Insurance and Benefits – FENG Long Term Care Programs

Norm Weinstock has arranged for special discounts with some of the major providers of Long Term Care Programs. Your participation will also help FENG. These programs are for members of FENG as well as members of their family. If you have any questions about this program contact:

Norm Weinstock
203-227-2105
NormWeinstock@TheFENG.org
norm.weinstock@erols.com

What Is Long Term Care?

Long term care is an array of services – personal care, health, social and supportive – that aims to provide assistance and improve the quality of life of those with chronic, long term conditions.

"Long Term Care will be the burning healthcare issue of the 21st century, as baby boomers struggle to prepare for their own needs and to take care of their parents as well. We must begin to prepare now for those challenges."1

Most commonly, a long term care need arises when an individual is unable to perform some activities of daily living (ADLs) without assistance, such as: Eating, bathing, dressing, transferring, toileting, or maintaining continence. Or, an individual has a severe cognitive impairment (such as Alzheimer’s) or similar irreversible dementia.

Close to 80% of all long term care patients simply need help with the activities of daily living rather than medical treatment.

The United States Government General Accounting Office has issued a report stating that 30% of the population over age sixty five have limitations with two or more activities of daily living (ADL). Two or more limitations of ADLs is the standard trigger point for Long Term Care Insurance policies. [ view report ]

The same report states that for the year 2000 males reaching 65 years old on average will live to age 80.9 and females to age 84.2

Where is Long Term Care Most Often Provided?

  • At Home
  • In Assisted Living Facilities
  • In Adult Day Care Centers
  • A Hospice (Home or Facility)
  • In Nursing Homes

Over 80% of persons receiving long term care are in home and community-based settings, not in nursing homes.2

Between ages 65 and 74, there are 7 disabled people living in the community for every one in a nursing home. Between ages 75 and 84, there are 3 disabled people living in the community for every one in a nursing home. At age 85+ there are 1.2 disabled people in the community for every one in a nursing home3

Costs

Nursing home care average annual costs (semi-private) is $57,764.90 – Double that in some areas.4 Home Care on average costs $18.00 per hour – Over $52,000 per year for 8 hours of care per day.5

Program Limitations

  • Medicaid* requires persons to meet strict financial guidelines
  • Self-Insuring requires use of personal assets
  • Medicare requires continuous health improvement, and pays no costs after 100 days
  • Private health insurance pays only for skilled care, a fraction of all long term care costs

What is Your Best Option?

Self Insure and utilize retirement savings? Qualify for government assistance by “spending down” family assets? Depend on private insurance to transfer risk?

LTCi: What Are The Benefits?

Should an individual need long term care, LTCi: enables disabled individuals to remain in their home longer, supports individual’s desires not to burden other family members, helps provide financial security and peace of mind, and allows more opportunities for social interaction.

What Are The Benefits?

  • Helps protect assets, including your home
  • Helps protect your spouse's standard of living
  • Helps provide choice of services, choice of settings, choice of benefits
  • Helps provide better care – on average 14 more hours per week of personal care.6

Choosing a Policy

Basic Policy Design:
Facility/Nursing Home Services provides benefits for care provided in Nursing and Assisted Living Facilities. Facility/Nursing Home Services and Home/Community Care Services provides benefits for either Facility/Nursing Home Services or Home/Community Care Services

Benefit Duration:
The amount of time a policy will pay benefits. A policy may be designed to pay for a specific number of years (minimum 2 years) or lifetime (unlimited).

Elimination Period:
The amount of time before a policy will begin paying benefits. It can also be referred to as ‘deductible’ period – the amount of time (ie: 30 days) an individual must pay for care prior to receiving benefits.

Daily Benefit:
The maximum amount your policy will pay for any one day of services. The amount of benefit available to reimburse actual charges.

Examples of Optional Benefits Available with LTCi:

  • Daily Benefit Inflation Protection
  • Indemnity Benefit
  • Alternative Care Plans
  • Respite Care Benefit
  • Nonforfeiture Benefit
  • Restoration of Benefits
  • Personal Care Advisor
  • Waiver of Premium (single/joint)
  • Spousal/Joint policy discount.

Tax Advantages

All benefits received under a tax-qualified policy are generally income tax free**. For individuals, premiums may be deductible as Medical Expense (7.5% of adjusted gross income) subject to age & premium limitations**

Currently this product is only available in the seventeen states where Norm Weinstock is licensed. Contact Norm for details normweinstock@thefeng.org.

* Medicaid guidelines vary by state. Contact your local Medicaidoffice for more information.
** Non Tax Qualified LTCipolicies may also be available. Consult your tax advisor for more details

1. Representative Pete Stark (CA) upon introducing The Omnibus Long Term Care Act of 1999, Aug., 1999
2. Long-Term Care: An Overview, Testimony before Senate Committee on Finance, March 27, 2001, Statement of Carol O’Shaughnessy
3. Tilly, J. Goldenson: The Urban Institute, March 2001
4. MetLife Mature Market Institute – Market Survey of Nursing Home & home Care Costs August 2003
5. Kaiser Family Foundation, "Long Term Care Insurance: Who Should Buy It and What Should They Buy?" – March 2003
6. Health Insurance Association of America, Benefits of Long Term Care Insurance September 2002