Your personal and financial independence means the world to you. You've worked hard to earn it, and you're serious about protecting it. Today, thanks to healthier lifestyles and medical innovation, we're all living longer than ever before. But living longer also significantly increases our chances of requiring some form of extended professional health care.
It has been said that the fear of dying too soon has been replaced by the consequences of living too long. Long term care costs can be high, and can threaten the financial security you've worked so hard to achieve.
What Is Long Term Care Insurance?
Long Term Care insurance provides benefits to pay the cost of health and personal care services for someone who due to a chronic illness or cognitive impairment is no longer able to take care of themselves.
Why Do I Need It?
Concern is growing, particularly among "baby boomers", that people are going to outlive their assets.
- Will your savings be enough to cover the cost of long term care?
- Will you be able to choose between home and facility care if you become ill?
- Will you become a financial and emotional burden on your family?
Some facts to consider...
- According to the New England Journal of Medicine, 42% of people who turned 65 in 1990 will spend time in a nursing home before they die.
- An aging population means the largest percentage of our population is nearing retirement with continued high expectations for their standard of living.
- People aged 65 or older account for 50% of hospital days, 40% of prescription drug expenses, and represent almost 100% of people in Long Term Care facilities.
- New technology and medical breakthroughs are prolonging life, but at the same time contributing to a greater number of people living longer with chronic disabling conditions
- Baby boomers will cost the health care system an additional $530 billion over the next 40 years
How expensive can long-term care be?
The quick answer is "more than you think!" Private nursing homes can cost more than $3,500 per month. Government nursing homes can cost less, but often have long waiting lists. Home care providers, which may include a private registered nurse, charge a rate of approximately $45 per hour. Less skilled care, like assistance with eating or light housework, can cost at least $20 - $25 per hour.
Won't the government look after me when I'm old?
Many of us think the government will look after us in our old age. If you become chronically disabled or mentally impaired, your provincial government plan may cover only a portion of the care, assistance and supervision you may need.
If you do qualify for a full government subsidy, you will have to abide by their terms and conditions - government nursing homes, government regulated home care and only the benefits allowed within their parameters.
The subsidy level for nursing home care is reviewed annually. If your income exceeds this level, you would be eligible for only a partial subsidy, or you could receive no subsidy at all on the cost of your accommodation.
Your Long Term Care Plan can.
- Provide a tax-free daily benefit amount in the event of a long term illness or disability.
- Offer an alternative to using assets to finance long term care costs.
- Enable you to remain in your own home as long as possible.
- Allow you to choose a facility that meets your standard of care, comfort and location.
- Protect your hard-earned retirement assets, children's inheritance, and plans for charitable gifting.
Who Is Eligible?
Generally people between the ages of 18 and 80 are eligible to qualify for Long Term Care plans.
Benefit Limits
Long Term Care plans provide benefits in amounts from $1,000 to $9,000 per month. Plans are generally available in increments of $100. Benefits are received "tax-free".
Benefit Periods
Long Term Care plans provide for a payment of benefits for a predetermined period of time. You can choose to have benefits available for the following periods:
- 2 years
- 5 years
- For your lifetime
Are My Premiums Guaranteed Not To Change?
Premiums are level and generally payable for life, but not guaranteed.
Premium payments do not generally change for the first 5 years of the policy. Thereafter however, the premium payment is subject to change. Some plans offer caps or limits as to how much the premium can change and how long you are required to pay.
Types of Plans Available
Long Term Care plans are generally made available in three types.
Income Plans:
- The insured person receives a monthly benefit that can be used at their discretion.
- No receipt is required with this type of plan. It does not matter what expense is incurred because of your state of health.
Indemnity Plans:
- The insured person receives a daily income subject to the daily benefit maximums for each day that care is received, as defined under the plan. The care must be approved by the insurance company.
Reimbursement Plans:
- If the insured selected the Home Care option, a refund of expenses is given (receipts for the care received must be submitted), up to a maximum of the daily benefit amount.
When Would I Be Able To Claim?
Long Term Care plans are subject to a waiting or elimination period. This period is generally one of the following and is selected at the time of the application.
- 0 days
- 30 days
- 60 days
- 90 days
- 180 days
To qualify for Long Term Care benefits, the insured person requires a doctor's diagnosis.
- If the insured person becomes unable to perform 2 of the following 6 activities of daily living without the help of another person: bathing, dressing, toileting, transferring, continence, eating, or
- If the insured is suffering from a cognitive impairment endangering his health or safety, (IE: Alzheimer's disease and other types of permanent senile dementia).
Types of Care Available
Facility Care Insurance
This insurance provides a daily benefit for every day that the insured person requires health and personal care services within a long-term care facility.
Home Care Insurance
Home care insurance is an optional benefit purchased in addition to facility care insurance. This daily benefit reimburses the cost of home care for an insured person. Home care is defined as a medically necessary long-term care program, recommended by a physician and provided by a licensed nurse or health care worker in the insured person's own home.
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