Most people think long-term care refers to nursing home care for elderly individuals. You might be surprised to discover who actually needs care… and who pays.

While it’s true that nursing home care qualifies as long-term care, that’s only part of the picture.

Long-term care encompasses a wide range of services when individuals are unable to care for themselves and need help with normal ‘Activities of Daily Living’ (ADLs). These include eating, bathing, dressing, toileting and transferring (such as moving from your bed to the bathroom).

It’s also the supervision someone with a cognitive impairment (such as Alzheimer’s disease) typically requires.

Millions of working-age Americans need long-term care while recovering from an accident, because of chronic (long-lasting) health problems or a disability that affects their ability to perform everyday activities.

Most long-term care takes place right in the home.
Americans spend $33.1 billion for home health care services.
(National Association for Home Care, Basic Statistics, Nov 2001)

Nearly 13 million Americans of all ages now need assistance from others to carry out everyday activities. Most people (about 80%) who need care live at home, not in institutions. You or a loved one could find a need for long-term care for various reasons, such as an Accident, Disabling Condition, Heart Attack, Stroke, Parkinson’s, Cancer, Multiple Sclerosis or Advancing Age.

Old age isn’t the only reason you might need long-term care. Some 40% are working-age adults aged 18-to-64 (5.1 million) who need care because of disabling accidents and illnesses.
(U.S. General Accounting Office, Long-Term Care: GAO/HEHS-95-26, Nov 7, 1994 Rev. March 1996)

You might be surprised how affordable protection really is, especially when you compare it to having to pay for care yourself. You can save more by getting protection at younger ages and when you take advantage of discounts available (such as spousal or partner discounts).

• To avoid depending on others for care.
• To enable you to choose the LTC services that you want if you ever need them.
• To protect your savings and assets.
• To avoid welfare.
• To be able to leave an estate for heirs.
• Because the government will not cover the care you may need in the future.

Many people think that their health plan and/or Medicare will cover their long-term care needs. Unfortunately, they are WRONG.

If You Qualify for Medicare

Medicare pays ‘approved’ long-term care costs (say a skilled nursing facility) for the first 20 days of ‘qualifying’ care and then only a portion of the cost for the next 80 days. After 100 days, Medicare pay nothing.

Medicare provides no coverage for custodial care, either in your own home or a facility… and no coverage in a nursing home without prior hospitalization. Your supplemental health insurance (‘Medi-gap’) generally will not pay for long-term care costs either.

If You DO NOT Qualify for Medicare

Your individual medical, HMO or employer-provided health insurance generally won’t pay for long-term care. These policies limit covered benefits to hospitalization, doctors and qualifying medical services.

Did you know, you must “health qualify?"

A change in your health can make it impossible for you to “health qualify” for long-term care insurance. A current health condition may not disqualify you... but you should find out now before it gets worse.

• Care at home: A health-care professional coming to your home just 3 times a week can cost $12,000 a year or more.
  (Mature Market Inst 2000)
• Care in a Facility: Costs for an individual range depending where you live, from $90 per day to $295 a day. The national average is $55,845 per-year… and increasing yearly.
  (Mature Market Inst 2000)