you will also reap benefits. These include reimbursement of premiums if a claim is not made for a period such as ten years after making premium payments. Also, there may be a discount available for two policies to be issued simultaneously. Good health may also qualify you for a discount as a preferred insured, but very often, if you have significant disabilities, the rating will not merely increase your premium but will also prevent you from obtaining the insurance at all.
Most policies also provide that a nominated family member or good friend will receive notice if you are unable to make payments due to incapacity. This occurs when the insured becomes incapacitated by reason of Alzheimer’s or some other mental disorder and does not understand the nature of receiving a bill and making payment. In these situations, the insurance company will provide notice to a third party that the premium has not been paid so that care may be taken to determine the cause of non-payment and prevent the policy’s lapse. In the event that you are nominated in this capacity, you should make sure that the insurance company always has your current address.
While no one likes to pay for it, long term care insurance is one that should not be overlooked. While there may not be any right time to purchase it, you should make sure that the policy is purchased during working years, when there will be sufficient income and assets to pay for it. In addition, you should review the potential cost of this policy over a significant number of years and also calculate the potential benefit if a claim had to be made against it.
There are additional issues to consider when purchasing or reviewing the purchase of this type of insurance, and a good source to review all your options is a Consumer’s Guide to Long Term Care Insurance. It may be obtained through any agent who is recommending the purchase of insurance or the Insurance Commissioner in your state.
By: Hyman G. Darling, Esq.