![HRM Icon](http://206.241.31.141/ImageCache/CustomsToday/layout_5ftemplates/images/hrm_2ejpg/v1/image_2ddata/1/hrm.jpg) | Long Term Care Insurance Should you or your family members purchase it? | It's estimated that 50 percent of all Americans will eventually need assistance with their "activities of daily living." Long term care insurance is designed to address the needs of Americans who may someday find themselves in this situation, and who will need the funds to pay a professional caretaker or to cover the cost of assisted living or residence in a nursing home. Long term care can be expensive. At $50,000 to $80,000 per year for nursing home care, $30,000 to $55,000 annually for assisted living facilities, and $15 per hour for home health aides, the cost of long term care can quickly deplete savings. Long term care insurance is designed to defray a predetermined amount of anticipated costs. Federal and postal employees and retirees, members and retirees of the uniformed services, and qualified family members will now be eligible to apply for the government's latest federal benefits plan. The Office of Personnel Management (OPM) selected LTC Partners, created by the MetLife and John Hancock insurance companies, to offer coverage. Employees may enroll in long term health coverage during the July 1 through December 31, 2002, Federal Long Term Care Insurance Program (FLTCIP) open season.Except in very limited cases, "traditional" health insurance such as the plans available through the Federal Employees Health Benefits (FEHB) program does not cover the costs of long term care. Neither does Medicare. Coverage may apply for a limited period only if "skilled" nursing care is required following an illness or injury or a recent hospital stay. Skilled nursing care is medically necessary care performed by licensed medical professionals-care that includes tube feeding, speech or physical therapy, and administration of IVs. Assistance provided by health aides, attendants, or live-in companions is not considered skilled nursing care. Medicaid may cover some long term care costs but only for individuals whose annual incomes put them at or below their state's poverty level.According to OPM, between 300,000 and 500,000 of the 20 million individuals eligible for the program are expected to enroll this year. | Evaluate your needs before applying Before applying, evaluate personal and family medical history to determine the likelihood of needing long term care. Also review current and future financial needs. Is there an appropriate level of health, homeowner's, or renter's insurance? Are there savings for emergencies? If your "financial house" is in order, the added protection and peace of mind from long term care coverage may be a good addition to your financial portfolio. Policy costs Premium rates depend on a number of factors: age, benefit level, waiting period, and duration of the benefits you choose. Unlike your FEHB plan, each FLTCIP policyholder will be responsible for the entire cost of the premium. And depending on the type of policy you choose, the cost per month could be considerable. Underwriting As with the majority of insurance programs, the insurer must determine if a prospective enrollee presents an acceptable level of risk. "Underwriting," or reviewing of an applicant’s health history, is required to be eligible for FLTCIP coverage. For most current employees and their spouses, determining risk level begins when the applicant is asked to complete a short form containing five or six health-related questions. A more extensive questionnaire may be required, depending on an applicant’s current health, employment status, or choice of plan.Long term care services include:- Nursing home care
- Home health care and home care assistance
- Assisted living care
- Adult day care
- Respite care for the primary caregiver
When do benefits begin? The standard waiting period for benefits to begin is 90 days. During this period a policyholder must be unable to perform at least two of the "activities of daily living" without assistance. These activities include eating, transferring (moving to/from a bed or chair), toileting, continence, bathing, and dressing. Coverage begins if assistance is required for more than 90 days.How do I get more information and/or apply? For the latest information about the FLTCIP, visit the OPM Web site or contact LTC Partners directly at 1-800-582-3337. You can also visit the LTC Web site at www.ltcfeds.com. While there, sign up to receive the new monthly publication, Get Smart. The information in this free OPM sponsored brochure is designed to help you make sound decisions about federal long term care insurance and other issues that are important to you and your family. For additional information, contact the Employee Services Division, Human Resources Management, at 202-927-3900. |
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