News & Updates

Long Term Care Insurance - Seperating Fact and Fiction

There are a lot of misconceptions about Long Term Care Insurance, following are some of the most common:

Myth #1: Long Term Care Insurance is "Nursing Home" Insurance.

Fact:  Like many myths, this one is rooted in fact.  The first Long Term Care Insurance Policies, starting in the 1970's and continuing into the 1990's were sold to older individuals and generally only covered care in facilities.  Over the last decade, the average age of an applicant for Long Term Care Insurance has decreased from the mid 70'a to the current average of 57.  During this time, Long Term Care Insurance policies have become much more robust and comprehensive, including home care, adult day care and even in some cases cash stipends to claimants.  In practice, Long Term Care Insurance often serves as nursing home avoidance insurance.


Myth #2: I'm too young now, I can wait until I'm a retiree/senior citizen etc. to apply for coverage.

Fact:  Again, there was a window of time when this was the case.  However, as Long Term Care Insurance Policies have evolved to offer much more coverage in a variety of circumstances, qualifying for a policy has become increasingly difficult.  Many chronic medical conditions can permanently exclude you from qualifying for any coverage.  Minor health incidences, such as physical therapy for a minor sports injury, can temporarily disqualify you from qualifying for coverage.  Industry wide, 92% of Long Term Care Insurance policies issued in 2008 were to applicants under the age of 70.  For those who are lucky enough to qualify at an advanced age, the premiums are SUBSTANTIALLY more expensive and in almost any case, you would be better off purchasing it younger and paying a much smaller premium for a longer period of time.

Myth #3:  The government will pay for my care.

Fact:  There are some government resources available to pay for Long Term Care.  All of these programs, whether of the state or federal level, are some form of Medicaid.  Medicaid, like most public assistance programs is designed for people of extremely limited means.  For specifics, please visit: http://www.cms.hhs.gov/medicaideligibility/.  To make a long story short, to qualify, you must have limited income and nominal assets; including owning a home.  For those who have any type of asset, they must spend through almost all of it before qualifying.  For a long time, people have engaged in so called Medicaid Planning, in which personal assets are transferred to other individuals.  In addition to the obvious potential issues with this, the Deficit Reduction Act of 2005 increased look back periods and made the practice of transferring assets to qualify much more difficult.  Most people would agree that it is a reasonable assumption that future legislation will continue to try and eliminate loopholes that allow people to manipulate the system in order to qualify.


Myth #4:  My health insurance and/or Medicare supplemental insurance will cover me.

Fact:  With almost no exception, health insurance, Medicare and Medicare supplements provide coverage for a maximum of 100 days.  These types of insurance provide care and resources to help people recuperate from an illness or injury.  Generally speaking, "long term care" begins when you stop getting better, but require assistance with one or more activities of daily living.


Myth #5:  I probably won't need care, so I definitely don't need insruance

Fact:  Medical advancements and other factors have greatly increased the average life expectancy of Americans and it is reasonable to assume that this trend will continue.  One of the unintended consequences of these advances is that more people are requiring long term care and for longer periods of time.  As previously mentioned, once they reach 65 years of age 33% of men and 52% of women are likely to require nursing home care.  Approximately 75% of Americans will require some form of Long Term Care before they die.  However in a recent poll, 86% of 50-65 year olds, "do not expect they will need day-to-day assistance or ongoing health care during retirement."  Of course Long Term Care is not exclusive to senior citizens.  Right now, 42% of patients in nursing homes are under the age of 65.


Myth #6:   If I start investing the money I would spend on premiums, I will have plenty of moeny to pay for care when the time comes.

Fact:  The average healthy couple in their 50's, can purchase a comprehensive LTC Insurance Policy for a couple thousand dollars per year that will immediately give them access to a pool of money woth a couple hundred thousand dollars for long term care.  These policies should include inflation protection that will allow the pool of money to accrue interest and compound to offset the effects of future inflation.  In other words, just as most people don't think it makes sense to invest their Home Owner's Insurance premium instead of maintaining coverage, the same principles apply for Long Term Care.

Myth 7:  These policies are just too expensive.

Fact:  If you can't afford the solution, you definitely can't afford the problem.  Depending on age at the time of application, health, the amount of coverage applied for and a couple other factors, Long Term Care Insurance Policies can cost anywhere from a $300 to over $10,000 per year.  As is the case with most forms of insurance, the cost of coverage is based on the risk of an applicant filing a claim and the benefit amount available.  Now that Long Term Care Insurance has been around for almost 40 years, there is an adequate actuarial sample to reasonably project the number and amount of future claims.  These projections are the basis for the cost of Long Term Care Insurance.