MKH Insurance

Long Term Care

What is Long Term Care?

Long Term Care is required when chronic illness, accidents or injury, cognitive impairment, or the aging process has left you unable to care for yourself properly. Long Term Care provides continued assistance to perform Activities of Daily Living (ADL’s); like getting dressed, bathing, eating, toileting, transport from point A to point B, and incontinence. Long Term Care also provides assistance due to cognitive impairment such as Parkinsons or Alzheimers even though an individual may be able to perform ADL’s. A person may receive Long Term Care in their home, in the community (such as an adult day care center), in an assisted living facility, in a hospital, or in a nursing home. Long Term Care is not for skilled care that you might recevie from a hospital or doctor, and it is not for recovery from surgery or a minor accident where you might receive short term rehabilitation services.

Will I Need Long Term Care?

Americans who reach the age of 65 have a 50% chance of needing Long Term Care at some point in their lives. This percentage increases into reaching 70’s or higher. Contrary to popular belief, Long Term Care is not just for seniors. According to Long Term Care statistical studies, nearly 40% of people receving Long Term Care are now between the ages of 18 and 64. Working-aged Americans can and are receving Long Term Care.

How Much Does Long Term Care Cost?

The cost of Long Term Care can vary greatly based upon the individual receiving care. Nursing home costs can range from $65,000 – $200,000 annually based on the state where the individual resides. This can also vary depending upon whether the person is in a private room or a semi-private room. Nationally, assisted living facility costs can range from $20,000 – $56,000 annually. This is typically the cost for a one bedroom unit.

Home health care costs range from $25,000 – $60,000 annually.

Who Pays for Long Term Care?

1) Long Term Care Insurance

2) Self Insuring (with one’s assets)

3) Medicaid (individuals must qualify financially) Health insurance and Medicare are designed to pay for medically necessary skilled care and they limit what they pay for short term intermediate care. These types of coverage are not designed to pay for custodial care or help with Activities of Daily Living (ADL’s) such as bathing, transferring, toileting, dressing, eating, and incontinence.

Long Term Care Definitions

Skilled Care: Medically necessary

Intermediate Care: Short term rehabilitation

Custodial Care: Help performing Activities of Daily Living (ADL’s)/Long Term Care Disability insurance pays benefits when a person can not work due to accident or illness. It also pays for lost income, but will not pay for Long Term Care costs.

Employers

Long Term Care insurance is the missing link in the safety net created by employer benefit programs. More employees today have had some type of first-hand experience with long term care with family or friends. They are understanding the importance of providing long term care (emotional and financial) for their loved ones.

As an employer, offering long term care insurance as a worksite benefit can be very important to your overall strategy. Long term care insurance helps in recruiting and retention of top talent, contain health insurance costs, and bolster employee productivity (presenteeism). It also helps the employer provide education for their employees. Benefits can be added without cost to the company and can be carved out for certain classes of employees since there are no discrimination rules for long term care insurance.

As an employee, worksite long term care benefits provide access to long term planning, discounts on premiums, and possibly allow you a chance for coverage that may otherwise be declined if purchased outside the workplace.

MKH Insurance Services works with employers to:

Educate
Market to the top insurance companies
Provide a comprehensive strategy for communication of the value to employees
Conduct educational workshops for emplyees
Build a web-based educational presentation for employees and family members to understand the benefits of a company-sponsored plan
Provide one-on-one meetings with employees
Provide re-enrollments for new hires

Contact MKH Insurance Services to learn more about Worksite LTC insurance:

Premium Discounts
Flexibility
Simplified Medical Underwriting
Portability
Family Eligibility
Level Premiums
Executive Carve-Out Options

What are the different Parts of Medicare?

Medicare Part A (Hospital Insurance) helps cover:

1) Inpatient care in hospitals

2) Skilled nursing facility care

3) Hospice care

4) Home health care

Medicare Part B (Medical Insurance) helps cover:

1) Services from doctors and other health care providers

2) Outpatient care

3) Home health care

4) Durable medical equipment

5) Some preventive services

Medicare Part C (Medicare Advantage):

1) Includes all benefis and services covered under Part A and Part B

2) Usually includes Medicare prescription drug coverage (Part D) as part of the plan

3) Run by Medicare-approved private insurance companies

4) May include extra benefis and services for an extra cost

Medicare Part D (Medicare prescription drug coverage):

1) Helps cover the cost of prescription drugs

2) Run by Medicare-approved private insurance companies

3) May help lower your prescription drug costs and help protect against higher costs in the future

Supplement Insurance policies are also known as Medigap policies.

The Original Medicare (Part A and Part B) program pays for many, but not all, health care services and supplies. Medicare Supplement Insurance policies, sold by private companies, can help pay some of the health care costs that the Original Medicare program doesn’t cover, such as copayments, coinsurance, and deductibles.

For people who have Original Medicare and purchase a Medicare Supplement policy, Medicare will pay its share of the cost of what they approve for covered health care services. Then, the Medicare Supplement policy will pay its share of the approved covered health care services. People pay premiums for their Medicare Supplement directly to the insurance company providing the coverage.

Long Term Care Insurance

Life Insurance

Annuities

Disability Insurance

Health Insurance

Medicare Supplements

Medicare Advantage

Medicare Part D Prescription Rx

Contact MKH Insurance at 217-520-5609 for more information.