Dental Plans and Quotes

Get Dental Plans and Quotes

Use our simple application to get real time quotes on dental coverage from multiple carriers. Compare rates and providers quickly and easily by starting at the link at the bottom, but,…….You Must Read This First – It could save you thousands of dollars!!!

Which Dental Plan to Choose: Dental Insurance or a Discount Dental Plan???

What is a dental discount plan? A dental discount plan is a dental plan offered by dentists who wish to offer their patients (who are members of this discount plan) a discount for their dental services.

Why would a dentist offer dental services at a discount? If a dental practice has times during their hours of operation where there are empty dental chairs then they are not maximizing their income potential. If a dental office is utilizing only 60% of their maximum capacity then they could grow another 40% to get to maximum capacity therefore allowing them to earn more money. How can a dentist solve this problem? A dentist can offer a discount on their dental services enticing potential patients to come in and have dental work done. By offering services at a discount, a dentist can get their dental practice closer to maximizing their income earnings.

How can a dentist offer a discount on services and still make an income? There is no paperwork, no billing to send out, no extra staff or extra hours to pay for office employees to handle claims and administration.

What’s in it for the Plan Discount Carriers? They solicit the dentists to sign on and agree to provide discount services. They in turn establish relationships with insurance agents and brokers to distribute their discount plans to potential customers. The customers pay the annual fee to the discount program and the Discount Plan Carriers make money. It’s a win-win-win for the Dentists, the Discount Plan Carriers and the dental patients.

Why would a patient prefer a discount dental plan over a dental discount plan? There are several reasons.

1. A discount plan has no claims forms or paperwork to keep up with. The member simply shows their discount plan card at the window after the appointment and the dental service provided is automatically discounted at a pre-set amount already agreed to by the discount plan and the dentist.

2. There is no waiting period when someone signs up for a discount plan. The new member can receive service almost immediately (within 3 business days) when they become a member. The minimum time frame from filling the application to having the plans effective date is the first day of the following month, although most dental insurance plans have a waiting period from 6 to 18 months before a member can receive certain services. If you have a bad tooth ache that’s a long time to wait!

3. The premium on a dental insurance plan can be anywhere from 2 to 10 times more expensive than a dental discount plan.

4. Dental insurance typically has a deductible you must pay before coverage begins on certain services. A dental discount plan has no deductible at all.

5. Dental insurance caps the total benefit paid out per person per year. Once you reach the cap, all of the rest of your dental expenses are paid on your own dime without any help. Dental discount plans have no cap or maximum amount of services you can receive.

6. Many discount plans offer other benefits such as vision, hearing, prescription benefits and other discounts as well. Dental insurance typically has no other benefit associated

with membership.

7. Dental insurance does not help pay for cosmetic dentistry unlike most dental discount plans.

WCBurke Dental Plans

Choosing a Long Term Care Insurance Carrier

There are several key considerations in choosing a Long Term Care Insurance carrier.

Financial Strength. All insurance companies have been rated by one or more financial rating agency. Rating agencies like A.M. Best among others rate the financial condition of a carrier and issue a rating. The higher the grade the better the perceived financial stability of the insurance company.

Premium or Cost. The cost of a policy will be a factor when it comes to determining whether or not you should purchase a long term care insurance policy. It is important to make sure that before you decide to purchase the least expensive policy you understand what you are buying.

Partnership for Long Term Care. A number of states have adopted a long term care insurance partnership program. This is a private/public alliance amongst state governments and insurance companies to provide a way for Medicaid to work with private long term care insurance companies. For more information click here: Partnership.

Rate History. It is important to know how often and by how much an insurance carrier has increased the premiums in the past on their LTC policies. Also insurance companies may increase the premiums based on approval from the state insurance department.

Policy Features and Benefits. The features and benefits available from a long term care insurance policy not only vary by company, but by product. A few of these features and benefits include premium discounts, shared benefits, cash benefits, and return of premium.

“Hey!!! Don’t even think about putting me in a nursing home!!!”

Stay out of the Nursing Home Insurance!

When I speak to folks about LTCi I often get a response like, “I don’t want to think about nursing homes…why do you want to talk about putting me in a nursing home?” I respond with, “I’m not wanting to put you in the nursing home…in fact, I want to talk about keeping you OUT of the nursing home. Now how does that sound? Well, now you have my attention!” And so the conversation carries on.

Here are some facts to consider. Of those who have Long Term Care Insurance (LTCi) only 9% will pass away in a nursing home facility. Why is that? If you have LTCi you have options. Almost all of the plans today include provisions for home health care. Let’s face it, seniors want to be independent and maintain control in their lives for as long as possible. Aging in your own home brings a sense of peace,  comfort and happiness especially if you’ve lived in the same house for a long time.

Another feature that LTCi policies have today is the ability to take out small amounts of cash to pay for certain services as you need them. As you age many times your loss of good health is gradual over a period of time. For example, perhaps you find it increasingly more difficult to mow the lawn and do the cooking. You could hire the teenager down the street to mow your lawn and find someone from a local church or a catering company that delivers home cooked, pre-made meals that can be warmed in the microwave. How much would that cost? Maybe $500 or $600 per month. You could draw that amount out each month and continue in that condition for a while.

Finally, a number of policies today have a provision that will allow you to share your benefit with your spouse. For example, you and your spouse purchase LTCi and sometime later one of you is diagnosed with Alzheimer’s Disease in which you could start using your coverage little by little. If the Alzheimer’s Disease lasts 5 or 10 years or more you could very easily run out of coverage on the disabled spouse. With the shared benefit feature the other spouse can share their coverage allowing you more options on your LTC decisions.

LTCi should be more aptly named, “Stay out of the nursing home insurance.” Facing old age and the likelihood of becoming medically dependent on others can be a horrifying prospect without having a safety net backing you as you age. Do not wait…call or email today to have a conversation with me about LTCi.

Cigna Study Shows Consumer-Driven Health Plans Can Save

Cigna Study Shows Consumer-Driven Health Plans Can Save $9,700 Per Employee Over Five Years
FEBRUARY 16, 2012

CDHP customers lowered their costs, improved their health profile, were more informed and engaged in health care choices, participated in health improvement programs, chose generic medications and avoided unnecessary trips to the ER.

BLOOMFIELD, Conn.–(BUSINESS WIRE)–When American workers engage in health-smart habits offered in consumer-driven health plans (CDHP), they reduced their health risks and lower their total medical costs an average of $9,700 per employee over a five-year period, according to a recent study of health care claims representing 1.1 million Cigna customers in consumer-driven health plans, PPOs and HMOs.

“The data once again shows that the combination of incentives, easy-to-engage health programs, and consumer decision support tools can improve health while reducing costs.”

The Sixth Annual Cigna Choice Fund Experience Study, released today, shows individuals enrolled in Cigna Choice Fund®, Cigna’s consumer-driven health plan, lowered their costs without compromising care by becoming more engaged, informed and active health care consumers. Cigna’s CDHP pairs a qualified medical plan with a Health Savings Account (HSA) or Health Reimbursement Account (HRA). According to the study, when compared to customers in traditional PPO and HMO plans, those in a CDHP:

Lowered their health risks: Cigna CDHP customers lowered their risk of developing or worsening a chronic condition. According to the study, when employers fully transitioned to offering only a CDHP option, individuals improved their health risk profile by 10 percent in the first year compared to customers in a traditional plan option.

Reduced total medical costs: Cigna CDHP medical cost trend was 16 percent lower than traditional plans during the first year. Over five years, cumulative cost savings averaged $9,700 per employee enrolled in a Cigna CDHP compared to employees who remained in a traditional health plan. Cost reductions were achieved without employers shifting out-of-pocket health expenses to their employees.

Received higher levels of care: Cigna CDHP customers had consistent or higher use of over 400 evidenced-based medical best practices (than their counterparts in traditional plans. Cigna CDHP customers also sought preventive care, such as annual office visits and mammograms, more frequently than customers enrolled in a traditional plan.

Were more engaged in health improvement: Through proper plan design plan and the use of incentives, Cigna CDHP customers were more likely to have completed a health risk assessment and participated in the Cigna Health Advisor® health coaching program than those enrolled in a traditional plan.

Were more savvy consumers of health care: Cigna CDHP customers enrolled in Cigna Pharmacy Management® were more likely to choose generic medications and had 14 percent lower pharmacy costs compared to those in a traditional plan. In addition, CDHP customers used the emergency room at a 13 percent lower rate than individuals enrolled in HMO and PPO plans.

More likely to compare cost and quality: Cigna CDHP customers were twice as likely to use myCigna.com online cost and quality information to help them select a doctor or to review potential medical costs than customers enrolled in traditional plans.

“Each year the evidence increasingly shows that properly designed consumer-driven health plans can lower health risks, reduce medical costs and drive engagement,” said Cigna Chief Medical Officer, Dr. Alan Muney. “The data once again shows that the combination of incentives, easy-to-engage health programs, and consumer decision support tools can improve health while reducing costs.”

Cigna continues to improve its CDHP offering, including enhancing its online and mobile information. For example, Choice Fund customers can use their web-enabled mobile phone to look-up what expenses may be paid via their HRA and Flexible Spending Account (FSA) funds, compare drug costs and find a doctor or facility. In addition, Cigna’s new online bill pay feature, MyClaimPay, gives customers a convenient way to pay health care professionals directly from HRA and FSA funds on mycigna.com.

Joe Mondy
Cigna Corporation

Baby Boomers Are In For A Retirement Health Shock

Baby Boomers Are In For A Retirement Health Shock

So here’s the “news” from a retirement and health poll released this week by the Robert Wood Johnson Foundation, Harvard School of Public Health and NPR:  We decline in old age, but a lot of us seem to be in denial about that.

Some 39% of current retirees say their health is worse now than it was five years before retirement, but only 13% of pre-retirees (meaning baby boomers over 50 who are still working) think their health will be worse in retirement.  (Pollsters questioned 1,254 adults over 50 in July and August. Full results here. )

Huh?  This makes absolutely no sense, particularly when you consider that many pre-retirees plan to retire later—or never stop working—owing to financial worries.  In the survey, only 25% of pre-retirees expect to retire before age 65 (compared to the 60% of current retirees who did) and 18% expect to work to 70 or beyond.  With retirement so delayed, why wouldn’t their health be worse when they finally hang it up?

In fact, as much as the retirement gurus like to lecture boomers about being financially unprepared for retirement, this survey suggests they are morerealistic about the money troubles they might face than the health challenges. For example, 22% of pre-retirees expect their finances to be worse in retirement than they are now—and that’s even after taking into account their plans to work longer and delay retirement.

As I’ve written here, boomers have gotten the message that they’ll need to work longer—and most will be okay if they are able to hang in there until 66 or beyond.  The risk is that some may not be  healthy enough to stick it out that long, or that employers may not want them.

Okay, ready for some good news on retirement?  Despite some  health and financial surprises, only 25% of current retirees say life is worse than before retirement and 29% rate it as better. Contributing to this improved quality of life, say retirees, is they have less stress (39%); a better relationship with family and spouse (35% and 34%, respectively); more time for hobbies, sports, volunteering and other activities they like (34%); and healthier eating habits (34%).

Janet Novack, Forbes Staff

Creating a Revolution in Nursing Homes: Putting Home and Heart In to Long-Term Care

Creating a Revolution in Nursing Homes: Putting Home and Heart In to Long-Term Care

RWJF Celebrates the 100th Green House Home

Published: Sep 26, 2011

On September 27, 2011, the Robert Wood Johnson Foundation and NCB Capital Impact celebrated an inspiring milestone – the opening of the 100th Green House home, which employs a revolutionary long-term care model that provides seniors with improved care without increasing costs. Green House homes provide elders with a high quality of life and quality of care in a setting that feels like a real home. As a result, residents are happier and have better health outcomes. They enjoy life more fully, remain independent longer, and receive more direct care time daily from skilled Green House providers.

The announcement comes on the heels of a recent survey on health and retirement commissioned by RWJF that reinforces the need for improvements to long-term nursing care. Nearly 80 percent of respondents (pre-retirees and retirees) expected to have trouble paying for long-term care, for either themselves or a spouse. Aside from cost, respondents were highly concerned about the quality of care (73 percent) and the quality of life in institutional facilities (82 percent). But one of the most pressing findings is that eight out of ten were very or somewhat worried about being in an institutional environment that is not as comfortable as home. And roughly three-fourths of pre-retirees worried about having too few nurses to provide the care they needed or losing their privacy in a traditional nursing home facility.

These same consumer concerns are also being echoed by policy makers. At a time when federal and state budgets are under increasing strain, our older American population is growing. With that growth comes demand for long-term care and for high-quality home and community-based alternatives to traditional nursing homes. The Green House model provides policymakers with a viable alternative to institutional care that meets the needs of families and older Americans, but does not cost more than the traditional nursing home model.

The Green House movement recognizes that just because someone no longer can live independently, it doesn’t mean they must surrender their dignity and realize their worst nursing home fears. RWJF has supported this concept since its inception, long before the 100th Green House home was erected in West Orange, New Jersey. In 2005, RWJF provided funding for Green House to develop a business and development plan, followed by the first model Green House built in Tupelo, Mississippi. Since then, RWJF has invested approximately $20 million in building the evidence related to the model’s effectiveness and its continued spread.

One hundred homes later, preliminary research indicates the model is succeeding. Aside from improving the quality of life for seniors, Green House residents also receive better and safer care. For example, residents experience far fewer bed sores which can turn into deadly infections. And they need to be hospitalized far less as well.

For all these reasons, the Foundation is launching an accelerated expansion of the Green House initiative by following a three-pronged strategy:

  • · Phasing Green House into the mainstream of long-term care
  • · Creating viable financing options for new Green Houses through the creation of a $10-million loan fund
  • · Researching and evaluating the quality, cost and outcomes of Green House care

Retirement and Health Poll: Summary

Summary


In the coming years, an increasing number of Americans will reach an age when they will consider retirement. This will include many people who represent the “baby boomer” generation. Given the different experiences and values of this demographic group, as well as the changing nature of the American life, the nature of retirement itself may change. This poll was conducted in order to capture first-hand the perspective of those who will shape the nature of retirement moving forward: people over age 50, including not only people who have retired, but also people who plan to retire (“pre-retirees”) and those who do not plan to do so. The poll covers the following areas: 1) The retirement experience of retirees and the expectations of pre-retirees; 2) Perspectives on the timing of retirement; 3) Steps taken to stay healthy in retirement; 4) Views on the role of Medicare and Medicaid in retirement; 5) Perceptions of what makes a community a healthy place for retired people; and 6) Concerns about being admitted to a nursing home during retirement.


1. The Retirement Experience of Retirees and the Expectations of Pre-retirees

For most retirees, life in retirement is better or the same as it was before, but it is worse for a substantial minority in key areas, including health and finances. For nearly three-quarters of retirees (73%), life in retirement is better than or the same as it was during the 5 years before they retired (29% say better; 44% say about the same). Areas where the greatest share of retirees say life in retirement is better than the 5 years before included: their stress (39%), their relationship with their family (35%), their relationship with their spouse (34%), the amount of time they spend doing activities they like to do, such as sports, hobbies or volunteering (34%), and the healthfulness of their diet (34%). Despite these generally positive findings, it is notable that sizable minorities of retirees feel that life in retirement, and key aspects of it, are worse than in the 5 years before they retired. For example, twenty-five percent of retirees say life is worse, 39% say their health is worse, and 35% say their financial situation is worse.

Pre-retirees may underestimate the challenges of retirement. In comparison to fraction of retirees who say that life and these areas are worse in retirement, a smaller share of pre-retirees predict that life and these key areas will be worse for them. For example, only 14% pre-retirees predict that life overall will be worse when they retire, compared to the 25% of retirees who say it actually is worse. Only 13% of pre-retirees think their health would be worse, while 39% of retirees say it actually is. Less than a quarter of pre-retirees (22%) predict their financial situation would be, while a third of retirees (35%) say it actually is. Only 1% of pre-retirees predict that the amount of exercise they will get will be worse, but a third of retirees (34%) say it actually is. Only 11% of pre-retirees predict that the amount of time they spend traveling to places they want to go would be worse while a third of retirees (34%) say it actually is.

2. Perspectives on the Timing of Retirement

Pre-retirees expect to retire later than the earlier cohort and some expect not ever to fully retire. For example, 60% of pre-retirees expect to retire at age 65 or older while 26% of retirees did retire at age 65 or older.  Further, more pre-retirees now plan to retire later than they expected to during their 40s as compared to retirees who actually retired later than they expected to during their 40s (39% vs. 12%). There is also a smaller, but still notable, minority of those who have not retired yet who say they never will retire fully (15%).


Finances play a key role in the decision to delay or even avoid retirement among those not yet retired. Fifty-four percent of pre-retirees say the primary reason they now expect to retire later than they did when they were in their 40s is that they do not feel they can afford it financially. Further, 51% of people who say that they will never fully retire say they do not feel they can afford to retire financially. Notably, among those who have retired but retired later than they expected to when they were in their 40s, financial reasons are not the primary drivers. For example, nearly one in three (29%) say the primary reason they retired later was that they enjoyed working.


A substantial minority of pre-retirees and retirees say they don’t or won’t have enough money to live comfortably. Many pre-retirees and retirees feel they need a sizable income to live comfortably in retirement – more than Social Security is likely to provide.1 More than 4 in 5 pre-retirees (81%) and nearly two-thirds of retirees (63%) believe they do or will need more than $35K annually to retire. Looking at even higher levels of income, half of pre-retirees (50%) and more than a third of retirees (36%) believe they will or do need $50K annually or more to live comfortably in retirement. About a quarter of pre-retirees (27%) and a third of retirees (35%) say they won’t have the annual income they need to live comfortably in retirement.


3. Steps Taken to Stay Healthy in Retirement

Both pre-retirees and retirees expect a long, relatively healthy life. In fact, the majority of both pre-retirees and retirees expect to live into their eighties and beyond (78% of pre-retirees,72% of retirees), with a substantial minority saying they expect to live until at least 90 (29% of pre-retirees, 32% of retirees). [SLIDE 11] Majorities of both groups believe their health in retirement will be or is better than the health of people in their parents’ generation (58% pre-retirees and 53% of retirees).


Both retirees and pre-retirees have taken steps to stay healthy, but pre-retirees are more likely to mention exercising and changing their diet. The top three things that a majority of both pre-retirees and retirees have done to stay healthy during retirement, include: 1) maintained good relationships with friends and family (95% pre-retirees, 94% retirees); 2) watched their weight (83% pre-retirees, 76% retirees); and 3) seen a doctor regularly (80% pre-retirees, 88% retirees).  When looking at additional actions people have taken to stay healthy in retirement, pre-retirees are more likely than retirees to say they have changed their diet (68% of pre-retirees vs. 58% of retirees) and much more likely to say they have increased the amount of physical activity they get (72% of pre-retirees vs. 44% of retirees).
————————————————————————————————————————–
1$35K is slightly more than twice the amount that an average retired worker receives in Social Security benefits today. See: http://ssacusthelp.ssa.gov/app/answers/detail/a_id/13/~/average-monthly-socialsecurity-benefit-for-a-retired-worker


4. Views on the Roles of Medicare and Medicaid in Retirement

Medicare is seen as a more important program than Medicaid in retirement among both retirees and pre-retirees. For example, 65% of pre-retirees and 74% of retirees saying Medicare will be/is very important. In comparison, only 38% in each group say that Medicaid will be/is very important in their retirement. Retires and pre-retirees say that Medicaid will have little role in paying for their long-term nursing home care if they need it. Only 10% of pre-retirees and 7% of retirees say Medicaid will pay the majority of their costs for 3 months in a nursing home. Reflecting the importance of the program, about a third of pre-retirees (33%) and retirees (36%) say that waiting 2 years longer to receive Medicare benefits would be/would have been a major problem for them and their family.

Pre-retirees and retirees differ in their views on the future of Medicare, but neither group wants a complete overhaul or major change to the program. Pre-retirees are less likely to be confident that Medicare will continue to provide benefits of at least equal value to current benefits during their retirement than retirees are (38% vs. 52%). There is not a majority support for a complete overhaul/major change in Medicare among either pre-retirees or retirees; however, more pre-retirees than retirees want such changes in the program (47% vs. 32%). In addition, more retirees than pre-retirees say that the government should not try to control the costs of Medicare (27% vs. 13%).


A substantial minority of pre-retirees say they are likely to have trouble paying for health care in retirement, and a substantial minority of retirees say they have actually experienced many of these problems. About three in ten pre-retirees say it is very likely they will have trouble paying for health care insurance premiums (31%) or long-term care (30%), while a quarter of pre-retirees say it is very likely they will have trouble paying overall medical bills (27%), or paying for the drugs they/their spouse needs (24%).  Approximately 1 in 5 retirees has actually experienced trouble paying for each of several different health care services, including: the drugs they/their spouse needs (22%); health care insurance premiums (21%); overall medical bills (21%); long-term care (19%); or preventive care they/their spouse needs (18%).

5. Perceptions of What Makes a Community a Healthy Place for Retired People

While pre-retirees and retirees agree on many community characteristics that keep retirees healthy, retirees draw attention to drug store access and pre-retirees emphasize space for physical activity. Many people who retire may move from their current home to a new community or re-consider the characteristics of their existing communities from a new perspective. There is widespread agreement among both groups about the top aspects of communities that help retired people stay healthy. The top factors include: Clean air and water (88% pre-retirees, 90% retirees); low crime rate (86% pre-retirees, 80% retirees); access to affordable fruits and vegetables (83% pre-retirees, 79% retirees); access to high quality doctors and hospitals (82% pre-retirees, 84% retirees). In addition, pre-retirees are more likely than retirees to report that access to outdoor space for walking, jogging, and sports is important (80% pre-retirees vs. 68% retirees), while retirees are more likely to report the importance of access to pharmacies or drug stores (77% retirees vs. 65% pre-retirees).


6. Concerns about Being Admitted to a Nursing Home During Retirement

Admission to a nursing home would worry most retirees and pre-retirees. At some point during retirement, many people will require long-term nursing care, including care in a nursing home. If they did get admitted to a nursing home, both pre-retirees and retirees would worry a great deal about the problems they could face in a nursing home. The top things pre-retirees and retirees were ‘very’ or ‘somewhat’ worried about were: 1) Being in an institutional environment that is not as comfortable as a home (82% pre-retirees, 78% retirees); 2) the cleanliness of the facility (78% pre-retirees, 74% retirees); 3) having too few nurses to provide the care you need (77% pre-retirees, 69% retirees); 4) the quality of health care provided (76% pre-retirees, 69% retirees); and 5) having limited privacy (74% pre-retirees, 65% retirees).

Methodology
This poll is part of an on-going series of surveys developed by researchers at the Harvard Opinion Research Program (HORP) at the Harvard School of Public Health in partnership with the Robert Wood Johnson Foundation and NPR. The research team consists of the following members at each institution.


Harvard School of Public Health: Robert J. Blendon, Professor of Health Policy and Political Analysis and Executive Director of HORP; Gillian K. SteelFisher, Research Scientist and Assistant Director of HORP; Johanna Mailhot, Research Specialist; and Eran Ben-Porath of SSRS/ICR, an independent research company.
Robert Wood Johnson Foundation: Fred Mann, Interim Vice President, Communications; Kate Sullivan Hare, Director Policy Outreach and Public Affairs; and David Colby, Vice President, Research and Evaluation.


NPR: Joe Neel, Deputy Senior Supervising Editor; Anne Gudenkauf, Senior Supervising Editor, Science Desk; Steve Drummond, Senior National Editor.
Interviews were conducted via telephone (including both landline and cell phone) by SSRS/ICR of Media (PA) July 25 to August 18, 2011 among a nationally representative sample of 1254 adults over 50. It includes 755 are retirees and 409 are pre-retirees (those who have not retired but plan to). The margin of error for total respondents is +/-3.32% at the 95% confidence level.
Possible sources of non-sampling error include non-response bias, as well as question wording and ordering effects. Non-response in telephone surveys produces some known biases in survey-derived estimates because participation tends to vary for different subgroups of the population. To compensate for these known biases and for variations in probability of selection within and across households, sample data are weighted by household size, cell phone/landline use and demographics (sex, age, race/ethnicity, education, marital status and census region) to reflect the true population. Other techniques, including random-digit dialing, replicate subsamples, and systematic respondent selection within households, are used to ensure that the sample is representative.

NPR is an award-winning, multimedia news organization and an influential force in American life. In collaboration with more than 900 independent public radio stations nationwide, NPR strives to create a more informed public – one challenged and invigorated by a deeper understanding and appreciation of events, ideas and cultures. NPR reaches a growing audience of 27 million listeners weekly; to find local stations and broadcast times for NPR programs, visit www.npr.org/stations

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For nearly 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Learn more at www.rwjf.org.
Harvard School of Public Health is dedicated to advancing the public’s health through learning, discovery and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children’s health to quality of care measurement; from health care management to international health and human rights. For more information on the school, visit www.hsph.harvard.edu.

Long Term Care

What is Long Term Care (LTC)?

It’s personal care for people whose health has declined to the point where they need  need someone to help them with two or more “activities of daily living” which includes dressing, bathing, eating, taking medication, toileting and transferring (getting in and out of a chair or a bed.) The other indication that someone is in need of Long Term Care is that they have become cognitively impaired. Cognitively impaired may be defined as the impairment to judge accurately, reason and act prudently in everyday actions. The impairment is considered severe enough to cause possible injury or damage to oneself or others in bodily harm or loss of property. LTC may include a long term care facility such as a nursing home, assisted and independent living facilities, adult day care as well as home health care.

Why is LTC planning more important than ever?

1. Cost. The average cost of a nursing home in the U.S. in 2011 was $193 per day and $213 per day for a private room. Assisted living costs $3,261 per month and home health care goes for about $20 an hour that according to Genworth Financial.

2. Increasing longevity. We are now living longer. According to “World Life Expectancy” life expectancy in the U.S. once we turn age 65 in 2011 is 85 years old for males and 88 years old for females. We are living longer than ever and just because we are living longer doesn’t mean we will not end up in a Nursing home…it could mean we stay alive in a nursing home a lot longer.

3. Underwriting may not be favorable. According to one nationally known personal finance radio talk show host age 60 is the optimal time to buy LTC Insurance (LTCi.) In a perfect world this seems reasonable unfortunately, as we get older passing underwriting requirements becomes more difficult. The LTCi carriers report about a 30% decline rate if you wait until you’re 57 years of age. The most procrastinated tasks is acquiring insurance. You don’t wait to watch your house to catch fire before calling to insure your house against a fire…it’s too late then.

4. It’s a bad economic choice unless you’re extremely wealthy or extremely poor. To work hard and save your money over the course of 40 or 50 years and then to be hit with a stroke or Alzheimer’s Disease could wipe out your savings. A stay of 5 years in the nursing home would set you back about $300,000 if you paid out of pocket, $600,000 if both spouses are in need. A simple $2,000 per year premium for a LTC policy for 10 years would be $20,000.

5. “But what if I grow old and never need LTCi?” A common objection although you never complain about having to spend $20,000 on fire insurance when chances are good you will never have a fire. Chances of needing LTCi: 3 out of 4 seniors age 65 and over, 75%. Chances your house will burn down: .08%

6. “Well doesn’t Medicare cover Nursing Home and Home Health Care?” No, very little if any is paid for by Medicare. Medicare as well as all health insurance is designed to get from a position of sickness or injury back to normal everyday life. LTCi is designed for people who will usually not return to a normal wellness state. LTC basically allows you to live with as much comfort as possible for the long term (until death.) People receiving LTC are not expected to make a comeback in terms of a normal productive life. The only type of coverage for this is LTCi.

7. “But how about Medicaid? I heard that once you can get on Medicaid your LTC is paid for by the state.” Medicaid is only available for those who live in poverty. Here is what’s necessary to receive Medicaid payments for LTC.  1) Your assets have not been transferred to someone else (like your children or someone else) in the past 5 years from the date you actually need LTC. 2) The spouse needing LTC (referred to as the “Institutionalized Spouse”) will have all their monthly cash flow such as a pension and Social Security income going straight to the nursing home before Medicaid kicks in. In addition, the stay at home spouse officially called the “Impoverished Spouse” or the “Community Spouse” must show that there is no more than $113,640 (in 2012 and adjusted annually for inflation) in assets, a maximum of $1,500 of cash value life insurance, one automobile, some personal affects such as jewelry and furniture and of course only one house which is is the primary residence. 3) The institutionalized spouse will be limited to facilities that accept Medicaid. What if the nearest facility is 100 miles away from the impoverished spouse’s home? 4) Medicaid is not an entitlement program, but rather a loan. At the passing of the impoverished spouse assets including the home will be sold to satisfy the amount of services Medicaid paid for also known as Estate Recovery. 5) In most states, Medicaid only covers the cost of nursing homes, not home health care, adult day care or assisted and independent living facilities.

8. “I’ll let my children take care of me like I did for my folks” Really? Have you had that conversation with your adult children? Sure they might feel obligated but what a sacrifice to ask of them. Who wants to ask their children to care for them? What about your adult child’s spouse and their own children? I know their are some living like this because there is no other choice but this is no way you want to be remembered. Take action now! Maybe your children can help pay for LTCi; if they can afford it great. Asking them to help pay your LTCi is much easier than asking if you can move in with them and have them take care of you.

Uncle Sam Can Help You Pay For Long-Term Care Insurance – Forbes

Uncle Sam Can Help You Pay For Long-Term Care Insurance – Forbes

Can a tax deduction help you afford long-term care insurance? If you’re buying it as an individual, maybe. If you’re self-employed and buying it through your business, absolutely. “It’s kind of a hidden secret,” says Lisa McAree, an insurance broker in Braintree, Mass. “Accountants will say you ought to contribute to a 401(k) retirement plan, or buy an SUV [to snag a tax break] but they don’t often bring up the fact that you can buy long-term care insurance through your business and get a tax deduction,” she adds.

McAree just signed up Kathleen Hagan, a single boomer who is a medical technology consultant in Watertown, Mass., with a long-term care policy from Prudential. The premium runs $3,204 a year, and it’s 100% deductible as a business expense on her federal income tax return. Basically, that’s like getting a 30% discount (or more, depending on your tax bracket). Plus, the benefits, if you eventually need them, are tax-free. Massachusetts doesn’t offer a tax break but many states do. Manulife’s John Hancock has a list of state incentives in its Long-Term Insurance 2011 Federal and State Tax Guide.

The federal tax break didn’t drive Hagan’s decision to buy. She had it on her to-do list. But the tax savings enabled her to get a policy with better coverage, she says. “It’s like saving for retirement and getting a will,” Hagan says. “It’s one of those things you need to do. I was a Girl Scout!”

Not everyone can get a tax break for long-term care premiums. If you’re buying a policy as an individual (not through your business), long-term care premiums are deductible as medical expense deductions, and those are only allowed to the extent they exceed 7.5% of your adjusted gross income. So for older folks with high medical expenses and relatively low incomes, the long-term care premium tax deduction is more likely to come into play than for middle-aged folks. (Another wrinkle: under ObamaCare, starting Jan. 1, 2013, the 7.5% floor goes up to 10% unless the taxpayer or his or her spouse is 65 or older).

There’s a second hurdle: an age-related premium limit on how much is potentially deductible (you deduct the lesser of the actual premium paid or the age-related premium). In 2011, if you’re 41 to 50, it’s $640 a year; if you’re 51 to 60 it’s $1,270; if you’re 61-70 it’s $3,390; and if you’re 71 and older, it’s $4,240.

Here’s the deal for self-employed folks with business income that passes through onto their personal returns. They don’t face the 7.5% AGI limit. Instead, they can deduct 100% of the premiums paid for themselves (and spouse) as a business expense, just like health insurance. These folks are still subject to the age-related premium limits, but that doesn’t necessarily limit your deduction—it didn’t in Hagan’s case.

Hagan’s long-term care purchase topped off a health and wellness makeover she started a few years ago. She tap dances, rows and cross-country skis. Her hope is that if she ever needs to borrow on her policy that she can have healthcare and assisted living services in her first floor condo in a charming old Victorian house. “I hope it’s the biggest waste of money I ever spent,” she says.

Ashlea Ebeling, Forbes Staff

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Stay out of the Nursing Home Insurance

Stay out of the Nursing Home Insurance

When I speak to folks about LTCi I often get a response like, “I don’t want to think about LTC…why do you want to talk about putting me in a nursing home?” I respond with, “I’m not wanting to put you in the nursing home…in fact I’m calling you to talk about keeping you OUT of the nursing home. Now how does that sound? Well now you have my attention!” And so the conversation carries on.

Here are some facts to consider. Of those who have Long Term Care Insurance (LTCi) only 9% will pass away in a nursing home facility. Why is that? If you have LTCi you have options. Almost all of the plans today include provisions for home health care. Let’s face it, seniors want to be independent and maintain a relative amount of control in their lives for as long as possible. Aging in your own home brings a sense of peace,  comfort and happiness especially if you’ve lived in the same house for a long time.

Another feature that LTCi policies have today is the ability to take out small amounts of cash to pay for certain services as you need them. For example, as you age many times you age slowly and your loss of good health is gradual. Perhaps you find it impossible to mow the lawn and do the cooking. You could hire the teenager down the street to mow your lawn and find someone from a local church or small company that delivers home cooked, pre-made meals that can be warmed in the microwave. How much would that cost? Maybe $500 or $600 per month. You could draw that amount out each month and continue in that condition for a while.

Finally, a number of policies today have a provision that will allow you to share your benefit with your spouse. For example, you and your spouse purchase LTCi and sometime later one of you is diagnosed with Alzheimer’s Disease in which you could start using your coverage little by little. If the Alzheimer’s Disease lasts 5 or 10 years or more you could very easily run out of coverage on the disabled spouse. With the shared benefit feature the other spouse can share their coverage allowing you more options on your LTC decisions.

LTCi should be more aptly named, “Stay out of the nursing home insurance.” Facing old age and the likelihood of becoming medically dependent on others can be a horrifying prospect without having a safety net backing you as you age. Do not wait…call or email today to have a conversation about LTCi.

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