hi welcome to all the seniors i'm your host tom callahan only seniors is a show where we talk about senior living in elder care issues one of them that i'd like to point out is long term care insurance and sim portman's senior living today is carol einhorn she's also a long term care insurance expert and author of numerous articles regarding long term care her welcome to the senior sink to be here let's let's start with the basics wood is long term care insurance long term care insurance has been around for about thirty years and basically what it does it will pay for care an individual might need in their own home which is everyone's preference if they can in a in the system living facility in a nursing home or even an adult daycare center and it will pay for any type of care whether it's custodial care help with dressing and bathing and basic activities of daily living or other levels of care as well or once was suddenly on so many people's minds for long term care well that's that's a good question and  primarily i think it's because we're living longer you know it used to be a that you know we live to our seventy's and eighty's and that was an exception now living to our ninety's or hundreds is not the exception so we're living longer medicine is getting better and better and so even though we're living longer we're not always living better and what's been happening is the caregivers are becoming older as well so if if i'm in my mid sixty's or my mid seventy's i may need some help myself but i might be caring for an aging parent so a lot of times once people have been through it and taken care of the room parents they can stick it on their minds that she this is something that we should be thinking about how common is it becoming for long term care to be necessary well the most recent statistics tell us if we make it to age sixty five seventy percent of us will need long term care seventy percent yes so it's it's pretty frightening now that doesn't mean we're all going to need years and years and years of carrots and some of the short amount of care but the reality is that many people will need some type of long term care and we can certainly be way stretches and keep our heads in the sand enough think about it or we can try to take a little bit more of a proactive role and think gee what would happen to my family if i need long term care it's funny because when we look at long term care we automatically think of just seniors and when should people start looking into long term care insurance well it's funny you say just seniors because many of the people who need long term care even though you know i just expressed the statistic that if you're sixty five or older seventy percent might need long term care but many of the people that actually are using long term care are between the ages of eighteen and sixty five so that's there are a lot of people who need long term care  much younger age in terms of thinking about it if we wait until there's a problem you know the handwriting is on the wall you know our health is beginning to fail we you know we've had an incident of some sort it's too late so more and more attorneys accountants financial planners are encouraging people you need to start thinking about this when you're in your forty's it's really you know in terms of retirement planning we don't wait until we're sixty five and we're ready to retire or seventy or whatever age you're going to retire to think about retirement planning the same thing it should be true with long term care planning we can't wait till we're sixty five or seventy three about it we need to start thinking about it when we were much younger it's a guess that ties in with regular retirement planning they say you know the minute you have your first professional job you should start pretty money into a four one k start you start planning your retirement the right financial planning and unexpectedly when he was in his middle sixty's he needed a heart transplant and he did not have long term care insurance and due to a glitch in medicare medicare didn't pay for it and then the secondary insurance didn't pay for it well to make a very long story short he subsequently needed long term care he had a heart transplant he survived the surgery which was not really a blessing although we didn't know it at the time and he needed long term care and the cost of the care was exorbitant and it cost our family over a million dollars that was my rude awakening to think about long term care and he was just sixty five he was just sixty five now that also motivated me and my husband to you know i became involved in long term care insurance and started working with it and selling it and consulting about it when my husband and i reached forty you know we had just seen what had gone through what my dad had gone through my mom had gone through my brother and  so you know we took the step at age forty which is unusual but it's becoming more and more common to do something for ourselves now we've had that insurance we bought long term care insurance in our early forty's we've had that insurance for and i want to say how many years of well over twenty years and even though we have been paying for the two of us a lot of money  thousand dollars a year for over twenty years it's a lot of money we're talking forty fifty thousand dollars we've laid out if we were to try to purchase that insurance today it would be prohibitive in just two or three years we would probably equal all of the premiums we've paid and the clincher is what if our health had changed in the meantime and we couldn't even get the insurance so there are requirements you can't buy the insurance when you already have a health problem you have to do it before there is an issue so we you know in retrospect we were very smart but now my goal is to encourage people you need to think about this when you're in your forty's and fifty's just comment is you know you don't buy car insurance once you hit the other car right you know you need to have the car insurance before you take the car know that's how i think i would you know if i can frame it to people you know if you have car insurance you should have long term care insurance as well absolutely and i say that i say the same thing i say you know your house is on just starting to touch on costs tell us more about you know how much is long term care insurance cos that's that's the tough question it's like how much does a car cost you know it's hard but there are certain factors that will you know help determine the cost one of the things you've already mentioned in passing and that is your health if you already have a health problem either you may not be insurable or if you can get the coverage it may be more expensive so your health how long will the policy pay for care you can get a policy used to be my husband and i were fortunate when we got our policy it was for an unlimited period of time can't buy that type of policy anymore for the most part ok so how long will the policy pay for care will the pay for two years of care or six years of care and you can also get a policy for couple that is a bundled or shared policy so you can get instead of you getting six years in a partner or spouse getting sixty years you can get a bundle of twelve years so how long will the policy pay for care the average amount of care we're told that most people need is under four years we tend to either get better and need it or get worse and die so how long will a paper care how much per month will the policy pay for care in air area you know the cost of care you know depending upon whether it's home care or nursing home or assisted living runs the full gamut do you know what the most expensive state in the country is for long term care probably new jersey it is is one of the hyatt new jersey into new york and pennsylvania are among the highest but the highest is believe it or not alaska at that there is just so live there are so few people that are providing caregivers there so the cost of care in alaska is two hundred seventy dollars a day the cost of care in louisiana is about one hundred sixty one dollars a day so how much you know coverage do you want do you want to policy that pay two hundred or one hundred fifty and the insurance doesn't necessarily have to cover every penny of the cost of care a lot of people have their own income their own assets to help pay for the care as well so that's a variable how much per day or per month will the policy paper care what is the deductible will the policy pay on day one or do you have to pay the first thirty days or sixty days or ninety days out of pocket and then what type of inflation protection do you build into the policy right takes if you would get something today my husband and i we i said we got our policy years and years ago it had a five percent inflation protection in it so even though our policy originally was one hundred dollars a day now it's well over three hundred dollars a day ok so all those factors determine the cost but to try to help now you down you know to me to give you an idea of cost let's let's take a let's take a sixty to sixty one year old ok a sixty sixty one year old who  who is looking for a policy let's say they want pretty good policy with eight thousand dollars a month benefit now in area nursing homes could easily cost ten to fifteen a month ok so we're not covering the full cost right but we're doing a fairly good job in the out balance would come out of pocket home care could be a lot less or a lot more depending upon part of the need right now ok so if they  that policy let's say with a ninety day duck double and three percent inflation and this is a sixty or sixty one year old the premium could be anywhere and it sounds strange  i'm saying this but could be anywhere because i've already given you parameters from three thousand dollars a year to nine thousand dollars a year ok and and it's there's only two factors that will make that germanic spread and those two factors are their gender and whether or not they are married or have a partner so this is not even taking into account their health but just that cost is much higher for women than men and if you are if you also have a partner about thirty five hundred dollars a year so there is it can be a dramatic difference depending upon your course your health is well it's factored into that but your health and then all the other pieces that we talked about so i know that doesn't totally answer your question but it gives us a good range again it's just like car insurance you know you've got to sit down with an agent to figure out you know m i covering the full liability is it a brand new car do i have a loan on it if not you know which same thing is you've got to factor in you know it's not a one size fits all right and you know that would be wonderful if there was that but then you know there's so many shades of gray that it's impossible to do  it so it just goes back to sitting down with an insurance person and saying you know seeing that with your insurance person saying hey let's talk about long term care you touched on something and again that i want to circle back around to for everything basically in order for let's us talk about in general in order for the policy to pay at all and then i'll try to get to the details of what it will pay for so in order for the policy to pay it all first a doctor and if it's a good policy it's not the insurance company's doctor it's your own doctor or health professional needs to say that in their opinion this is likely long term care now the government of defining long term care is carrier likely the need for at least ninety days so somebody first has to sort of sign off and say we think this is long term this is going to be at least a ninety day event now they may be wrong but they have to express their opinion that they think it's long term care and then one of two things has to happen either that there is cognitive impairment meaning memory loss and military dimension out simers or if the individual cannot perform two of the basic activities  daily living dressing themselves bathing toileting transferring eating continence so if either of those events happens either the cognitive  perform to activities of daily living then the policy will pay and it will pay in your own home or a family member or someone in an assisted living facility in adult daycare center or a nursing home but what it's going to pay for in the facility is the room in the board it's not going to pay if an individual needs let's say depends it's not going to pay for medications it's not going to pay for private duty nurse it's not going to pay you know for hairdressing or laundry or any of those things and for home care for the most part it's only going to pay if you go through a licensed home health care agency it's not going to pay if you have this wonderful friend or may or a companion who can provide the care it won't do that it will pay for an aide or companion if that person is hired through a licensed agency and that's for the insurance companies protection as well as your own and i'm sure you know i want to know about that anybody who watches this show knows that i am a big proponent of if you need care in the house you hire a licensed insured bonded agency don't get the woman who took care of your aunt's friends cousins first husband's dying mother you know  license ensured bonded professionals who are trained who have backup who won't steal you blind and who can be paid for a long term care insurance another reason to go that route now from what i understand there's also an elimination period which you talked about the deductible correct ok now that works how the well the first x number of days that you need care you will pay out of pocket now sometimes depending upon your situation medicare might be paying those states but sometimes medicare will not pay those days basically the insurance company will say if you have a ninety day deductible deductible or a ninety day waiting period or a ninety day elimination period those terms are used interchangeably and in the various policies we won't pay you're on your own to figure out a way to pay if medicare covers it fine if not if you have to pay out of your own pocket that's ok but we won't pay those first days what some of the insurance carriers are doing is you can sort of do a split type of situation where you have a ninety day waiting period for facility care and zero day wait met in other words coverage on day one for home care and that fits in nicely because medicare sometimes if you meet their stringent requirements in a nursing home will pay the first ninety days along with your medicare supplement if you have that which brings up you know doesn't medicare medicaid pay for most things doesn't now expand on that we now know everybody always thinks medicare will cover girl yeah man a parent does a pretty good job for us in a hospital situation a doctor situation if we have medicare and then we have medicare supplement of some sort  medicare does a rather good job in that sense in that scenario but in a nursing home scenario or a home care or assisted living facility scenario it's not designed to do that it will do very limited  in a nursing home medicare will pay all of the first twenty days and then there is a co pay up to date eighty but the co pay is rather rather steep you still need to pay a lot about i don't know the true seven sixteen can probably look it up two thousand and sixteen number as we we can certainly provide for you but and then after day one hundred medicare doesn't pay anything so and order for medicare to pay you have to go straight from a hospital nursing home the care has to be considered skilled care it has to be likely to be restored of in some sense so we can't count on medicare medicaid is basically welfare for those of us who run out of assets and certainly if we don't have assets we shouldn't be thinking about buying long term care insurance if there's no money if you can't afford premium then you shouldn't have the policy but it is not a lot of people will think well no you know i can falsely impoverish myself i can give my money to my kids and i can rank kids and you know you're shaking your head i'm sure you've seen situations doesn't work popper on paper does not work either there's lookback period there's all sorts of problems with you know you can be can have the most wonderful kids in the world but if you give them your money it's then their money and then if they get sued or haven't worked or something else the money is not yours anymore so we don't encourage people to do that medicaid for those of us who need it will pay for and nursing home but we don't necessarily have a choice of where exactly what so that that's another issue and you know you've got if you're looking at an assisted living assisted living have what's called a spend down period you've got to have two to three years of the spend down before you can apply for medicaid and then they can't guarantee you a slot you know because only ten percent of their communities are slotted for medicaid if you don't have a b states realize that one of their biggest expenses this medicaid and for people who who need it it's fine but then there's the concern of those who will try to get rid of their money simply to qualify to get the state to pay for their nursing home bed there is in new jersey and in most states something called a partnership plan it's a partnership between the states and insurance companies and weight basically what it is i t's a dollar for dollar protection of your assets should you require long term care and you've purchased a long term care policy so if you purchased for instance a long term care policy that would one hundred thousand dollars out in benefits should you require care then instead of having to spend down as you just you know eluded to and in order to qualify for medicaid you basically have to spend down you can keep whatever amount of insurance coverage you have it's yours it will go to your errors if you want it you can use it to get your hair done every week or you know anything you want so it's a partnership between the states and the insurance companies to encourage people basically to consider buying long term care insurance and also to protect their assets if they want one final question are all the companies that offer long term care policies the same or do we just each company differ in what they offer and you know the policies are similar but there are different types of policies out there there are traditional long term care policies there are also now policies where you can combine life insurance and long term care together so that if you don't need long term care at all costs there's always a question on paying all this premium for all these pot you know all these years and then what happens if i never use it well we have that's what we hope happens just like we hope we never use our car insurance or fire insurance but there are policies where if you never use it then there that that goes to the heiress but the companies you really need people need to look carefully at the ratings of the companies there are independent rating sources that you can go to any library or look up online and make that the company is is well rated but you should know that in an injured new jersey and in most states there is protection for the consumer so if a company ever does have a financial problem and this is never happened but people are always worried what if it does happen people are protected and there is there is a guaranteed trust fund in new jersey that would protect the consumer as well today so one things people should really do is if they're looking to long term care insurance one talk to your agent make sure that they have it they can sell it if not connect contact you sure sure carol how do the how do i have contact you well you can contact me my phone number is two six seven eight five two zero two two two and you can also contact me by email and e mail address is  have there are so many more questions that could be had about long term care insurance but really it boils down to you should talk to your insurance agent it's a very good thing to have and as somebody who used to be on the facility side i know when somebody moved into one of my communities and they ha long term care insurance it made all the difference you know it took somebody from having to share a room to they got their own room yeah it can make a big difference it's a great investment and just like car insurance you're not going to use it right away but you are eventually going to use it i'm tom tell him thank you for joining us here on only seniors