Long Term Care Insurance

Long Term Care insurance pays expenses if you need long term care at home, in an assisted living facility or in a nursing home. As of 2009, the average daily rate for a stay in semi-private room in a nursing home is $198 or $72,270 a year - and prices are expected to continue to go up.

Common wisdom is that prime candidates for long term care insurance are people with assets to invest between $200,000 and in the $2 - 5,000,000 range. People with a lower amount of assets generally can't afford the premiums and may qualify for Medicaid. People with assets over $2,000,000 can usually afford the necessary care depending on how easily the assets can be converted to cash.

If you have a history of a serious health condition:

• Health conditions are reasons for denials or higher rates. You may have to wait a period of time such as 12 months before getting a policy.
• Shop around if one insurer rejects you, charges a higher rate or imposes a waiting period before coverage starts.
• You may be able to get coverage through an employer or other group where no health questions are asked. The federal government is one such employer. To learn more about the government offers, call: 800.582.3337 or visit: www.ltcfeds.com
• If you lie about your health history on an application and the company issues a policy, the company generally has the right to refuse to pay a claim when it learns the truth.

When considering which Long Term Care policy to purchase, look for a policy:

• That provides the coverage you need. The cost of long term care depends on the severity of the disability, the amount of care which is required and your location. To learn the costs of nursing home care, assisted living care and home care in your state, go to Met Life's Mature Market Institute: www.metlife.com/mmi  Look for "what's new". 
• That has a price you can afford now and in the future.
• That has built-in protection against inflation so the benefit doesn't become less meaningful or even worthless by the time you need it.
• That provides benefits for the period of time you'll need.
• From an insurer with the financial stability to have the funds to pay if and when you file a claim.

Before buying a policy, consider whether there are alternatives that would work as well for you.

If you don't buy a policy and need help figuring out how to obtain long term care and how to pay for it, contact your state Long Term Care Ombudsman.

Because prices and coverages vary, and it may be difficult to find a policy with a health history, it is advisable to work with a broker who specializes in Long Term Care Insurance and deals with several insurance companies. He or she is likely to know which companies will be favorable to your situation. Or you can purchase Long Term Care Insurance on line. It can be difficult to compare policies because there is no standardization.

If you don't have a broker, you can locate one in your area through American Association of Long-Term Care Insurance: www.aaltci.org/agent_locate.html , Tel.: 818.597.3227,

When you receive your copy of a policy, check it over. You have 30 days to review it and send it back if it's not what you want.

There are steps to take to reduce the risk that the policy will unintentionally lapse or a claim won't be filed in a timely manner, or at all.

If you have an older policy with limited coverage, find out if the insurer will add an amendment (a "rider") to bring it up-to-date. Alternatively, try to buy a second policy for the extra coverage.

Claims under a Long Term Care Insurance policy are usually straightforward. It is advisable to inform the person or people closest to you of the claims requirement in advance so they can take the necessary steps if you are unable to.

If your claim is turned down, it is generally worthwhile to appeal.

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