Won’t Medicare and my health insurance pay for long-term care services?

Long-Term Care Insurance provides funds to help you cover long-term care costs in the same manner Health Insurance provides financial coverage for doctor’s visits and hospital bills. However, it is very important to understand that Long-Term Care Insurance and Health Insurance are two distinctly different types of insurance. Health Insurance would likely provide coverage for doctor visits, hospitalization, and maybe even some prescription medicines. But if the individual’s condition progresses to the point where he or she requires long-term care or constant supervision and assistance with daily activities, Health Insurance would likely not provide coverage for that care.

Health insurance was not designed to cover the long-term care expenses for those who may have suffered permanent paralysis from an accident or stroke, developed Alzheimer’s, or perhaps need care as a natural result of aging.

This is where Long-Term Care Insurance comes in. Long-Term Care Insurance has been designed to pick up and provide coverage where Health Insurance leaves off. So in the case where the individual’s condition has progressed to the point where he or she requires assistance carrying out basic activities of daily living (like bathing, eating, toileting, dressing and moving about), Long-Term Care Insurance would provide funds to help cover the insured’s long-term care expenses, in support of any care the family is able to provide.

Those who have purchased Long-Term Care Insurance share that it has also helped them maintain their independence and freedom of choice over how and where their care services are provided. Long-Term Care Insurance can allow you to protect your assets and help ensure that your long-term care needs will not create a physical, financial or emotional burden on your family.

Becky Wehrli
Long-term Care Insurance Specialist

How does my health factor into Long-term Care Insurance?

Long-Term Care insurance is based on an individual’s physical and cognitive health at time of application. Each insurance company has different “health standards” which affect eligibility, timing and the price of your insurance policy. A health questionnaire helps a long-term care specialist learn about your unique health history, enabling her to make appropriate policy recommendations. All health information is kept strictly confidential.

A medical diagnosis related to chronic conditions such as Alzheimer’s Disease, Parkinson’s Disease or Multiple Sclerosis, may preclude you from Long-Term Care insurance. Most other conditions such as cancer, heart attack or stroke, are insurable after a period of stability, ranging from 3 month to 2+ years and depends on the severity of the condition and plan of treatment. Sharing your health information with your LTC specialists helps to determine the best product, timing for an application and insurance carrier for you to obtain coverage.

The health questionnaire will be completed in writing at the time of your application for coverage. While not all-inclusive, the following list will give you an idea as to the information you will be asked to provide.

  • Age, Height, Weight
  • Name of your primary care physician; date and reason for last visit
  • Information about current prescription or over-the-counter medications taken routinely including name, dosage and reason prescribed
  • Current and previous consultation/treatment history including, in- or out-patient hospitalization, rehabilitation, physical therapy, pending test results, request for additional testing, referral to a specialist
  • Personal history of cancer, heart attack, stroke, diabetes or arthritis
  • Disclosure of any use of tobacco products

Specific content will depend on the underwriting requirements of your preferred product and insurance provider.

 2017 Becky Wehrli LTC

For more information about Long-Term Care Insurance

Contact Becky Wehrli 503-758-5725 or info@BeckyLTC.com

How do I know if Long-Term Care Insurance is right for me?

We are all living longer, and the harsh reality is, if we need care, it’s going to be expensive…and we are not covered.  Costs are soaring, statistically we are living longer and most of us are going to need care at some point in our lives.  Medicare and your health insurance do not cover long-term care services.  You will be faced with self-insuring to pay costs and liquidating or selling assets, all while ensuring you leave enough assets and income for future care of a surviving spouse.  It can be a daunting challenge.

Well, the solutions have changed.  No longer is traditional long-term care insurance the only answer.

Traditional LTC insurance provides the lowest premium with comprehensive benefits and features.  However underwriting may be more challenging and premiums may increase over time.  Additionally, you may not use your benefit.

Hybrid Products combine life insurance with LTC insurance.  You receive a benefit either through use of LTC services, or a death benefit.  Underwriting may be less restrictive, so it could be easier to qualify.  Premiums are guaranteed not to increase and there is a cash value if the policy is cancelled.  However, some policies require a single premium ($50,000 minimum) and you may be able to find lower premiums if you purchase life insurance and LTC coverage separately.

Short Term Care is insurance to pay for care of up to a maximum of one year.  It can be an attractive cost-effective alternative to traditional LTC insurance.  And the underwriting process tends to be less restrictive offering a solution to individuals with pre-existing conditions.  However, the premiums for these policies may increase over time.  And you may find that you utilize your benefit and still need care, thereby requiring self-pay or spend down to qualify for government assistance through Medicaid.

All these options are viable and beneficial in certain situations.  There is no perfect solution that fits all situations.   Education and consultation with a long-term care specialist is the key to helping you find which solution is best for you and your family.

© 2017 Becky Wehrli

For more information about Long-Term Care Insurance

Contact Becky Wehrli 503-758-5725 or info@BeckyLTC.com