Long Term Care-Who to Turn to for Help-Part II.

(11/17/10)- MetLife Inc. said it would stop selling new long-term care policies as of December 30, although it would continue the coverage of its already existing 600,000 policyholders. The company is also asking state regulators for permission to raise premiums on many policies by as much as 44%

According to a recent survey conducted by Millman Inc., MetLife had $36.3 million in long-term-care sales in 2009, making it the 4th biggest selling insurance company in the United States on this type of policy. John Hancock with $116.1 million in sales was the largest with Genworth Financial's $197.5 million in sales ranked second.

Genworth Financial is seeking an18% increase on older policies held by about 25 % of its policyholders

It is estimated by industry sources that there are about 8 million long-term-care policyholders in existence in the United States today.

Allianz SE and Minnesota Life Insurance Co., a subsidiary of Securian Financial Group recently halted sales of new long-term-care policies.

John Hancock recently stated that it would ask state regulators for an average 40% increase for about 850,000 of its 1.1-million long-term-care policyholders. It also suspended sales of new long-term-care policies to employer-benefits programs.

John Hancock is a subsidiary of Manulife Financial Corp.

(11/5/09)- There is a provision in the House version of their new health-care bill that would create a new federal long-term care benefit that would pay cash to people who became disabled. There is no such provision in any of the bills that have been introduced in the Senate.

Premiums for the program would be automatically deducted from the paychecks of employees of participating employers, but the workers would have the option to opt out of the program if they did not want to participate in the plan.

Payouts would go only to employees who had paid premiums for at least 5 years.

The program would pay at least $50 per day, with the amount calibrated by the disability of the recipients. The worker would be eligible if he/she could not perform two or more daily activities, such as eating or bathing on their own. The benefit would continue until they recovered or died.

The government would set the amount of the premium.

In an analysis of the program by the Congressional Budget Office, it was determined that the program would be in the black by $72 billion in its first 10 years, and by a smaller amount in the following decade, as more participants start to receive payments under the program. The CBO analysis assumed that the monthly premium would be $123, and a typical daily benefit would be $75.

John Rother, executive vice-president of AARP, which supports the long-term care program, said the benefit would be "enough to pay for the kind of care most people need."

(7/1/09)- For more information on long-term care insurance, go to the U.S. government Web site at That site contains information about policies and pricing and plenty of consumer advice.

The National Association of Insurance Commissioners publishes a free booklet, " A Shopper's Guide to Long-Term Care", that you can order at their Web site

(10/22/03)- According to Perspectives in Health and Aging (Vol. 12, #1, 1997), "about 5.8 million people age 65 and older; 5.3 million adults between the ages of 18 and 64: and 400,000 children currently need long-term care services. With the exploding growth of the nation's aging population, researchers estimate that by the year 2030, more than 12 million older Americans alone will need either formal or informal long-term care services. Sources that offer essential tips, strategies and checklists to help people in their search for the type of long-term health care are provided below.

e-mail: or

American Association of Homes and Services for the Aging 901 E. Street, NW

Washington, DC 20004-2037

202/783-2242 http:/

Provides housing, health, community and related services to older people

Assisted Living Facilities Association of America 10300 Eaton Place, Suite 400

Fairfax, VA 22031

703/691-8100 Enhances the quality of life in assisted living residences
Eldercare Locator Washington, DC 1/800/677-1116 Designed to help older persons and caregivers locate local support services.
Foundation for Hospice and Home Care 513 C Street NE

Washington, DC 200002

202/547-6586 Educates public, and conducts research on aging, health and social policies
National Association for Home Care 228 7th Street, SE

Washington, DC 20003

202/547-7424 Professional organization representing agencies providing home care services
National Citizens Coalition for Nursing Home Reform 1424 16th Street, NW,

Suite 202

Washington, DC 20036-2211

202/332-2275 Defines and achieves quality for people with long- term- care needs through informed, empowered consumers
National Long- Term Care Resource Center Institute of Health Services Research

University of Minnesota School of Public Health

420 Delaware SE

Box 197 Mayo

Minneapolis, MN 55455

612/624-5434 Assists the aging network to develop, administer, monitor and refine community based long- term care systems reform
National Resource Center: Diversity and Long- Term Care

Heller School-Institute for Health Policy

Brandeis University

Waltham, MA 02254-9110

1/800/456-9966 The Center concentrates on diversity issues in four areas: resource distribution, infrastructure (systems and services), care strategies, and consumer roles and choices
National Resource Center on Long- Term Care,

National Association of State Units on Aging

1225 I Street, Suite 725

Washington, DC 20005

202/898-2578 Concentrates on development, improvement, and enhancement of home and community-based care
National Resource and Policy Center on Rural Long- Term Care

Center on Aging

University of Kansas Medical Center

3901 Rainbow Boulevard

Kansas City, KS 66160-7117

913/588-1636 Internet

Focuses on improving the availability of and access to effective, efficient, appropriate and acceptable community-based, long- term-care services for rural older and disabled people.

National Resource and Policy Center on Housing and Long- Term Care

Andrus Gerontological Center

University of Southern California

Los Angeles, CA 90089-0191

213/740-1364 Internet

Works to make housing an integral part of long- term care

Source: Perspectives in Health and Aging, Vol. 12, #1, 1997

Keep in mind that there are many different kinds of sites for delivering long-term care services: a home; a community setting (such as an adult day center); a board and care home or assisted living facility; or a more institutional setting such as a nursing home.

Costs of these various types of delivery sites vary. Cost of nursing home care typically costs in the neighborhood of $60,000 annually. Assisted living facilities vary dramatically in price, depending on the amenities available with the average about $30,000 per year. These figures indicate that such services are unaffordable for many.

In 1995, national aggregate long-term care expenditures exceeded $100 billion annually. Medicaid financed 37.8 percent, 32.5 percent by individuals and their families, 17.8 percent by Medicare, 5.5 percent by private insurance and 7.3 percent from other private and public sources (according to the US Health and Human Services Department's Health Care Financing Administration).

Medicare covers an individual's skilled nursing home or rehabilitative care for up to 100 days after leaving a hospital. Although the first 20 days are fully covered, the remaining 80 days require a $109 daily patient co-payment. Supplemental policies may be purchased by older persons to enhance their Medicare coverage but their premiums may be quite expensive.

A new study by Consumer Reports, a publication of the nonprofit Consumer Union, a consumer-information organization found that long-term care insurance is "too risky and too expensive" for most people. According to the study many consumers have trouble paying the high premium for the policy and may ultimately let the policy drop. Another fault that it found with the policies is that they often cover only a small percentage of the total cost.

The study looked at 47 long-term care insurance policies offered by seven insurance companies in California, a state that has the largest elderly population. Of the seven insurance companies, three were found to be in poor financial shape, so that the insurance company might not be around in 20 or 30 years.

Medicare will pay for home care only if a patient is homebound and requires part-time nursing care or therapy under a physician-devised plan. Medicaid will pay almost all part-time skilled nursing, home-maker-home health services and medical supplies and equipment for those meeting eligibility requirements.

In order to be eligible for Medicaid, a person must have limited income and assets. Those who are not already poor must exhaust most of their existing resources before Medicaid will cover their nursing home costs.

Savings, checking accounts, certificates of deposit, IRAs, stocks, bonds, and all other investments are considered assets when determining Medicaid eligibility. You must use up these assets before applying for Medicaid. However, a spouse may keep at least $1326 in income and between $15,804 and $79,020 in assets, depending on state of residence.

Please also see our article Long Term Nursing Care Facilities-Nationwide Nursing Home Costs


by Allan Rubin and Harold Rubin, MS, ABD, CRC, Guest Lecturer
updated November 17, 2009

To e-mail: hrubin12@nyc, or

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