Elder Law Q & A: August 2016

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Q: What is the average cost of long-term care insurance?

A: The cost of long-term care insurance will depend on the daily benefit, the elimination period, age at time of purchase and the length of the policy.

Q: What factors should be considered when purchasing long-term care insurance?

A: Consider whether your retirement income will be sufficient to cover the cost of long-term care. Also consider whether the policy will cover nursing home, assisted living, adult day care and in-home care. Consider inflation protection options, and whether or not the policy is in the State Partnership Program. For more information and a rather exhaustive long-term care policy checklist, you may download "Guide to Long-Term Care Insurance" at www.ahip.org, or you may order "A Shopper's Guide to Long-Term Care Insurance" free from the National Association of Insurance Commissioners at www.maic.org/index_ltc_section.htm.

Q: What is the State Partnership Program?

A: This is a public-private venture designed to encourage Tennesseans to plan for their long-term care needs. Enrollment in a Partnership Program long-term care insurance policy can result in significant savings down the line. You can protect additional personal assets when applying for TennCare if you've helped defer costs of long-term care with a Partnership Program.

Q: How do you qualify to begin to receive long-term care benefits?

A: Most long-term care policies have two potential benefit triggers: (1) the policy holder must require assistance with two or more "activities of daily living" (ADLs). ADLs are eating, bathing, dressing, transferring toileting and continence. Your policy will specify how many ADLs you must need help with before you qualify. Or the second trigger is (2) cognitive impairment in which memory, judgment and reasoning ability are reduced to the point where you need supervision for your safety. Often there is a document that must be completed by the policy holder's physician. Almost always the insurance company will send a nurse or case manager to make an assessment.

Q: How much and how does the long-term care policy pay? How are benefits calculated?

A: You must look to the specific policy, but some things to take into consideration would be if the policy pays differently depending on the location of care services. Meaning, does the policy pay differently depending on the individual being at home with caregivers, in assisted living, or must they actually be in a licensed nursing home before the policy pays out. Then you need to understand the elimination period. That is the number of days you will have to pay out-of-pocket for covered care before your policy begins paying.

Q: If I am receiving benefits from my long-term care insurance plan, do I still need to pay premiums?

A: Again, that is policy-specific; however, many if not most policies include a "waiver of premium" clause under which a policy holder would no longer be required to pay premiums once benefits become payable.

For almost 20 years, the Elder Law Practice of Timothy L. Takacs has been helping families respond to the legal, financial, physical and psychological challenges presented by long life, illness and disability. As an elder law practice that specializes in Life Care Planning, we help families protect assets and coordinate care. Founder Timothy L. Takacs, Certified Elder Law Attorney, one of the most respected elder law attorneys in the nation, leads an interdisciplinary team of care coordinators and other professionals who work together to enhance the quality of life for elders. "Like" Elder Law Practice of Timothy L. Takacs on Facebook and see the latest from Elder Law Practice in your Facebook newsfeed each day. To learn more, call 615-824-2571.

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