About Long Term Care Insurance | Elder Options of Texas

The Need for Long-Term Care

By 2030, 24 million Americans will need long-term care (LTC), nearly double the current need, but the supply of caregivers is shrinking rapidly relative to the demand.

LTC is not the long-term provision of medical care. Rather, LTC typically refers to assistance with activities of daily living (ADLs), which are routine activities people do every day to live. There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring (moving from one place to another, such as from bed to chair), and continence.

The ease with which individuals can perform these ADLs helps determine what type of LTC they may need. Individuals may need help with these activities from birth or after a physical or mental health decline, and they may need these services for the remainder of their life or only temporarily, such as while recovering from a medical incident.

Of course, an individual may need long-term help with many other types of activities, too, such as meal preparation, bill payment, and household chores (sometimes referred to as instrumental activities of daily living, or IADLs); while these types of services are typically not considered health care services, a caregiver may assist with these activities, as well.

Medicare DOES NOT pay for 'long term' nursing home care. Another good reason long term care insurance should be part of your financial plan. The phrase "long-term care" refers to the help that people with chronic illnesses, disabilities or other conditions need on a daily basis over an extended period of time.

The type of help needed can range from assistance with simple activities (such as bathing, dressing and eating) to skilled care that's provided by nurses, therapists or other professionals.

Long term care is a type of personal care service you may need if you become unable to care for yourself because of a prolonged physical illness, a disability, or a cognitive impairment, such as Alzheimer's disease.

Long term care is different from traditional medical care that attempts to treat or cure illnesses. Long-term care helps you maintain your current lifestyle, but it may not improve or correct your medical problems. Care may be provided at home or in a hospice, adult day care center, nursing home, or assisted living facility.

Benefits of Long-Term Care Insurance

Purchasing long-term care insurance can give you peace of mind and protect the nest egg you worked so hard to build. You'll know that if you become ill, you can afford the care you need and still have enough money in your nest egg for you and your spouse to eat. Plus, your kids won't be burdened with huge payments for your care.

The optimal age to shop for a long-term care policy, assuming you're still in good health and eligible for coverage, is between 60 and 65, financial advisers say. Couples might take a look five years earlier.

Now you may be thinking: What about government programs? Can't they help? Don't make the mistake of believing Medicare will cover long-term care costs. It doesn't. And while Medicaid-the government program designed for people who truly don't have any money-will cover long-term care expenses, it should never be your first choice.

Side note: It's common for people to try to cheat the system by moving assets out of their parent's name to get the government to pay for LTC without touching those assets. That is considered fraud-a federal crime-and the government will prosecute you! Don't fall into that trap.

Unlike traditional health insurance long-term care insurance policies reimburse policyholders a daily amount (up to a pre-selected limit). Long-term care insurance can cover assisted living/memory care, adult daycare, respite care, hospice care, nursing home,and home modification to accommodate disabilities. If home care coverage is purchased the long-term care insurance can pay for needed home care often from the first day care is needed.

Monthly Median Costs in Texas for Long Term Care.

Genworth Logo Average Cost of Texas In-Home Care
Based on annual rate divided by 12 months (assumes 44 hours per week)

Average Cost of Texas ASsisted Living and Adult Day Health Care
Adults Day: Based on annual rate divided by 12 months.

Assisted Living: As reported, monthly rate, private, one bedroom.

Average cost of Texas Nursing Home Facility
Nursing Home: Based on annual rate divided by 12 months.

To view Genworth's Median Cost of Care in Texas

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Long-Term Care Partnership Program

Texas created the Long Term Care Partnership Program as an incentive for Texans to plan for their long-term care needs. The partnership is a joint effort between private insurers and the state. Insurers must follow state and federal guidelines to sell partnership policies.

A Texas Partnership for Long-Term Care qualified policy provides you, as the purchaser, with the right to apply for Medicaid under modified eligibility rules that include a special feature called an asset disregard. This allows you to keep assets that would otherwise not be allowed if you need to apply, and qualify, for Medicaid in order to receive additional long-term care services. The amount of assets Medicaid will disregard is equal to the amount of the benefits you actually receive under your long term care Partnership qualified policy.

Since these policies must include inflation protection, the amount of the benefits you receive can be higher than the amount of insurance protection you originally purchased.

* * * If you have a Partnership-qualified long term care insurance policy and receive $200,000 in benefits, you can apply for Medicaid and, if eligible, retain $200,000 worth of assets over and above the State's Medicaid asset threshold. In most states the asset threshold is $2,000 for a single person. Asset thresholds for married couples are typically more generous.

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Texas Long-Term Care Insurance

Texas LTC Partnership Program

Long-Term Care Partnership Program