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Have you heard of Long-Term Care Insurance? Are you wondering what it really is and who needs it?

Long-Term Care Insurance provides benefits to pay for nursing home or home care services. Neither private health insurance, Medicare nor individual resources are generally sufficient to cover the costs of long-term care when a family member(s) requires extensive home care or permanent nursing home care.

Are you aware that Medicare will only cover the first 20 days in a facility at 100% of the cost? The next 80 days of nursing care may be covered by Medicare, subject to an $89.50 co-insurance amount for which the client himself is responsible, resulting in a private-pay amount of $7,160 after the first 100 days of nursing home care.

Further, Medicare will not pay for nursing home care beyond the first 100 days - about three months. After the first 20 days, Medicare has very strict rules which make extending the coverage apply in very limited circumstances and therefore it is very likely that coverage will not extend past the first 20 days.

On top of the Medicare restrictions, most private health insurance does not provide comprehensive coverage for either nursing home or home care, leaving a wide gap in an individual's health insurance coverage. Presently, many people look to Medicaid to fill this gap. However, Medicaid may not afford an individual sufficient flexibility in selecting a skilled nursing facility, home health care agency and medical provider. In addition, in order to qualify for Medicaid, an individual may have to make irrevocable and restrictive transfers. Further, there are numerous cuts proposed for the Medicaid program which may make it even more difficult to qualify for and more unattractive.

Please look for the next issue of our newsletter for more information on long-term care insurance, including what to look for in a policy.

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