Debbie Dare, CLTC, LTCPLong Term Care Solutions Specialist
Celebrating my 22nd year in the LTC Insurance industry
Presentation PurposeExplain the importance of planning for
long-term care
Explain the myths associated with Long-Term Care
Explain how we can help you plan for long-term care
?
What is the 1st thing that comes to mind when you hear long term care?
For most people…It’s Nursing Homes. But in reality, it is …..
What is long-term care?The type of care needed if you can no longer
perform the normal Activities of Living (ADLS)Bathing, Continence, Dressing, Eating, Toileting or Transferring
The type of care needed when you are diagnosed as chronically ill
The type of care needed when you have a severe cognitive impairment, such as can result from head trauma or Alzheimer’s Disease
Examples…… Acute Care VS Long-Term Care
* Short duration * Lengthy duration 90 days
* Get better * Maintain function* Medical care * Personal assistance* Hospital or * Home, assisted doctor’s office living facility,
nursing home, or adult day Services
What are the benefits of planning for LTC?Help protect your LIFESTYLE
Help protect your family
Help protect and allow your retirement assets to grow
If you do nothing your plan may be to:Have your spouse or children provide care
Use your assets when your family can no longer provide care
Apply for Medicaid after almost all assets are spent
What are some of the situations that may require long-term care services?
Spinal cord injuryMotorcycle accidentsBoating accidentsUn-successful surgeriesStrokeHeart diseaseDementia
Nearly half of those requiring long-term care services are under age 65—including 5.3 million working age adults and 400,000 children.
Source: The Henry J. Kaiser Family Foundation, Kaiser Commission on Medicaid Facts, 2001.
Where are long-term care services provided?
At homeIn a community setting, such as an adult day
care or adult day health centersIn various facilities that assist people with long-
term care needs; for example, assisted living facilities, residential care facilities or residential care facilities for the elderly*
In hospice home-care programs or facilitiesIn nursing homes
*Facility types vary by state. For more information on the various types of facilities in your state, consult with your sales representative.
Myths Associates with LTCIt won’t happen to me
I’m already covered
My family can take care of me
I can’t afford long-term care insurance
Fact:“In 2006, about nine million men and women over the age
of 65 needed long-term care”
Since 2006 Stroke has been the leading cause of serious, long-term disability in the United Sates.
Each year about 795,000 people suffer a Stroke. About 600,000 of these are first attacks and 185,000 are recurring attacks.
Every 30 seconds, someone in the U.S. has a Stroke.
Sources: Health Insurance Association of America, A Guide to Long-Term Care Insurance, The American Heart Association & The American Stroke Association, Heart Disease and Stroke Statistics 2009.
Do you agree you are at Risk?LTC RISK AGE TODAY
RISK AGE?
Doesn’t it make sense to plan TODAY for that risk?
Fact:Long-Term personal/custodial care is NOTcovered by:Individual Medical PlansGroup Health PlansHMOs (Regular or Medicare)MedicareMedicare SupplementDisability Income Insurance
What is Medicare? What does it cover?
Government health insurance program for people age 65 plus
Pays for skilled nursing facility up to100 days per spell of illness following hospitalization
Pays for some skilled at-home care but only for short-term medical conditions and NOT for ongoing assistance
What is required for Medicare to pay for care in a skilled nursing facility?
Must receive skilled careMust be a Medicare certified facilityMust follow a 3-day consecutive hospital
stayPays 100% of cost for first 20 daysA co-payment of $137.50 is required from
days 21 – 100No coverage after day 100
What is required for Medicare to pay for home health care?
Must need doctor approved at-home skilled care and plan for that care
Must need intermittent skilled nursing care, physical therapy, speech pathology or occupational therapy
Medicare-certified home health agencyMust be homebound
What sociological changes have impacted caregiving responsibilities?
Smaller families living farther apart
Women in the workforce
Delayed childbirth
Divorce
Fact:In a study of working caregivers, (10) “Women
who are family caregivers are 2.5 times more likely than non-caregivers to live in poverty and five times more likely to receive Supplemental Social Security (SSI).”
“In 2000 typical working family caregiver lost $109 per day in wages and health benefits due to the need to provide care at home.”
20% - cut back to part-time22% - took a leave of absence
(10) CareConnection.com 2/2010 – Health and Retirement Study, National Institute of Aging, 1992-2004
Can you afford the cost of long-term care?A home health care aide costs an average
of $33,069 per year, based on $18.12 an hour for 5 hours per day
Average annual cost of Assisted living is $54,000, based on $150.00 a day
Average annual cost of Nursing Home care for a semi-private room is $73,080, based on$203++ per day
Genworth Financial 4/2009 CareScout Study
Medicare: Reality Vs. Perception
Medicare covered only 13.7% of total nursing home and other institutional care expenditures(7)
Yet… 55% of American age 45+ believe Medicare
covers nursing home stays for 3 months or more for age related or other chronic conditions
Source: (7) Department of Health and Human Services, Centers for Medicare and Medicaid ServicesOffice of the Actuary, Personal Health Care Expenditures, 2001.(8) AARP (American Association of Retired Persons). The Costs of Long-Term Care; Public Perceptions Versus Reality, 2001
What is Medicaid?How does it work?
Federal government pays a share of the medical assistance expenditures under each state’s Medicaid program
Requires “spending down” to near depletion of financial and personal assets
You may be temporarily ineligible for benefits if you transfer assets
Source: United States Health Council, Long-Term Care Planning-A Dollar and Sense Guide, 2002.
What are your wishes?
Stay HomeMaintain normalcy in your familyFreedom from financial burdensNo burden on family members/caregivers
Compare the Cost of LTC Insurance to the Cost of Care
AgeAge Monthly Monthly $$
3535 $28 - $28 - $37$37
4545 $46 - 54$46 - 54
5555 $78 -84$78 -84
Type of Type of CareCare
20092009 20302030
MonthlMonthly y
Home Home CareCare
$2,700$2,700 $5,667$5,667
MonthlMonthly y PersonPersonal Careal Care
$4,500$4,500 $6,241$6,241
MonthlMonthlyy
NursinNursing g HomeHome
$6,000$6,000++
$15,88$15,8833
VSCost of LTC Insurance
National Average Cost of LTC
Services
MedAmerica or MetLife $3000 a month, 3 year Benefit Period 100% Home care, 90/100 Day Elimination Period, 5% Automatic Simple Inflation. Cash from MedAmerica - Indemnity from MetLife
Long-Term Care Insurance can help:
Maintain lifestyleMaintain choice on how & where to receive
careProtect family assets & financial futureMinimize physical, emotional and financial
dependence on familyProtect retirement assetsAssure high-quality careFills the gaps of other insurances
Why Address This Now?
Younger active lifestyle, with more accidents and injuries
Ability to balance $’s you put into 401k, etc., with the cost of a long term care insurance policy.
Modern medicine is diagnosing diseases earlier and earlier
Tightened underwriting (you could become ineligible earlier)
LTC insurance is affordable, based on benefit design!
How can we help?
Sign up for a one-to-one meeting by completing the “Can you afford NOT to plan for Long Term Care!” and/or the Health Questionnaire and
faxing to Debbie at 717-652-5884.
QUESTIONS?????
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