Frequently Asked Questions

Question: 1. What is an appropriate age at which to purchase LTCI?
Answer The majority of policies purchased today are between the ages of 50 and 75. That being said, people can still buy policies in their 80’s, if they are healthy. Also, people in their 40’s, and younger, will sometimes consider LTCI, if they’ve had a personal experience with a friend or family member.
Question: 2. What is covered by a LTCI policy?
Answer A common misconception is that LTCI is Nursing Home Insurance. In fact, the opposite is true. Most people who own LTCI are concerned about Home Health Care. Most LTCI policies cover Home Health Care, Assisted Living, Adult Day Care, Alzheimer’s Care and, of course, Nursing Home Care.
Question: 3. Are pre-existing conditions covered by LTCI policies?
Answer Yes. Pre-existing conditions are covered immediately. If you are approved, then you will be covered immediately for any condition you currently have, and, also, for any condition you may develop in the future.
Question: 4. What determines whether I’m eligible for benefits?
Answer Your inability to perform 2 out of the 6 Activities of Daily Living, which are: eating, bathing, dressing, toileting, transferring and maintaining continence, or if you have a severe cognitive impairment.
Question: 5. Who decides where and what type of care I can receive?
Answer As long as you are benefit-eligible, you, your family and your doctor can all have input as to where you should receive your care. The insurance company cannot tell you what to do.
Question: 6. Can the company raise my premium rates?
Answer A company CANNOT raise your rates because you have gotten older, or because you have developed an illness. They can, however, raise rates if they do it for every policyholder of the same policy series in a particular state. There are some major carriers that have never had a rate increase.
Question: 7. Why should I buy LTCI if I can afford to self-insure?
Answer Every person who owns LTCI can afford to self-insure for a period of time. Some people can self-insure for 3 years, others can do it for 10 years, and still others can do it for 25 years and more. If a person can’t afford to self-insure for some period of time, then they typically can’t afford the premium. If a person is insurance minded, then they have always shifted the risk to insurance throughout their lifetime, whether for their home, car or health. Unfortunately, because of what LTCI means, people will tend to stick their heads in the sand and choose not to address this issue by saying things like, “I’ll pay for it if it happens.” What they’re really saying is, “It’s not going to happen to me.” The insurance minded person, no matter how much money they have, will typically address this problem head-on, and remove some of the risk off of their estate and their family.
Question: 8. Who can I hire for Home Health Care?
Answer Some companies require you to use a Home Health Care agency. You can hire anyone from an RN all the way down to a Home Health Aide. Other companies will allow you to hire an independent caregiver.
Question: 9. Are there discounts for applying as a couple?
Answer Yes. Discounts range from 30 to 50% depending on the company.
Question: 10. Should I still buy a policy even if my spouse cannot qualify?
Answer Absolutely. While it is unfortunate that you cannot both be insured, insuring one of you fixes half the problem. At least your spouse and/or family will benefit from the policy if you were to need care.
Question: 11. How much coverage should I own?
Answer That depends on your individual situation. The average cost of a Nursing Home today is roughly $6,000 per month. The average length of time for needing care is 2½ to 3 years. Most claims are not going beyond 5 years. There is no rule that says you need to insure this entire problem. The idea here is to shift some of the risk off of your estate and on to the insurance company. For example, if you had a policy that would pay you $4,500 per month, then you would have to write a check for $1500. That’s a lot better than writing a check for the full $6,000. The best way to decide on the design of your policy is to sit down with one of our experienced agents, who will tailor a program to fit your specific needs.