September 07, 2008
Myths of Long-Term Care Insurance
Long-term care insurance helps protect assets and preserve inheritance for heirs.
It should be obvious to anyone with ears that when rocker Pete Townshend wrote the immortal words, "Hope I die before I get old," he had not stopped to consider the possibility that long-term care insurance might one day alleviate retirees' worries regarding payment of future non-medical care services. (Then again, maybe he just needed something to rhyme with "Things they do look awful c-c-cold.")
With increased life spans, smaller families, more women in the workplace and a greater tendency among people to leave their hometowns, it's likely that retirees will require some professional looking after as they enter their 70s and 80s. It's also likely they haven't planned for this. Long-term care insurance aims to alleviate that dilemma, covering services provided in nursing homes and assisted living facilities, as well as at-home care or in other community-based settings. However, there tends to be a lot of misinformation out there, misinformation in need of correction:
Myth: Anyone over 50 ought to have long-term care insurance.
Fact: Long-term care insurance is not for everyone over 50.
According to the Insurance Information Institute, about 60 percent of men aged 65 years and older will need some kind of long-term care in their lives. That percentage rises to 79 percent for women in the same age group. But those numbers fall dramatically when the need for long-term care runs past five years. Only 11 percent of men aged 65 years and older will need long-term care for five or more years, compared to 28 percent for women.
With that in mind, people with enough income to pay for four years of long term care "out of pocket" don't need long-term care insurance. That's a considerable expense—nursing home care can run anywhere from $50,000 to over $100,000 per year. (At-home care is less, usually, but not very much.) Meanwhile, people with virtually no income would likely qualify for Medicaid to pay their long-term care needs.
For the rest of us aged 50 or older, long-term care insurance ought to be considered as part of our estate planning – but just as one of many options. The National Council on Aging, for instance, encourages people over 62 to consider using reverse mortgages.
"Since most older persons own their own homes and do not have long-term care insurance, the reverse mortgage can be a solution for many people," said Scott Parkin, vice president of communications at National Council on Aging.
Myth: Long-term care insurance pays for specialized medical care.
Fact: Long-term care insurance pays for non-medical care.
It's a product covering bills accrued from assistance pertaining to daily, non-medical activities such as eating, bathing, moving from place to place, getting dressed and using the bathroom. That said, most policies kick in only when a physician deems this type of care necessary, usually when a person is unable to perform two or more of these kinds of everyday activities.
Myth: Long-term care insurance is largely redundant, since Medicare covers long-term care services.
Fact: Medicare doesn't cover long-term care, except on rare occasions.
Medicare won't cover long-term care per se, since most long-term care is not skilled care and doesn't take place in a nursing home. That said, it will cover the first 100 days of a nursing home stay if a person is receiving "skilled care," has undergone a qualifying hospital stay of three or more days and entered the nursing home within thirty days of that hospital visit.
"Basically, [Medicare] covers a short time in a nursing home, usually for rehab," Parkin said. "It doesn't really pay for long-term care."
Myth: Insurance companies waive their premiums once a person starts receiving long-term care.
Fact: Don't count on it.
A policy ought to include a waiver that frees the policy holder from paying premiums while he or she is receiving long-term care, but don't assume that's the case. Check for restrictions or qualifications, such as what kind of care, exactly, must be received before this waiver kicks in.
Myth: All long-term care insurance policies are the same.
Fact: No, they're not.
Long-term care insurance hasn't been around for very long—fewer than 20 years. Therefore, common knowledge regarding what to look for and what to look out for isn't well-established. So what do you need to look for? Consider these issues:
• Whether the coverage is comprehensive or "facility only," meaning the policy only covers one type of care—nursing home facilities. Comprehensive coverage covers care-at-home, adult day care, hospice car, and respite care, as well as nursing home facilities.
• Whether the policy includes a waiting period (also known as an elimination period) before it kicks in. The longer the waiting period, the cheaper the policy. Thirty to forty days is reasonable.
• As an indicator of whether you can afford a particular long-term care insurance policy, the premium should not be more than seven percent of what you expect your retirement income to be.
• Whether the policy contains inflation protection. If someone buys a $75-per-day policy one week after their 50th birthday, chances are that by the time that person reaches an age when he or she needs the coverage, $75 won't go very far. Most people would be wise to look for a five percent annual inflation adjustment, at least.
• Whether the policy has "flexibility." As demand for long-term care insurance changes, new options will be offered. Good policies should allow for coverage of new types of care, or at least be willing to update for a small fee.
(login / or create an account to comment)