Here are the answers to some Frequently Asked Questions. If your question isn’t answered here, please E-mail us.
Q: I’m healthy as a horse. What makes you think I’ll need it?
A: Long Term Care is not for the present; it’s for your future. More than 50% of the population 65 years and older will need Long Term Care during their lifetime. For a married couple, there’s a 75% chance that one of the partners will need Long Term Care. Serious illness or accidents can strike, suddenly requiring many years of Long Term Care.
Q: Doesn't my social security or HMO cover Long Term Care?
A: Think again. The government will only assist once you’re on Medicaid (Medi-Cal in California). To be eligible, you must first "spend down" all your assets to poverty level and lose your independence and personal freedoms. You no longer have any choice in your long term care plans.
Medicare and most HMOs do not cover "custodial care" which is over 95% of all Long Term Care expenses, nor are they required to do so. Only "skilled care" is covered for a limited amount of time and it represents just 2% of all Long Term Care expenses.
Q: I’d rather just pay for the nursing home not the insurance. Is that doable?
A: Sure -- if you have unlimited sums of money that you want to part with. The average yearly cost of a nursing home in California is $51,100 ($140 per day). Some homes cost as much as $73,000 a year ($200 per day). Most stays of over 90 days duration are between 2 ½ to 5 years and 20% of those stays last over 5 years. Can you afford to pay $100,000 to $500,000 or more for Long Term Care? How will this affect your heirs? You already have Auto and Homeowners insurance, why not Long Term Care insurance?
Q: I don’t want to make payments all my life. What are my options?
A: Some insurance companies have a single premium plan. Other companies have a 10 year payment plan where the policy is paid in full after 10 years. This works very well when you are younger and the premiums are lower.
Q: What if I make payments but die before I get into a nursing home? What happens to my policy?
A: With most insurance companies, you can purchase "non forfeiture" benefits that pay back your premiums in case of death, reduced by policy benefits already received. Some companies have a "Return of Premiums" option. It typically returns 80% of your premiums less any paid out benefit payments, at the end of 10 years for a substantial additional premium.
Q: What’s an elimination period?
A: This works like a deductible and represents the number of days at the beginning of the covered stay before the benefit payments actually begin. The longer the elimination period, the lower the premium.
Q: What does "spend down" mean?
A: For you to be eligible for Medicaid, you would have to spend all your hard-earned assets to a poverty level.
Q: I’m 57 years young and my wife is 55. We’re in reasonably good health. Can you give us a ballpark figure of what the premiums would cost us?
A: Assuming you both qualify as preferred risk and non-smoker
THE TOTAL CURRENT ANNUAL PREMIUM, PAYABLE FOR ONLY 10 YEARS, IS $2,524.88 = $1,262.44 PER PERSON! AFTER THIS THE LIFETIME JOINT POLICY WOULD BE PAID UP IN FULL.
| Policy Benefits |
Benefit Period |
Benefit |
Elimination Period |
| Nursing facility confinement |
lifetime |
up to $100/day |
90 days |
| Residential care facility |
lifetime |
up to $100/day |
90 days |
| Home care |
lifetime |
up to $100/day |
90 days |
Waiver of premium – Waived after 90 days confinement in a nursing facility
Riders or optional benefits – Simple Cost of Living Adjustments (COLA)
10 Pay Premium Option – Policy is fully paid up after 10 years of premium payments. No future premiums can be charged after the 10th year.
Q: I’m the CFO of a corporation. Can I offer Long Term Care benefits to our employees or just our executives?
A: Yes. Check out our Group Discounts page.
Q: I’m self-employed. Is there any way I can get a discount through my chamber of commerce or trade association?
A: Yes. Check out our Group Discounts page.
Q: My parents cannot afford Long Term Care insurance. Can I buy it for them?
A: Yes. It’s prudent thinking because it’s likely that you will be involved in their long term health care decisions.
Q: Does Long Term Care cover Alzheimer’s disease?
A: Yes, and other forms of cognitive impairment. As you get older the chances of needing Long Term Care for cognitive impairment are dramatically increased.
Q: Are there any tax benefits?
A: Yes. Check out our Tax Benefits page.
Q: I’m a veteran. Won’t the government be responsible for my Long Term Care?
A: Maybe. The Department of Veterans’ Affairs provides health care based upon a set of eligibility guidelines consisting of three categories:
Category A -- ensures that veterans with service connected disabilities and eligible veterans with lower incomes are assured hospital care. Custodial care is not provided.
Categories B and C -- ensure that veterans who were disabled in service might receive care on a "space available" basis only. The co-payment is based on the level of income.
For more information call the Veteran’s Benefits Department at (800)424-8200.
Q: What spousal discounts are available? What is a domestic partnership?
A: Any two people living together in the same household applying for a joint policy such as:
Husband and wife
Two siblings living together
Opposite sex relationships -- not married
Same-sex relationships
If applying at the same time, there’s a 50% discount for the younger person under this plan. The annual premium of this joint policy is rated on the older age of the joint applicants.
Here’s an example of how the joint policy for a domestic partnership might work for you:
Assume an average daily benefit of $120.00 for lifetime coverage with a 5% simple interest cost of living increase built into the policy benefits. $120 a day may not sound like much but $43, 800 dollars per year for each partner does! $64, 700 in 10 years! $87,600 in 20 years! Your lifetime coverage would be provided after a 90-day elimination period under a Comprehensive Plan for nursing homes, alternative residential care facilities, adult day care or home care. The older you get, the more your premiums cost.
Buy now while you’re healthy and you increase the lifetime benefit for joint coverage with many more years of valuable protection. Here’s an example of the cost of waiting…
| The cost today if you pay... |
Annually |
10 Yr. Pay |
| At age 50, the annual premium for both applicants is |
$ 1,189.00 |
$ 2,142.00 |
| If you wait for tomorrow...the cost is... |
Annually |
10 Yr. Pay |
| At age 55, the annual premium for both applicants is |
$ 1,647.00 |
$ 2,882.00 |
| At age 60, the annual premium for both applicants is |
$ 2,509.00 |
$ 4,141.00 |
| At age 65, the annual premium for both applicants is |
$ 4,776.00 |
$ 7,402.00 |
Q: How do I get started?
A: Fill out our On-Line Quote Request Form.
