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Bruce Sackrison

Bruce Sackrison is a Napa Valley Register columnist who will write about property and casualty insurance matters.

This week, I’ll answer some common questions I receive about long-term care insurance.

1. Who qualifies for long-term care insurance?

Not everyone qualifies.

This is the toughest conversation that I have with people here in Napa, California.

You can purchase long-term care insurance only when you are healthy and before you need it.

Here is some sobering data from a study in 2007 by the American Association for Long-Term Care Insurance:

  • Your chance of being declined for a policy at age 50 is about 14 percent.
  • Your chance of being declined for a policy at age 70 is about 45 percent.

Putting off purchasing long-term insurance is risky.

2. What type of care is covered?

Unlike Medicare and Medicaid, your long-term care insurance policy covers a wide variety of care options.

Best of all, the government is not in charge of deciding what care you’ll receive.

You are.

Most long-term care policies also include coverage for a care coordinator to help you navigate the many options available.

Instead of being told by the government what you’ll get, you’ll be part of the decision-making team.

And you’ll have choices you may not otherwise have under government coverage.

It’s more than just “nursing home coverage,” long-term care insurance coverage also includes:

  • Alternate care
  • Adult daycare services
  • Nurse, therapists, and home-health aids
  • Respite care (giving your caregivers a break)
  • Personal care services for activities of daily living
  • Homemaker help (shopping, meal preparation, housekeeping)

3. Where can I receive long-term care?

Long-term care insurance is designed to provide coverage almost anywhere:

  • Your own home
  • Assisted-living facilities
  • Licensed nursing homes
  • Other qualified long-term care facilities
  • International facilities for long-term care

Long-term care insurance will let you decide where to get care.

4. When does coverage begin?

You qualify for benefits when you become chronically ill and are no longer able to perform two or more of these activities of daily living: bathing, dressing, eating, transferring, toileting and continence. Also, if you need constant supervision due to a severe cognitive impairment, you generally qualify.

Once eligible, your time-deductible begins. It’s called an elimination period and you can choose between 90 days and 365 days before benefits begin.

5. How much does long-term care insurance pay?

You get to choose your benefits.

Once your elimination period (time-deductible) is satisfied, your policy will pay according to the two benefit options you selected:

Monthly benefit: This is the maximum amount per month that can be paid. This can range from $1,500 per month to as much as $10,000 per month.

Policy limit: This is the maximum number of months that you receive benefits. It typically ranges from 24 to 60 months.

My advice:

The benefit choices of elimination period, monthly benefit and policy limit affect your premium.

You should work with your local insurance agent to help you figure out which choices make the most sense for you.

If you don’t have a local agent, I’d be happy to answer any questions you have.

I specialize in long-term care insurance. Send me an email or call me. I’d be happy to answer questions with no obligation.

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Bruce Sackrison is an insurance property and casualty broker affiliated with Professional Insurance Associates. He is at 707-931-0186 or bruces@sackifs.com.

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