Insurance/Long-term Care Options

Question 1

Describe Medicaid:

Answer 1

Available to the poor

Benefits can be paid by the government at either the state or federal levels or a combination of the two.

Eligibility is determined based on a person’s assets

Question 2

How does Medicaid work for those entering a nursing home?

Answer 2

Can apply for Medicaid and are eligible for Medicaid assistance once assets are spent down, subject to State limits

Question 3

What is the penalty period for Medicaid?

Answer 3

Based on the amount of assets gifted in the five years, 60 months, prior to entering the nursing home.

Any gifted assets, direct or to trust, will be assessed in the formula

Divide the amount of the gifts by the nursing home cost per month to determine the number of months there would be no Medicaid coverage once assets are spent down

Question 4

When are Medicare benefits available?

Answer 4

Benefits are available to those eligible for social security

Question 5

What is a continuing Care retirement community CCRC?

Answer 5

A retirement community that offers several levels of health Care on site:

Independent living
Assisted living
Memory Care
Skilled nursing and rehabilitation

Question 6

What is a private long-term care policy?

Answer 6

Provides coverage for nursing home stays and other types of care not covered by health insurance

Question 7

What determines eligibility for benefits under a private long-term care policy?

Answer 7

Must be chronically ill or suffer from substantial cognitive impairment

Chronically ill-unable to 6 ADLs for at least 90 days. (eating, bathing, dressing, transferring from bed to chair, using the toilet, and continence)

Substantial cognitive impairment-behavior threatens own or others health and safety

Question 8

What are long-term care tax benefits?

Answer 8

Premiums are tax-deductible and limited based upon age of the insured

benefits are tax-free as long as policy is qualified, a qualified policy has the following provisions: person is expected to need care for at least 90 days, unable to perform two or more activities of daily living a person suffers substantial cognitive impairment

Question 9

What are the characteristics of a long-term care policy?

Answer 9

Does not contain a surrender value

Is limited to qualified long-term care services

Uses dividends to reduce future premiums or increase benefits

meets consumer protection laws and does not pay for expenses covered under Medicare