Long Term Care

Comprehensive Long-Term Care Insurance
Chances are you have life insurance to protect your assets from an unexpected death. You have auto insurance to protect your automobile from an unexpected accident. And, you have homeowners insurance to protect your home from an unexpected fire.

However, what if you, your spouse or your family had to face the costs associated with your recovery from an unexpected illness or injury, who would pay the bills?

With a Comprehensive Long-Term Care policy you can help protect yourself or your family from the high costs associated with such unfortunate situation.

What Kinds of Coverage will YOU receive?
Regardless of the plan you select you will receive coverage for expenses due to the following types of care, services and supplies:

Nursing Facility Carethe policy will pay the charges for Nursing Facility care, room, board and ancillary services and supplies, up to your Maximum Daily Benefit Amount. You must stay in a nursing facility legally operated to provide:

  • Skilled Nursing Care
  • Intermediate Nursing Care
  • Custodial Nursing Care

Residential Care Facility
the policy will pay the charges for all qualified Long-Term Care Services covered by your policy that you receive while staying I a Residential Care Facility, up to your Maximum Daily Benefit Amount.

Bed Reservation Charges
the policy will pay the daily charge, up to your Maximum Daily Benefit Amount, to reserve your Nursing Facility or Residential Care Facility bed when your are hospitalized after we start paying benefits for your stay. We will pay for up to 30 days during each Calendar Year.

Home Health Care

We will pay the monthly charges, up to your Maximum Monthly Benefit Amount, for the following:
Visit by;

  • Licensed Nurses
  • Legally Qualified Physical, Occupational and Speech Therapists
  • Home Health Aides
  • Audiology Services
  • Medical Social Services by a Social Worker

The above services must be provided by a Home Health Care Agency, or where there is no available Home Health Care Agency, a person who is licensed or certified to provide such services and who is specified in a Plan of Care.

Personal Care

We will pay the charges, up to your Maximum Monthly Benefit Amount, for the following when included in the Plan of Care;

  • Ambulation assistance
  • Bathing, dressing, and grooming services
  • Bowel, bladder, and menstrual care
  • Repositioning, transfer, skin care, and range of motion exercises
  • Feeding and hydration assistance
  • Assistance with self-administration of medications
  • Assistance with the instrumental activities of daily living

Homemaker Services

We will pay the charges, up to your Maximum Monthly Benefit Amount, for the following when included in the Plane of Care;

  • Domestic, laundry or cleaning services
  • Reasonable food and shopping errands
  • Meal preparation and clean-up
  • Transportation assistance to and from medical appointments
  • Thorough cleaning of your home to remove hazardous debris or dirt

Respite Care

We will pay up to 21 days of Respite Care during each calendar year. We will pay up to your Maximum Daily or Monthly Benefit Amount as shown below, when the Respite Care consists of the following;

  • Nursing Facility Care (Maximum Daily Amount)
  • Home Health Care (Maximum Monthly Amount)
  • Residential Facility Care (Maximum Daily Amount)
  • Personal Care (Maximum Monthly Amount)
  • Homemaker Services (Maximum Monthly Amount)
  • Adult Day Care (Maximum Monthly Amount)

The services and care must be provide by persons or facilities qualified to do so.

Hospice Services

If your doctor certifies that you have a life expectancy of less than one year and have no reasonable prospect of cure, we will pay the charges up to your Maximum Monthly Benefit Amount, for outpatient services which are not paid by Medicare and are designed to;

  • Provide palliative care to you and supportive care to  your unpaid caregiver and family
  • Alleviate the discomforts of experiencing the last phases of life

Adult Day Health / Social Care

We will pay the charges, up to your Maximum Monthly Benefit Amount when the following are provided by an Adult Day Care Facility, an Adult Social Day Care Facility, Adult Day Health Care Facility or an Alzheimer Day Care Resource Center

  • Meals
  • The personal care and supervision you require
  • Social, recreational, and health activities designed to improve your self-awareness and level of functioning
  • Transportation to and from the facility where Adult Day Health / Social Care is received

Caregiver Training

We will pay the charges up to 25% of the Maximum Monthly Benefit towards professional training for the relative or friend who will begin to take care of you in your home, without charge.

Monitoring Equipment

We will pay up to an amount equal to 5% of your Maximum Monthly Benefit Amount per month, for up to 12 months during your lifetime, for the rental or lease of an emergency medical response system or medication monitoring or dispensing equipment installed when recommended as part of your Plan of Care.

Home Modifications
– the policy will pay up to a lifetime benefit amount equal to 30 times your Maximum Daily Benefit Amount towards, the chargers for physical modification to your home or the installation of equipment such as ramps or grab bars, that will let you live there instead of having to stay in a facility. You, your doctor, registered professional nurse or licensed social worker and we must agree beforehand to do this.

Home Based Care
– If you choose the Facility and Home Based Care option you will also receive coverage for expenses due to the following types of care, services and supplies:
Home Health Care – the policy will pay the charges up to your Maximum Daily Benefit Amount for the following:

  • Part-time or intermittent and speech therapy
  • Physical, occupational and speech therapy
  • Home Health Aid services
  • Audiology services
  • Medical social services

The above services must be provided by a Home Health Care Agency an organization or person

Choose a Plan Best Suited to Your Individual Needs and Budget

You can select the Maximum Daily Benefit amount up to $300 per day and select the specified coverage from a year (365days) up to 500, 730, 1000, 1095, 1460,1500,1825, 2000, 2190, 2500,  2920 days (8 years) or even for as long as you live.
Maximum Benefit Amount ($) = Daily Benefit Amount multiplied by your chosen days 365, 500, etc.  ($300 x 365 days = $109,500.00)
($300 x 500 days = $150,000.00)
You can select from many elimination period; 0, 15, 30, 60, or 90 days. The 60 and 90 day elimination periods are not available with the 365 or 500 maximum benefit multiplier. 
There are two more factors that mainly affect your premium when you decide buying a Long Term Care policy.

  • Your age (the younger you are the cheaper the policy is)
  • Selected a compound interest option 3%, 4%, or 5%

Elimination Period

Specific provisions in a typical long term care insurance policy govern your eligibility for benefits. These are defined below, with additional comment for clarification where needed.

Explanation; Elimination Period is the number of days after the Original Coverage Effective Date of this Policy during which you must be: both Chronically Ill and receiving Primary Services (other than Hospice Care and Respite Care), before certain Benefits become payable. These days need not be consecutive. The Elimination Period for the certain Policy is shown in the policy.  Benefits will not be paid for Covered Services you receive during the Elimination Period.

You only have to satisfy the Elimination Period once. Once you have satisfied a day of the Elimination Period, that day is satisfied for the life of the Policy.

COMMENT: The Elimination Period in this long term care Policy is like a waiting period or a deductible period in your typical health insurance policy. Subject to the exceptions stated above, no long term care benefits are covered under the Policy during this period. You are responsible for paying all long term care costs incurred during the Elimination Period.

This is an important aspect to consider when buying a long term care insurance policy. Elimination periods range from 10 days to one year depending on the insurance company. Generally, you can decide what the length of your Elimination Period should be (depending on your budget), but it affects the cost of the premium. The shorter the elimination period, the higher your premium will be; the longer the elimination period, the lower the premium will be. A typical elimination period is around 60 or 90 days, but if you elect an elimination period of 6 months to one year, you might reduce your premium by as much as a third.

Your decision on the length of the Elimination Period must take into consideration your ability to pay for long term care expenses and, along with it, the quality/cost of the long term care facility you would consider. In many situations an older person only needs care for a short period of time. A long Elimination Period could mean you would not receive any Benefits at all. But the real purpose of long term care insurance is not to cover the costs of a short period of care, but to prevent the potentially financially devastating costs of a long period of expensive care. That’s why it is called long term care insurance. Therefore, purchasing a policy with a longer Elimination Period (90 days to 180 days) probably makes good sense if it results in substantial premium savings. This is particularly true if you are buying the policy when you are in your 40s, 50s or 60s and will probably be paying the premium for many years.

Typically, most insurance policies have the most attractive rates for 90-day elimination periods. A policy with anything longer than 90 days, while less expensive, may not save you much for the extra risk you take on. Before buying LTC insurance, make sure you know the terms of the elimination period.

For further details please e-mail me at or call me at so I can provide you with the best possible service.

Insurers and their representatives are not permitted by law to offer tax or legal advice. The general information here was written to support the sales, marketing or service of insurance policies by previous experience and data. Based on individuals’ particular circumstances and objectives, they should seek specific advice from their own qualified and duly licensed independent tax or legal advisors. No one may rely upon or use the information here for the purpose of avoiding any tax or tax penalty that may be imposed by the Internal Revenue Code or other applicable law.