Title: Long Term Care
1Long Term Care
- What you should know
- Long-term care provides a variety of services for
people who are unable to care for themselves. It
is designed specifically to cover the costs
associated with extended long-term care. Avoiding
this protection could deplete your assets in the
event that you are unable to continue working.
Long-term care insurance picks up where your
health insurance leaves off. For more
information, please contact your local HR office,
or by clicking the CNA link at the bottom of the
Benefits Web page (www.usmc-mccs.org), or by
calling CNA at 1-877-777-9072. - With Long-term care, you choose who provides your
care and where. - Most people start contributing to LTC when they
get sick, which results in 30-40 applications
being denied due to a pre-existing condition, so
why wait? Enroll now. The earlier you enroll,
the cheaper the premiums will be. - Since the cost of Long Term Care insurance is
generally based on your age at the time of
application, your premiums will be lower the
younger you are when you apply. - What does Long Term Care cover?
- Long-term care is not one service, but many
services designed to help people who have chronic
conditions and are unable to care for themselves.
The chronic condition may be permanent or
temporary. Services might include assistance
within the home for day to day activities, or
special attention in a nursing home. - Long Term care can be provided in a variety of
settings - Private Home
- Assisted Living Facility
- Adult Day Care center
- Nursing Home
- Who pays for Long Term Care?
- Long-term care insurance is can seem costly, but
worth it if you have assets you would like to
protect, without jeopardizing your familys
finances. Many people
- incorrectly assume that health insurance,
government programs such as Medicaid and
Medicare, or personal savings will pay long term
care costs. - Medicare Health Insurance Pays medical
expenses. It almost never pays for custodial
care, the kind of day-to-day care people
typically need as they get older. - Medicaid to get Medicaid help, you must meet
federal and state guidelines for income and
assets. You may have to spend down or use up
most of your assets on your health care before
Medicaid is able to help. - Personal Savings You could allocate savings to
pay for long-term care, but if you have limited
savings, you may go through the money in two to
three years. At 5,000 a month or more,
long-term care costs can quickly deplete your
savings. - Why do you need LTC?
- Nearly 40 of the people receiving long-term care
services are working adults between the ages of
18-64¹. - Wealth Preservation Long-term care costs
between 50,000 - 100,000 per year. Medicare
and traditional health insurance does not pay for
LTC. Without LTC coverage, the average American
loses their entire life savings within 11 months
when LTC is needed. - As people age and our average life span
increases, the chances of needing long-term care
increase. After age 65, an American has more
than 70 chance of needing some form of long term
care. In general, the longer you live, the
higher your odds of needing long term care. - Common Long-term care Myths
- Im too young to need Long-term care. Anyone can
need long-term care at any time. We are all
susceptible to accidents, chronic illnesses, and
disabilities that may require us to seek
assistance with routine daily activities for an
extended period of time. - My family will take care of me. Taking care of a
family member is a time-consuming commitment that
often demands a significant number of hours from
multiple family members. Even if family members
can find the time to provide caregiving to a
family member, it often comes at a tremendous
financial cost and may lack professional skills
necessary. Caregiving can cost the average
caregiver in lost wages, pension benefits, and
Social Security.
2- Common myths (cont.)
- Medicare or Medicaid will cover my bills.
Medicare is generally available for people over
65 and disabled. It only pays limited amounts
for skilled care following a hospital stay and it
is not intended to cover care that assists people
with activities of daily living for long periods
of time. Specifically, Medicare covers the first
100 days of skilled care in a nursing home after
a hospital stay of at least 3 days and as long
as you enter a nursing home within 30 days of
leaving the hospital. Medicaid is a state-based
program supplemented by Federal funds that
provides health services to the poor and
impoverished. Medicaid might cover you if you
meet your states poverty criteria and receive
care that meets your states guidelines. - Health Insurance will cover my bills. Health
Insurance rarely covers ongoing chronic care
needs. Most health plans, are intended to cover
skilled, short term medical care as you recover
from an illness or injury. Typically, Health
Insurance does not cover custodial care. - I can save enough on my own. In 2005, the
national average cost of a semi-private room in a
nursing home was 64,240 annually². With an
average stay of 2.4 years, thats more than
154,000 per average stay. Paying for long-term
care out of pocket may be an option for you if
you can afford these expenses. - What is the difference between Long-term care and
Disability? - Disability income insurance is designed to
replace a portion of the income you lose if
youre unable to work due to an accident or
injury. It provides no additional benefits to
specifically pay for long-term care expenses. - How do you qualify for LTC Benefits?
- You must meet one of the following criteria
- Be unable to perform any 2 of the 6 activities
of daily living, such as bathing, continence,
dressing, eating, toileting, transferring
either temporary or permanently. - Or be cognitively impaired (e.g., Alzheimers
Disease)
When should I apply for Long-term care Insurance?
Since the cost for long-term care insurance is
generally based on your age at the time of
application, your premiums will be lower the
younger you are when you apply. It is important
to apply for long-term care when you are in good
health. Thats because most long term care
insurance plans list certain medical conditions,
or combinations of conditions, that will prevent
some people from being approved for coverage. How
much does Long-term care cost? The cost of
long-term care varies greatly, depending on the
type of care, facility, and the region where you
receive your care. Homecare, which most people
prefer, is generally more affordable than nursing
home care, but still can be expensive. When
averaged nationally, the cost of a five-hour
visit by a home health aide is 95³. Thats well
over 24,000 per year (for a home health aide
visiting five hours per day, five days per week).
These costs rise significantly if
around-the-clock care is needed. Policy Benefits
FeaturesWith group long-term care insurance
from CNA, you choose a plan thats right for
you! Not everyone needs the same amount of
coverage, so you determine the amount of daily
benefit. Your daily benefit amount is the
maximum daily amount you can receive in benefits.
Listed below are some of the benefits and
features available in the group long-term care
plan Daily Benefit Amount Long-term care from
CNA offers a choice of three daily benefit
amounts, 100, 140 180. Nursing Home Benefit
Pays 100 of the eligible expenses per day, up to
your maximum daily benefit amount selected for
care received in a licensed nursing
home. Lifetime Maximum Benefit The lifetime
maximum translates into the total dollars you can
receive in benefits. It depends on the daily
benefit amount selected for nursing home care and
equates to a pool of dollars equal to 3 or 5
years of nursing home benefits. Community based
care Depending on the option selected, the plan
will pay either 50 or 100 of the maximum daily
nursing home benefit amount for care received
outside the nursing home, such as home health
care, center or an assisted living facility.
3Policy Benefits and Features (cont.) Level
Premiums Premiums are based on your
age-at-entry and the daily benefit you select.
You can never be singled out for a future
increase because you become older or ill.
Inflation Protection The CNA policy is
designed to allow you to keep up with inflation.
Youll be given opportunities to increase your
daily benefit amount so that you can protect
yourself against rising costs. An automatic
inflation adjustment is also available. Temporary
Bed Holding Pays the benefit amount to hold a
nursing home bed, up to 21 days per calendar
year, if you are temporarily absent from the
nursing home due to a hospital stay or other
event. Care Management A registered nurse or
social worker will develop a care plan that
integrates your wishes as well as the wishes of
your family and your family doctor. Caregiver
Training Benefit Pays the actual expenses
incurred for training an informal caregiver up to
three times the daily community- based
benefit. Emergency Alert Independent living at
home may require the ability to summon help
quickly. The plan pays the monthly rental or
lease fees for an emergency alert system up to an
amount equal to the daily community-based
benefit. Portability Feature You can take the
benefit with you, even if you leave MCCS! If
your employment status changes, you may continue
your coverage with the same benefits and rates on
a direct pay basis with CNA. You will be billed
on a quarterly basis. Waiver of Premium After
your waiting period is satisfied, you will not
have to pay premiums in order to keep your
coverage. Your premiums will be waived while you
are receiving benefits. This means you will
never have to repay those premiums. Waiting
Period 90 calendar days for any combination of
nursing home care and community-based care.
- Convenient Payroll Deductions You and your
spouses premiums will be deducted directly from
your paycheck, bi-weekly. Parents and in-laws,
etc., will be directly billed by CNA on a
quarterly basis - How to Qualify for Benefits
- To receive long-term care benefits you must be
certified as chronically ill by a licensed health
care practitioner and unable to perform at least
two Activities of Daily Living (ADL) for 90 days
without the substantial assistance of supervision
of another individual. Or, you must be certified
as requiring substantial supervision to protect
you from threats to your health and safety due to
a Severe Cognitive Impairment. - Who can enroll in Long-term care?
- Regular Full-Time or Regular Part time MCCS
employees. - Spouses of employees
- Retirees, spouses of retirees, parents,
parents-in-law, grandparents and grandparents in
law - Benefit eligible employees who enroll within 31
days following their date of eligibility are
guaranteed acceptance into the plan, provided you
are actively at work on the date your coverage
begins. - Coverage is not guaranteed must apply for
coverage by filling out an application form, and
evidence of insurability must be provided. - Additional Forms More Information
- You may obtain additional information on this
coverage by calling the CNA toll-free number at
1-877-777-9072
Long-term care is for EVERYONEnot just the
elderly. Protect yourself and your family today!
1. The Federal Long Term Care Insurance Program,
Long Term Care Basics, 2 April 2008.
2 . National Association of Insurance
Commissioners, A Shoppers Guide to Long-Term Care
Insurance. 2003 3. The Federal Long Term Care
Insurance Program, Long Term Care Basics, 2 April
2008._print.html