FAQs

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FAQ's

How much does LTCi cost?

With the right carrier, Long Term Care Insurance (LTCi) should cost far less than the cost of the care itself! The average premium can be as little as $75 per month for REAL Long Term Care Insurance (LTCi). Hint: A policy without built-in inflation protection might seem to have considerably lower premiums, but don’t be fooled, it will cost you more in the long run – don’t buy it!

LTCi premiums vary dramatically depending on your age, health, marital status and plan design. LTCi policies are custom designed to fit your particular needs, and we design your plan together, taking into account your retirement strategy, family health history, family support and your legacy wishes.

My goal is to help you buy the least amount of LTCi necessary from a quality insurance company. This is why it is so important to have a qualified, experienced, professional working for you, to carefully examine all the options available to you and guide you in your policy design.

When is the right age to purchase LTC insurance?

The correct time to purchase LTCi is when you can afford the premium now and with reasonable assurance in the future. Most people purchase LTCi between the ages of 45-65, because this is when most of us face a long term care event with a loved one and realize the need for protection. I also have clients who purchased policies while in their 30s, to protect the retirement funds they were already saving.

Your health can change for the worse at anytime. If it does, you could either become ineligible for LTCi or be subject to higher premiums when you first apply for LTCi, and throughout the duration of the policy . The good news? The healthier and younger you are when you apply, the lower your premium for the duration. Your health rating and age are locked in with application.

 My story – I purchased my insurance at age 44 for $90 per month. If I had waited 10 more years to age 54 and purchased the exact same policy, the monthly premium would have been $240. I am very happy I overrode my own procrastination and denial at age 44!

 

When considering the right age to purchase LTCi, ask yourself if you know when your health will change…… You risk everything and gain nothing by waiting.

How can I save money in buying my policy?

Don’t procrastinate! Buy early when you are younger, premium rates are less and you have preferred health. If you have a partner, purchase together to take advantage of spousal discounts. Inquire if your employer has group LTCi and then compare. Group policies can sometimes save you money, but not always. Design your policy to cover the greatest statistical needs and don’t let your fear drive you to purchase more coverage than is practical. Talk to an LTC specialist who represents several carriers. You would be surprised how different the premiums can be between several insurance companies for the same coverage.

Are my premiums tax deductible?

Yes, if you purchase a “Tax Qualified Long Term Care Insurance Policy”.

Individuals can deduct a limited amount of the annual premium based on age under health expenses on Schedule A of the federal tax return. LTCi premiums also qualify as a HSA (Health Savings Account) approved expense.

Business owners can deduct premiums as business expense. The amount changes according to the type of business (Partnership, Sole-Proprietor, C-Corp, etc.).

To get your free copy of the Tax Summary for Tax Qualified Long-Term Care Insurance click here.


LTCi is treated as accident and health insurance for individual taxpayers who itemize deductions.
The 2016 Deduction is limited to the lesser of the actual premium paid or eligible LTCi premium amount.

Eligible LTCi premium in  2016:  

Attained Age in tax year   Limitation on Premiums
Age 40 or Less $  390
Age 41-50 $  730
Age 50-60 $1,460
Age 61-70 $3,900
Age 71 and older $4,870

Long Term Disability versus Long Term Care Insurance, what is the difference?

The purpose of Long Term Disability Insurance (LTD) is to replace income. LTD is purchased as a percentage of income and you must prove income in order to purchase. When collecting LTD benefits, the purpose most likely is to pay the mortgage and monthly expenses that continue even if you are unable to work. LTD benefits are paid as a lump sum each month. Most LTD policies cancel at age 65 and claim benefits will also stop.

The purpose Long Term Care Insurance (LTCi) is to pay for caregivers at home, or to pay a long term care facility. LTCi cannot be canceled as long as you pay your premiums, regardless of age. There is NO income verification when you purchase LTCi and you can purchase the amount you wish. Benefits are typically paid as reimbursement and claims are paid until the policy limits (which you selected) are reached regardless of age.

Can anyone purchase Long Term Care Insurance?

A medical history which includes certain illnesses may result in an individual being turned down for long term care insurance. Alternatively, discounts are available for good health.

Want to know if you are insurable? Let’s talk

What is a California Partnership Policy?

California Partnership LTCi policies are available from a select number of insurance carriers who have met stringent standards set by the state. These policies pay for your care in the same way other high quality LTCi policies would; but, unlike a traditional policy, each dollar your Partnership policy pays out in benefits entitles you to keep a dollar of your assets if you ever need to apply for Medi-Cal services.

To request your free copy of the California Department of Health Services – California Partnership for Long Term Care click here.

What Do I Need to Know About Initiating a Long Term Insurance Claim?

Filing a claim is not difficult. As a full-service professional, I want to make it easy for my clients to obtain the optimum coverage to which they are entitled, and to do so as soon as they, or their families, feel that it is necessary.

Know the Ropes

In most cases, you will contact the insurance company directly and they will walk you through the necessary steps, but knowing the ropes before you make that first call can streamline the process and minimize stress.

Know Your Policy Benefit Triggers

Most policies today allow you to access your benefits when you need physical assistance with at least 2 of 6 activities of daily living (ADLs) or supervision due to cognitive impairment.

ADL assistance, such as assistance with bathing and dressing, can be in the form of standby care (i.e. balance problems causing falls) or hands-on care.

The most common claims for cognitive impairment are for dementia, including Alzheimer’s disease. It is important that your doctor is familiar with dementia associated with aging, and can administer in-depth memory tests (i.e. MoCA -Montreal Cognitive Assessment), as well as interview family members to understand any surrounding issues.

Enlist the Help of an Advocate

Most of us tend to minimize our ailments and limitations. This tendency will NOT help you in the claims process. For that reason, I highly recommend having a third party, i.e. someone fully knowledgeable about your current health history and situation, act as your advocate who will make the initial telephone call on your behalf and be present when your face-to-face assessment is completed. This is to insure that ALL relevant health information is given to the insurance company so they have a complete picture as to your needs.  In the best case scenario, this should be a spouse or partner, immediate family member, or close friend, but if need be, as a service to you, I can act as your advocate and assist with filing your claim. Other viable options are to hire a Geriatric Care Manager or to contact the Home Care Agency you plan to hire and ask them to assist you in opening your claim for benefits.

When in doubt, make the call!

Often, a long term care event begins with an acute condition (i.e. a fall and broken hip) and the expectation of recovery.  As we age, these conditions can frequently develop complications and recovery may be slow or not at all. The good news is, you are not penalized for starting the claims process, and if the situation is indeed deemed temporary (less than 90 days for most policies) the claim will then be closed by the insurance company.  However, should the condition worsen or become long term, you will now be that much closer to completing the process and getting your benefits.

What Are The Steps for Filing a Claim for Long Term Insurance?

As a full-service professional, I truly care about my clients, and want to make sure that they are able to easily obtain the optimum coverage to which they are entitled, and to do so as soon as they, or their families, feel that it is necessary. In the many years I have been assisting clients—including my own father— to navigate the system, I have found that in most cases, the claims process will involve these steps:

  1. Telephone intake call
  2. Face-to-Face Assessment
  3. Plan of Care
  4. Completing claims paperwork and Attending Physician’s Statement
  5. Benefits Payments

Step #1: Telephone Intake Call

When you or, preferably, your advocate contact your insurance carrier, the intake analyst will determine if starting the claim process is warranted.  The analyst may specifically ask which activities of daily living the claimant needs help with, or to describe the mental impairment symptoms.  It is the job of your advocate to make sure any pertinent information not asked for is given.

Step #2: Face-to-Face Assessment

Once you have completed the telephone assessment and it is determined that your claim should be initiated, you will be contacted by a care coordinator/manager to schedule an in-person interview, in your home.  (If you are in a skilled nursing facility and needing hands on assistance, the insurance company may waive the face to face assessment and request a report from the facility.) Your advocate should be present to make sure all pertinent information is given to the care manager.

Step #3: Plan of Care

When the Care Manager has completed the face to face assessment, he or she will prepare a plan of care, listing how many hours per day you need assistance from another person and the type of assistance needed, such as companion care for dementia or assistance with meal preparation and bathing.

Step #4: Completing Forms and the Attending Physician’s Statement

Once the telephone intake call has been successfully accomplished, the insurance company will usually mail out the claims packet to be completed. The packet will include a request for your Power of Attorney if someone other than yourself is, or will be, making decisions for you.

The most important form will be the Attending Physician’s statement that your doctor(s) will need to complete and sign. Fill out as much as possible before sending this to, or making an appointment with, the doctor for completion. Most doctors are extremely busy, so the easier you make it for them, the quicker it will get done.

Step #5: Benefit Payments

The majority of policy benefits are paid as reimbursement after you incur and pay for the services according to your plan of care. Practically speaking, the reimbursement model usually requires you to carry a 30 – 45 day receivable.  If you are incurring expenses for a facility or home care prior to your claim approval, don’t panic.  Approved expenses (listed on the plan of care) should be retroactively reimbursed from the date of diagnosis/event on the attending physician’s report.

Why should I work with Jody for Long Term Care Insurance, rather than my health insurance agent or financial advisor?

It’s all about expertise! As an independent insurance agent who has specialized in Long Term Care Planning for the past 15 years, I bring to you the benefit of my extensive knowledge and claims experience. Because the Long Term Care Insurance industry is so tightly regulated, you will actually pay the same for a particular policy, no matter whom you purchase it from. What makes all the difference in the world, however, is working with a professional who can customize your coverage to your own specific needs and budget, and not try to oversell you on coverage you don’t need, or even worse, push you into a policy that doesn’t provide you with adequate coverage when the time comes to use it.

As your LCTi professional I promise that I will be your advocate through the underwriting process, advise you on the most cost effective plan design, recommend the best plan from the best insurance carrier, even if this means I send your business elsewhere, tell you when LTCi is not appropriate to your situation, and not sell you a policy that will not benefit you.

Long Term Care insurance is a purchase decision you should make only once in your lifetime. Let me help you make the best choice for your future.

Do you have questions or need the bottom line? Contact Jody at (760) 944-3777