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- Long Term Care Insurance, Insurance for the unexpected
- What is Long-Term Care (LTC)?
- What are chances of needing LTC?
- What are the costs associated with LTC? & What are the funding sources to pay for LTC?
- Is LTC insurance right for me? & Why John Hancock LTC Insurance
- Next Steps…
What is Long-Term Care (LTC)?
- Activities of Daily Living
– Bathing
– Dressing
– Eating
– Toileting
– Continence
– Transferring
- Cognitive Impairment:
– A condition that leads you to require substantial supervision to protect yourself or others from threats to health and safety.
- Where Can I Get Long-Term Care Services?
– Your Home
– Assisted-Living Facility
– Adult Day Care Facility
– Nursing Home
80% of seniors requiring assistance with activities of daily living receive care at home or in community bases settings.¹
(1. General Accounting Office, Testimony Before Committee on Finance, U.S. Senate, 2001)
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What are chances of needing LTC? – Could it happen to you?
- What are your Long-Term Care experiences?
– Who?
– Where?
– How was it paid for?
– Who provided the care?
– How long did the person need care?
– Was the care expected or unexpected?
– How did the Long-Term Care affect the family?
– 60% of people who may need long-term care are 65 or older.
(Source: U.S. General Accounting Office, “Where Does the Population Live and Who Cares for Them,” LTC: Diverse, Growing Population Includes Millions of Americans of All Ages, January 2001. )
– 40% of those receiving Long-Term Care services are adults between the ages of 18 and 64.
(Source: U.S. General Accounting Office, “Where Does the Population Live and Who Cares for Them,” LTC: Diverse, Growing Population Includes Millions of Americans of All Ages, January 2001.)
– Among 22.4 million families in the United States, nearly one forth of all households provide care to elderly relatives.
(Source: Study by Brandeis University’s National Center of Women and Aging, December 1999.)
– By 2030, when the last of the Baby Boomers are retiring, the number of people age 65 and older will have doubled to 70 million.
(Source: American Council of Life Insurers, 2000.)
– The national average cost for a nursing home stay per year is $55,000¹ and may run as high as $93,000 in some states.²
Costs vary by the type of care received and by geography.
(Source: (1) Testimony before the Committee on Finance, “Baby Boom Generation Increases Challenge of Financing Needed Services,”
March 2001 (2) The New York State Partnership for Long-Term Care, Consumer Booklet: Affordable Financing for Long-Term Care, 1999)
– Extensive 24-hour home care can cost as much or more than a nursing home.
Costs vary by the type of care received and by geography.
( Source: The New York State Partnership for Long-Term Care, Consumer Booklet: Affordable Financing for Long-Term Care, 1999 )
– The range for home care costs is $10-$50 per hour and will vary with the type of care provided and the skill level of the provider.
Costs vary by the type of care received and by geography.
( Source: Long-Term care Planning Guide, United Seniors Health Council, January 2001. )
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What are the costs associated with LTC? & What are a few funding sources that can be used
to pay for LTC?
- How Would You Pay for Long-Term Care?
• Private/company
medical insurance?
• Medicare
• Medigap Insurance
• Medicaid
• Personal
Assets
• Family
- Private/company health insurance
– Skilled acute care only
– Not designed to pay for long-term custodial care
- Medicare¹
Skilled Care/Skilled Nursing Facility
– Three day prior hospital stay required
– Enter facility within 30 days
– Full costs covered for 20 days
– Minimal costs covered for next 80 days
– No coverage after 100 days in that benefit period
Home Health Care
– Part-time skilled nursing care
– Custodial homemaker services provided incidental to home health care
(1. 2003 Guide to health Insurance for People with Medicare, The Centers for Medicare & Medicaid Services and U.S. Department of Health and Human Services.)
- Medicare Supplement
– Medicare approved expenses only
- Medicaid¹
– Must “spend down” assets to State required level*
(1. Eligibility requirements apply and
vary by state. )
- Personal Assets
– One long-term illness may jeopardize your accumulated
retirement savings
- Family
• Long-Term Care is a family issue
• An estimated 60% of the disabled elderly living in communities rely exclusively on their families and other unpaid sources for care¹
• Seven of Ten unpaid caregivers are women¹
– Could your family care for you?
– Would you want them to?
(1. United States General Accounting
Office, Testimony Before Committee on Finance, U.S. Senate,
2001.
- Personal Assets
– One long-term illness may jeopardize your accumulated
retirement savings
- Who Pays the Long-Term Care Bill?
44% paid by Medicaid
25% paid out of pocket
14% paid by Medicare
10% paid by Private
4% paid by Other Private
3% paid by Other Public
- Private Long-Term Care Insurance Can Help
– Stay at home when you need care
– Maintain your independence
– Protect your income and assets
– Avoid dependence on family members
– Access high quality care
- Is There Any Risk You Haven’t Already Insured?
• Have you insured your home?
• Have you insured your car?
• Do you have medical insurance?
• Do you have a plan to pay long-term care expenses?
Why not insure one of your greatest risks with long-term care insurance?
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Is LTC insurance right for me?
- Why John Hancock Long-Term Care Insurance
• Benefit Flexibility
• Choice of Coverage
• Wide-ranging Home Health Care Benefits
• Pool of Money
• Inflation Protection
• Waiting Period
• Coverage for Alzheimer’s Disease*
*Diagnosed after policy effective date.
• Guaranteed Renewable¹
• Waiver of Premium Benefit
• Responsive and Experienced Claims Staff
• SharedCare²*
• FamilyCare Benefit³*
• Advantage List
(1. The insurer reserves a limited right to increase premiums by class
2. Not available with 10-year or Lifetime Benefit Period, or to ages 80-84. In AZ and NH, available only with the 4-5-or 6-year benefit period. In PA, available only with the 3-4-5- or 6-year Benefit Period. Only spouses are eligible in MD, NY, and LA for these benefits. In ID these benefits are not available to same sex domestic partners.
3. Not available in CT, LA, MD, NY, PA, and TX.
* Additional Premium will be required)
- Backed by the Strength of John Hancock
• More than 140 years of service.
• More than 400,000 long-term care insurance policyholders.
• Among the highest rated insurance companies for financial strength and stability as judged by the major rating agencies.
• Financial Strength
John Hancock is one of the highest-rated insurance companies in the country
Ratings are current as of May 2003:
A.M. Best A++ Superior
Fitch AA Very Strong
Moody’s Aa3 Excellent
Standard & Poor’s AA Very Strong
The rating refers only to the overall financial status of the company, and is not a recommendation of the specific policy provisions, rates, or practices of the insurance company.
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Next Steps…
- How do I get coverage?
• Appointment
– Make an appointment with your John Hancock Licensed Agent to assess your personal needs.
• Application
– Complete an application bases on that plan that is appropriate for you.
• Underwriting
– John Hancock evaluates the application and health history to determine eligibility.
• Delivery
– Upon approval, the policy is delivered.
• Coverage
– By paying premiums on time, policy and coverage will stay in force.
- Why start planning today?
• People often put off the decision
– Too often, people wait until they critically need care. By then, they may not qualify for coverage.
- Custom Care II Limitations
• Benefits will not be paid for changes during the Elimination Period, except for Care Advisory Services, the Stay at Home Benefit, and Respite Care.
• Benefits will not be paid in excess of the policy limit, except for Care Advisory Services, the Stay at Home Benefit, and for benefits paid under the Accidental Benefit that exceed the Daily or Monthly limit.
• This policy contains a coordination of benefits provision: we may reduce benefits payable under this policy for long-term care services if we also pay benefits for such services under any other individual long-term care policy issued by us. This includes policies providing nursing home, assisted living facility and or home heath care coverage, whether payable on an expense reimbursement, indemnity or any other basis.
- Essential Care II Limitations
• Benefits will not be paid for changes during the Elimination Period.
• Benefits will not be paid in excess of the policy limit, except for Care Advisory Services and the Stay at Home Benefit.
• If you received services covered under the Nursing Home Benefit, Assisted Living Facility Benefit, and the Home Health Care benefit on the same day, the only benefit payable for that day will be the greatest of the three benefits.
• This policy contains a coordination of benefits provision: we may reduce benefits payable under this policy for long-term care services if we also pay benefits for such services under any other individual long-term care policy issued by us. This includes policies providing nursing home, assisted living facility and or home heath care coverage, whether payable on an expense reimbursement, indemnity or any other basis.
Exceptions
• This policy does not cover care, treatment or charges:
– for intentionally self-inflicted injury
– required as a result of alcoholism or drug addition (unless the drug addition was a result of the administration of drugs as part of treatment by physician)
– due to war (declared or undeclared) or any act of war, or service in any of the armed forces or auxiliary units
– due to participation in a felony, riot, or insurrection
– normally not made in the absence of insurance
• This policy does not cover care, treatment or charges:
– provided by a member of your immediate family, unless:
• the family member is one of the following professionals: a duly licensed registered nurse, licensed vocational nurse, licensed practical nurse, physical therapist, occupational therapist, speech therapist, respiratory therapist, licensed social worker, or register dietitian;
• the family member is a regular employee of an organization (e.g. nursing home, assisted living facility, adult day care center, or home health care agency) which is providing the services;
• This policy does not cover care, treatment or charges:
– provided by a member of your immediate family, unless:
• the organization receives the payment for the services; and
• their family member receives not compensation other than the normal compensation for employees in his or her job category
– provided outside the 50 United States and the District of Columbia, except as described in the International Coverage
section of the policy
• This policy does not cover items or services furnished at your request for beautification convenience, or entertainment.
• In Massachusetts, the policy does not cover alcoholism or drug detoxification.
• In Connecticut there is no exclusion of service in the armed forces
• In North Carolina, the coordination of benefits provision is not applicable.
Thank you!
This is a general description of coverage and is not an insurance contract. Refer to the Outline of Coverage provided by our agent for an explanation of features and options. Only the individual long-term care insurance policy contains governing contractual provisions. You may request a sample policy to review such provisions.
The Long-Term Care insurance policy describes coverage’s provided under the policy, exclusions, limitations, any reductions in benefits, what you must do to keep your policy in force,and what would cause your policy to be discontinued. Please contact John Hancock or your Insurance Representative for information, costs, and complete details on coverage.
Long-Term Care Insurance is underwritten by John Hancock Life Insurance Company,
Boston, Massachusetts, 02117
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