Long-Term Care Insurance (LTC)
YOUR
LONG-TERM CARE OPTIONS | WHO
CAN BE COVERED |
WHEN BENEFITS ARE PAID | ABOUT
YOUR PREMIUMS AND ENROLLING
Long-term care refers to a wide range of personal care, health and
social services for people of all ages who suffer a chronic disease or
long-lasting disability. These services can be provided in a nursing
facility, an adult day care center or at home, and can involve some
nursing care. The cost for this kind of care is very high. Home care
can be as much as $20,000 per year, and nursing home care can range in
cost from $20,000 to $60,000 annually. Generally, you pay these expenses
out of your own pocket, because medical insurance and Medicare do not
cover long-term care. Typically, Medicaid is only available to members
after they have significantly depleted their assets and income. Long-term
care insurance is designed to protect you financially by paying benefits
if you need long-term care. It also helps you maintain greater independence
and a higher quality of life.
DID YOU KNOW…
- Nearly half of all Americans over age 65 require
long-term care for some period of time?
- Medical insurance and Medicare generally do
not cover long-term care?
- Medicaid covers some types of long-term care,
but restricts your choices of where this care can
be provided?
- Many Americans will spend their life savings
on less than one year of care?
YOUR LONG-TERM CARE OPTIONS
You can choose from one of three daily benefit levels and the corresponding monthly premium that is right for your needs and budget. The amount of the benefit depends on two factors: where the long-term care is provided - either in a nursing facility, or home/day/ assisted living facility - and the daily dollar level of the coverage you have selected. With any of these daily benefit options, benefits are paid on a monthly basis. The monthly benefit is equal to 100% of your elected daily benefit amount for care provided in a state-licensed nursing home facility, and 60% of your elected daily benefit amount for care provided in an assisted living facility or at home. If you wish, you can add on a reduced paid-up option and/or an inflation protection option.
WHO CAN BE COVERED
This plan is offered to you, your spouse, your parents or your
parents-in-law. "Parents" are biological (natural), adoptive, or
step-parents of eligible employees or spouses. Your spouse, parents
and parents-in-law will have to complete a medical underwriting
process and be approved to be accepted for long-term care coverage.
Your family members' premiums will be billed directly by the insurance
company. Your payroll deduction will be for your individual coverage
only.
WHEN BENEFITS ARE PAID
Benefits begin after a 90-day waiting period in which
you or a covered family member has an eligible physical
or cognitive disability. You qualify for benefits
if the disability creates a need for you to receive
continual help from another person to carry out any
three of the following six activities of daily living:
- eating
- dressing
- bathing
- using the toilet
- transferring from a bed to a chair
- continence
Benefits from long-term care insurance are not taxed
when you receive them.
ABOUT YOUR PREMIUMS AND ENROLLING
You pay for your long-term care coverage through the convenience of payroll deduction with after-tax dollars. Premium costs are based on your age as of the Benefit Calculation Date (October 1). Your family members' premiums are based on their age as of the date they apply for coverage. Their premiums will be sent directly to Unum, not deducted from payroll.
FOR THE PY 2008 OPEN ENROLLMENT ONLY, CURRENT EMPLOYEES MAY SELECT OR INCREASE LTC WITH NO
MEDICAL UNDERWRITING REQUIRED At all other times, if you are a current employee and
selecting long-term care insurance for the first time, or are currently enrolled and want to
increase your benefit level or add options, or are re-enrolling after discontinuing coverage,
check the You Decide for medical underwriting requirements. As a newly eligible employee,
you may select LTC with no medical underwriting required. For more information about long-term care
coverage, call Unum at 1-888-SOG-FLEX (1-888-764-3539).
The long-term care plan can play an important part in your future.
Coverage will stay in effect for as long as you continue to pay the
monthly premium, even if you should leave the State's employment.
You could then apply for coverage continuation and be billed by Unum
directly at your home.
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