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long term care is all we think about. So you don’t have to.


We get it. Nobody wants to think about long term care. That’s why we’re here. Thinking ahead to help protect your family and everything you’ve worked for.


What is long term care?

Long term care is the assistance or supervision you or a loved one may need when you are unable to perform some of life’s most basic activities – like bathing, dressing, eating and going to the bathroom. You may also need help due to Alzheimer’s disease or dementia. The need may arise at any age due to accidents, illness, or stroke, or may simply be due to the normal effects of aging. Long term care can be received at home, in your community, or in an assisted living or nursing facility.

Will I need it and what does it cost?

If you were turning 65 today, you’d have a 70% chance of needing some type of long term care in the future1. Costs vary based on need and location:

National average cost per year2

$17,680
Part-time care at
adult day care center

$43,539
Assisted
living facility

$46,332
Home
health aide3

$82,125
Nursing home
(semi-private room)

$92,378
Nursing home
(private room)

Costs are covered in four ways:

Out of pocket

Cover all costs yourself.


Medicare

May pay in full for up to 20 days of care in a skilled nursing facility and in part for up to 100 days. After that, you’re on your own. Even during that brief period it doesn’t cover home health aides or assisted living, in most cases. Also, Medicare is designed to pay for skilled care; it will not pay for personal care services unless you are also getting skilled care such as nursing or therapy, and the personal care must be related to treating an illness or injury.


Medicaid

Pays for nursing home care and some home care for low-income individuals. To qualify for Medicaid, you must meet stringent limits relative to income and assets. In most cases, the Medicaid recipient must spend down assets to around $2,000, and all income earned (except around $30 a month) must be used to pay for services. Medicaid will then cover the excess cost.


long term care insurance

Protects your assets by paying for covered expenses up to predetermined amounts. Depending upon your plan, it can pay for a wide variety of home, community-based, and facility care services not covered by government programs.

Starting the conversation with a loved one.


As hard as it is to think about long term care, we know it can be even harder to break the ice when discussing the topic with a family member who may soon need it. Here are a few ideas to help make sure your conversation goes smoothly.

Start face to face

It’s best to talk about something this important and emotional in person, if possible. Being able to hear each other’s voices, read each other’s body language, and see each other’s facial expressions can help things go smoothly.

Focus on the positive

Kick things off by emphasizing all the love and hard work your loved one has poured into helping the family get to where it is today.

Stay on task

Revisiting past discussions or disagreements can quickly derail the dialogue. If these distractions do arise, politely acknowledge them before steering the conversation back to the topic at hand.

Use examples

Bring the situation closer to home by sharing the positive and negative experiences of people you know.

Take time to listen

Few things turn a conversation sour more quickly than the feeling that you aren’t being heard. Slow down to allow your loved one to say everything they need to say, especially when you’re hearing things you don’t like.

Be prepared

Share specific facts on long term care costs and payment options like those found on this site.

Don’t get discouraged

If things don’t go as planned at first, understand that this is a difficult topic and may require an ongoing conversation with several chapters.

long term care isn’t just something we do, it’s all we do.

When you or a loved one need long term care, the financial and emotional strain can be quite challenging. At MedAmerica, we’re thinking ahead every day. By focusing our business solely on helping our insureds navigate a long term care event, we make thinking ahead and getting through this difficult time easier for you and your family.

  1. U.S. Department of Health and Human Services, www.longtermcare.gov, October 2014.
  2. "Genworth 2016 Cost of Care Survey." conducted by CareScout, April 2016.
  3. Based on 44 hours per week by 52 weeks.
How much does long term care insurance cost?

The cost of insurance premiums is determined by factors such as the age and health of the applicant, the types of care covered, the maximum amount of benefits, how soon benefits are paid and more. Because so many variables are involved, the fastest and simplest way to get an accurate idea of costs for your situation is to contact a long term care insurance agent or financial planner. To locate an insurance agent near you, you may want to visit agentreview.net.

What services are covered?

All policies differ, but long term care insurance may cover many services in addition to nursing home care that government programs do not, such as home health care and homemaker services, adult day care, and care in an assisted living facility. It’s important to carefully compare the services and facilities a policy covers before buying.

When is a good time to consider buying?

According to the American Association for long term care Insurance, the best age to apply is in your mid-50s, and recent studies show the average buyer today is 59. One reason to buy at this age is that locking in a policy when in good health can mean lower premiums. Another is that accidents, illness, and injury can make long term care necessary before old age. In fact, more than a quarter of long term care is provided to people under 65.

Will there be a medical exam?

Since the current health of the applicant is an important factor in determining if a person qualifies for long term care insurance coverage, you must be prepared to share health information with your insurance agent. Medical underwriting requirements vary by insurance carrier. Your insurance agent can tell you what to expect before you apply for a policy.

Glossary

Activities of Daily Living (ADLs):
Everyday functions and activities such as bathing, continence, dressing, eating, toileting and transferring. The inability to perform two of more of these activities can determine when benefits are paid.

Adult Day Care:
Care given during the day at a community-based center for adults who need help or supervision during the day, but don’t need 24-hour care.

Assisted Living Facility:
A residential development that provides health care and personal care services for those who need some help with activities of daily living, but don’t need the level of assistance a nursing home provides.

Benefit Trigger:
How an insurer determines when benefits are paid, such as the inability to perform two or more activities of daily living, or the need for substantial supervision due to dementia or Alzheimer’s disease.

Elimination Period:
Also called a waiting period, this is the length of time an insured must pay for covered long term care services before the insurance company begins to pay benefits. In general, lengthening the elimination period on a policy lowers the premium.

Guaranteed Renewable:
A policy that an insurance company must renew unless the benefits have been exhausted or the premiums have not been paid.

Home Health Care:
Services in the home, including nursing care, medical care, therapy, and household tasks.

Hospice Care:
Care designed to reduce discomfort for a patient who isn’t expected to live very long.

Inflation Protection:
A policy option that increases benefit levels to cover expected increases in long term care costs.

Nursing Home:
A licensed facility that provides care to those who are chronically ill or can no longer perform one or more activities of daily living.