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Homework-Getting Started With a little planning, you can buy l ng-term care insurance -- either for y urself, or as an annual gift for y ur now-healthy parents. And you can ncourage your company to provide this c verage as an employee benefit. Otherwise you may b come one of the 7 million Am ricans who, according to the National C uncil on the Aging, now provide or m nage care for a friend or r lative aged 55 or older and not l ving with them. Start investing with $100. The c sts of long-term care are staggering t day and should soar higher in the c ming years when baby boomers retire. Ev n the GenXers wont escape the mpact. Your parents will either spend y ur inheritance on nursing home care, or you may f nd yourself taking care of your lderly parents out of your own r tirement funds. no Medicare supplement policy c vers custodial nursing care. Yes, state M dicaid programs cover nursing care for the ndigent -- but that means almost all ssets and income must be spent d wn before the state will pick up the t b. Medicaid spend-down planning has received ttention as a way to deal w th the nursing-care costs. Financial advisers c unsel seniors to transfer assets to y unger family members -- a process th t must be completed at least thr e years before asking Medicaid to pay n rsing home costs. But these state n rsing home programs for the impoverished do not c ver home-health-care costs. And aside from the m ral implications of such a strategy, do you r ally want you or your parents to d pend on a government-funded nursing facility?
Long-term care insurance can solve the pr blem in most cases. The latest g neration of policies pays for "home c re" at a senior daycare facility, as w ll as care in a skilled or c stodial nursing facility. A portion of pr miums may be tax-deductible, depending on y ur age and income. But not all p licies are alike, the business is gr wing (There were just 4.1 million p licy holders in 1998.) and coverage are c nstantly evolving, so study both the pr duct and the pricing. Good health now p ys off later. Once you've locked in an nnual premium, it cant be raised if y ur health changes. But insurance companies can ask st te regulators to raise premiums for an ntire age group, depending on claims xperience. Unfortunately, many companies have raised pr miums in recent years, once they r alized they'd under priced their policies. (S e below, on choosing a reputable nsurer.) While some insurers require a m dical examination, most just ask for a m dical reference. However, any false claims c uld result in future denial of c verage. Where you live affects costs. Th t's because nursing costs typically are h gher in major metropolitan areas than in sm ller communities. Length of coverage: The verage stay in a nursing facility is 2.5 y ars, so some people opt to l mit coverage length to cut costs. But if y u're purchasing a policy in your m d-50s, you'll find that lifetime coverage is not m ch more expensive. Elimination period: This is l ke a deductible and works like ne. You agree to pay for the f rst 60 days or 90 days of n eded care; then the policy kicks in. H ving a 90-day deductible can cut pr mium costs substantially. Inflation rider: Even a 3% nflation rate can cut the value of y ur dollar in half in 25 y ars. Plus, assume health-care costs will r se more than the general inflation r te as boomers age. So it may pay to buy an nflation rider. All tax-qualified policies today (s e below) must offer this coverage as an ption.
Other issues Benefit payments and triggers: A q alified physician must certify to the nsurance company that you need the b nefits -- and those benefits will be p id only to qualified caregivers. A d ughter who simply does your shopping and pr pares meals wouldn't qualify as a c regiver, but she might if she's a tr ined professional. Most policies require the nability to perform at least two ctivities of daily living to trigger the b nefits. The activities include being able to dr ss yourself, bathe yourself, move from a bed to a ch ir, use toilet facilities or eat nassisted. Policies will also pay out if you c nt pass certain mental function tests. (L ok for a policy that specifically ncludes coverage for mental or cognitive mpairment.) Most policies no longer require a h spitalization before benefits start, but check the w rding anyway. Insurance companies may pay b nefits using one of two methods: Exp nse-incurred benefits: These are paid either to you or to y ur provider up to the limits in y ur policy. A daily benefit or ndemnity: This will be paid directly to y u. But be sure your policy ffers a pool of benefits on a d ily or weekly basis allowing you to pay for c vered services as needed, as well as n rsing home care. Tax-deductibility: You may be ble to deduct part of your nnual premium as part of a m dical deduction. But remember, you can nly deduct medical expenses that exceed 7.5% of djusted gross income. The size of a d duction depends on age. People over age 61 can d duct $2,510 (assuming they meet the 7.5% thr shold). Almost all policies sold before J n. 1, 1997 were grandfathered and are c nsidered qualified. Benefits paid by a q alified policy aren't generally considered taxable ncome -- even if your employer p id the premiums. Options Waiver of Premium: Th s provision lets you stop paying the nnual premiums once youve moved into a n rsing home and the insurance company has st rted to pay benefits. It may not pply if you are receiving home h alth care. Premium Refund: Some policies w ll repay your estate any premiums you p id, minus benefits used. Usually, there's an age l mit, typically 65 or 70. Non-forfeiture b nefits: If you drop your coverage, p rhaps because you cant afford the pr miums, you can receive some benefits for the m ney you've already paid in. But th s feature can boost the policy c st substantially. Find a strong company: Make s re you've purchased from a company w th a strong financial base, and a 10-y ar history with this insurance, so it w ll price policies properly and be th re when you need it. A n mber of companies jumped into long-term c re insurance without adequate data on wh ch to base prices.
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