©2012, GoldenCare USA Long Term Care and Health Insurance Health insurance protects against cost...

©2012, GoldenCare USA

Long Term Care and Health InsuranceLong Term Care and Health Insurance

Health insurance protects against cost of Health insurance protects against cost of treating illness or injury (as is Medicare)treating illness or injury (as is Medicare)

Both may cover limited “Skilled Care”Both may cover limited “Skilled Care” Long Term Care insurance covers on-going Long Term Care insurance covers on-going

care required by those unable to care for care required by those unable to care for themselvesthemselves

Long Term Care Insurance can allow you to be cared Long Term Care Insurance can allow you to be cared for in the comfort of your home!for in the comfort of your home!


Why Is LTCi An Issue Today?Why Is LTCi An Issue Today?

The “Aging Of America” is causing an increased need The “Aging Of America” is causing an increased need for health carefor health care First baby boomer turned age 65 in 2011First baby boomer turned age 65 in 2011 2007 to 2030 – 89% increase in 65+2007 to 2030 – 89% increase in 65+ 4 times faster than total population4 times faster than total population11

Medicare & Medicaid budgets are in trouble!Medicare & Medicaid budgets are in trouble!The Government simply can’t keep payingThe Government simply can’t keep paying

They had to change!They had to change!

1 Across the States 2009: Profiles in Long‐Term Care and Independent Living: Executive Summary, Data and 1 Across the States 2009: Profiles in Long‐Term Care and Independent Living: Executive Summary, Data and Rankings, 8th Edition, Gibson M, Fox‐Grage W, Houser A.. 2009 2 Kaye H, Harrington C, LaPlante M. Long‐Rankings, 8th Edition, Gibson M, Fox‐Grage W, Houser A.. 2009 2 Kaye H, Harrington C, LaPlante M. Long‐Term Care: Who Gets It, Who Provides It, Who Pays, And How Much? Health Affairs. January 2010Term Care: Who Gets It, Who Provides It, Who Pays, And How Much? Health Affairs. January 2010


The Beginning Of ChangeThe Beginning Of Change

2002: Federal Government began offering LTCi 2002: Federal Government began offering LTCi coverage to 22M employees, retirees and their coverage to 22M employees, retirees and their familiesfamilies

Tax Incentives were passed to encourage the Tax Incentives were passed to encourage the rest of Americans to purchase coveragerest of Americans to purchase coverage

States begin to provide tax incentivesStates begin to provide tax incentives Own Your Own Future campaignOwn Your Own Future campaign Deficit Reduction Act of 2005Deficit Reduction Act of 2005


DRA of 2005DRA of 2005

Severely tightened Medicaid rulesSeverely tightened Medicaid rules Extended look-back periodExtended look-back period

Increased penaltyIncreased penalty

Authorized State Partnership PlansAuthorized State Partnership Plans Gives people an incentive to buy Long Term Care Gives people an incentive to buy Long Term Care

insuranceinsurance

By offering dollar-for-dollar asset protectionBy offering dollar-for-dollar asset protection


The Agent’s Role & StepsThe Agent’s Role & Steps

Do Do youyou need long term care coverage?need long term care coverage? Educate Educate youyou about long term care! about long term care! Shop and design an affordable plan for Shop and design an affordable plan for you!you! Start the process for Start the process for you!you!

Many can’t qualify for coverage!Many can’t qualify for coverage!They waited too long!They waited too long!


You May Need Care At Any AgeYou May Need Care At Any Age

42.6% are under age 6542.6% are under age 65

Medicaid and the Uninsured, Kaiser Foundation, 2008Medicaid and the Uninsured, Kaiser Foundation, 2008

57.5% are 65 and older57.5% are 65 and older


Where Is Care Provided? Where Is Care Provided?

8.8 in Community8.8 in Community

Medicaid and the Uninsured, Kaiser Foundation, 2008Medicaid and the Uninsured, Kaiser Foundation, 2008

1.5M in Nursing Homes1.5M in Nursing Homes(in millions)

86% receive care in the community!86% receive care in the community!


Long Term Care – Acute NeedsLong Term Care – Acute Needs

Medicare uses Diagnostic Related Groups (DRG’s)

Hospitals get paid a set fee depending on diagnosis

Examples: Cardiac arrest – 3

days Hip fracture – 6 days

Remember: Most health policies also use methods

to limit hospital stays!


Long Term Care – Chronic NeedsLong Term Care – Chronic Needs

Alzheimer’s and dementia Chronic arthritis Osteoporosis and/or

broken bones Diabetes, kidney and

circulatory problems Major strokes

Can you see where somethingCan you see where somethinglike this could happen to you?like this could happen to you?


Here Are The Facts…Here Are The Facts…

70 percent of people over age 65 will require 70 percent of people over age 65 will require some long term care services at some point some long term care services at some point in their livesin their lives11

Woman are especially at risk, at age 65, they Woman are especially at risk, at age 65, they have a 79 percent chance of needing carehave a 79 percent chance of needing care11

Married couples have over a 90 percent Married couples have over a 90 percent chance that one of them will need carechance that one of them will need care11

1 U.S. Department of Health and Human Services, 20091 U.S. Department of Health and Human Services, 2009

©2012, GoldenCare USASource: “2010 Source: “2010 Cost of Care” Survey, Genworth Financial, 2010Cost of Care” Survey, Genworth Financial, 2010

Average LTC CostsAverage LTC Costs

Nursing Home (Private Bed)Nursing Home (Private Bed) $206 Day/$75,190 Annually$206 Day/$75,190 Annually

Nursing Home (Semi-Private)Nursing Home (Semi-Private)$185 Day/$67,525 Annually$185 Day/$67,525 Annually

Assisted Living (One bedroom)Assisted Living (One bedroom)$3,185 Month/$38,220 Annually$3,185 Month/$38,220 Annually

Home Health Aide (30 hrs week)Home Health Aide (30 hrs week)$18 Hour/$28,080 Annually$18 Hour/$28,080 Annually

Remember…These costs could double or

triple by the time you need care!


Who Really Pays?Who Really Pays?

MedicaidMedicaid42%42%

Out-of-pocketOut-of-pocket28%28%

Out-of-pocketOut-of-pocket28%28%

Medicare – 15%Medicare – 15%Medicare – 15%Medicare – 15%

Other – 2%Other – 2%Other – 2%Other – 2%

Private healthPrivate healthinsurance – 7%insurance – 7%Private healthPrivate health

insurance – 7%insurance – 7%

Veteran benefits – <2%Veteran benefits – <2%Veteran benefits – <2%Veteran benefits – <2%

Long Term Care: An Essential Element In Health Care Reform, 2008, Avalere Health LLCLong Term Care: An Essential Element In Health Care Reform, 2008, Avalere Health LLC


Long Term Care Has a Price TagLong Term Care Has a Price Tag Sooner or Later, Someone PaysSooner or Later, Someone Pays

Four Options…Four Options… Do nothing and hope for the bestDo nothing and hope for the best Spend down to poverty and let the Spend down to poverty and let the

government pay your billsgovernment pay your bills Self insure through savingsSelf insure through savings Transfer the riskTransfer the risk


3 Ways to Pay for LTC!3 Ways to Pay for LTC!

Be Be ((VeryVery)) Rich! Rich!

Be Be ((VeryVery)) Poor! Poor!

Be Insured!Be Insured!

It took a lifetime to build your nest egg…It took a lifetime to build your nest egg…

Why lose it?Why lose it?

Fire or tornado?Fire or tornado?Homeowners insuranceHomeowners insurance

Fire or tornado?Fire or tornado?Homeowners insuranceHomeowners insurance

Car accident?Car accident?AutoAuto

insuranceinsurance

Car accident?Car accident?AutoAuto

insuranceinsurance

Heart attack?Heart attack?Major Major

medicalmedicalinsuranceinsurance

Heart attack?Heart attack?Major Major

medicalmedicalinsuranceinsurance

Long term care?Long term care?You pay?You pay?

Long term care?Long term care?You pay?You pay?

House/Autos, Savings/Investments, Income

House/Autos, Savings/Investments, Income

The Walls Around Your EstateThe Walls Around Your Estate

1 in 2

1 in 2401 in 15

1 in 1,200

1. “Mastering Long-Term Care”, Journal of Financial Service Professionals, July 19992. “What Attorney Should Know About Long-Term Care Insurance”, Elder Law Journal, Vol. 7 #1, 1999


Why People Buy LTC Insurance?Why People Buy LTC Insurance?

1.1. Choice and independenceChoice and independence

2.2. Avoid over-burdening their childrenAvoid over-burdening their children

3.3. Protection of assets and incomeProtection of assets and income

1.1. Choice and independenceChoice and independence

2.2. Avoid over-burdening their childrenAvoid over-burdening their children

3.3. Protection of assets and incomeProtection of assets and income

Planning earlyPlanning earlycan accomplish all three!can accomplish all three!


What Would Be Your Reason?What Would Be Your Reason?

Give Give yourselfyourself a choice of quality care?a choice of quality care?

Maintain Maintain youryour personal independence? personal independence?

Avoid over-burdening Avoid over-burdening youryour children?children?

Protect Protect youryour savings and assets?savings and assets?

Pass on a legacy to Pass on a legacy to youryour heirs? heirs?

Avoid impoverishing Avoid impoverishing youryour spousespouse

Which is most important to you?Which is most important to you?


Long term care insurance is flexible…Long term care insurance is flexible…

Design a plan geared totally to priceDesign a plan geared totally to price

Design a plan geared totally to benefitsDesign a plan geared totally to benefits

Long term care insurance is flexible…Long term care insurance is flexible…

Design a plan geared totally to priceDesign a plan geared totally to price

Design a plan geared totally to benefitsDesign a plan geared totally to benefits

It’s Your Choice!It’s Your Choice!

OR…OR…

Anywhere in between!Anywhere in between!


Progression of CareProgression of CareFamily and Friends - Informal CareFamily and Friends - Informal Care

Pays CASH – Day One – NO Restrictions!Pays CASH – Day One – NO Restrictions! Pay family and friendsPay family and friends Cover additional costs and expensesCover additional costs and expenses Pay bills or use for any other purposePay bills or use for any other purpose No worries about submitting billsNo worries about submitting bills

Premiums are waived when benefits start!Premiums are waived when benefits start!

87% of people needing care87% of people needing carereceive that care from unpaid caregiversreceive that care from unpaid caregivers11

1 1 “Caregiving in the U.S.”, National Alliance for Caregiving and AARP, 2009“Caregiving in the U.S.”, National Alliance for Caregiving and AARP, 2009


Progression of CareProgression of CareFormalFormal Home Health CareHome Health Care

When your family needs helpWhen your family needs help Covers professional and basic services Covers professional and basic services

Nursing, therapy, specialist and Nursing, therapy, specialist and homemaker serviceshomemaker services

IncludesIncludes Therapeutic devices, medical alert and Therapeutic devices, medical alert and

home modificationhome modification

Let’s keep you out of a facilityLet’s keep you out of a facilityas long as possible!as long as possible!


Progression of CareProgression of CareAssisted Living FacilitiesAssisted Living Facilities

Offers attractive alternatives to the nursing Offers attractive alternatives to the nursing home includinghome including Assisted Living FacilitiesAssisted Living Facilities Congregate Care HomesCongregate Care Homes Alzheimer's Care UnitsAlzheimer's Care Units Personal Care and more!Personal Care and more!

Choice is the key here!Choice is the key here!You decide if and when you want options!You decide if and when you want options!


Progression of CareProgression of CareNursing HomeNursing Home

Covers all levels of care Covers all levels of care Skilled, intermediate, custodial and Skilled, intermediate, custodial and

personalpersonal No prior hospitalizationNo prior hospitalization Alzheimer's is coveredAlzheimer's is covered Guaranteed Renewable for lifeGuaranteed Renewable for life

Protection of assetsProtection of assetsis the key here!is the key here!

Let’s look at a Let’s look at a

personalized planpersonalized plan

for you!for you!

Additional SlidesAdditional Slides

Following slides are used toFollowing slides are used to

show additional points. show additional points.

Use as needed.Use as needed.

Is there any reason we Is there any reason we shouldn’t start the shouldn’t start the

process?process?

Find out if you can qualify for coverage now!Find out if you can qualify for coverage now!

If you can’t qualify - you don’t have to make a If you can’t qualify - you don’t have to make a decision!decision!

Make better decisions when knowledge is fresh in Make better decisions when knowledge is fresh in your mind, why wait!your mind, why wait!


Why Wait? NEVER A Better Time!Why Wait? NEVER A Better Time!

Will you get healthier?Will you get healthier? Will your income dramatically increase?Will your income dramatically increase? Will long-term care costs decrease?Will long-term care costs decrease? Your FINAL decision isn’t until AFTER you get your Your FINAL decision isn’t until AFTER you get your

policy.policy.

Think About It…Think About It…

Each year of waitingadds more lifetime cost to the plan!

Each year of waitingadds more lifetime cost to the plan!


Never Less Expensive Than Today…Never Less Expensive Than Today…

• Age At The Time Of ApplicationAge At The Time Of Application• Future Uninsurable ConcernsFuture Uninsurable Concerns


Never Less Expensive Than Today…Never Less Expensive Than Today…

• Age At The Time Of ApplicationAge At The Time Of Application• Future Uninsurable ConcernsFuture Uninsurable Concerns• How Waiting Affects Inflation How Waiting Affects Inflation

CoverageCoverage


Where Do We Go From Here?Where Do We Go From Here?

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