Due to growing client interest in long term care (LTC) insurance, this issue is dedicated to helping you understand what LTC insurance is and how it can be choreographed into a complete eldercare plan

Insuring Your Future
 Welcome to this special edition of our newsletter.  As our services and clientele continue to grow, we are finding that many attorneys, accountants, financial planners and insurance professionals look to us as a resource.  We are pleased to offer our expertise and to help with estate and financial planning issues.
.LTC insurance can help or hinder you depending upon the policy you choose.  We will help you to determine what you need to know to purchase the best policy to meet your personal needs.
 As always, we welcome your questions about long term care and long term care insurance.  It is our goal to connect you with the best possible resources that offer freedom of choice and quality care.  We look forward to talking with you.

Long Term Care Insurance - An Introduction
"The average person does not fear death.  The greatest fear is of the dependence and disability that may occur in old age."
Long term care is a diverse system of services designed for people with chronic health conditions or cognitive disabilities who are no longer able to care for themselves independently.  Such services may be provided at home, in a nursing home or by any number of other service options.
Long term care (LTC) insurance is a form of insurance available through private insurance companies as a means for individuals to protect themselves against the high cost of long term care.  LTC insurance isn't for everyone and having a policy that doesn't work for you is worse than having no policy at all.  Be sure to meet with someone who has your best interest in mind when choosing your LTC  policy.
A large percentage of us will spend time in a nursing home.  Many more of us will require home care services on an extended basis.  The annual cost of nursing home care in New York State can exceed $60,000. ($75,000 in the metropolitan area).  It can cost even more for 24-hour care at home.
"...But I thought Medicare would pay for it..."
Medicare and Medicare supplement (Medigap) insurance are beneficial in protecting against the costs of acute medical care.  Rehabilitative care and acute skilled medical problems are covered, usually for a period of 100 days in a skilled nursing facility (SNF).  However, most nursing home residents require custodial long term care which is covered only by private funds, LTC insurance and Medicaid.  Federal poverty guidelines for income and assets must be met to qualify for Medicaid.  Assets must be "spent down" to receive Medicaid assistance.  The need for long term care arises when chronic physical or cognitive conditions affect a person's ability to remain independent in everyday life activities. These activities of daily living (ADL's) including bathing, dressing, eating, transferring, toileting and continence. 
Most LTC policies are triggered when you need assistance with at least two ADLs or have cognitive loss which affects your ability to care for yourself.
LTC insurance typically covers nursing home care, assisted living, home health care, adult day care, respite care and continuing care.
The business of choosing a LTC insurance plan can be confusing at best.  There are a number of LTC policies on the market today.  Each has a distinguishing feature that sets it apart.  Insurance companies are competing to outdo one another with rates and benefits.  Be sure to shop around for the best plan for you.

TRUST PLANNING with LONG TERM CARE INSURANCE
by Benjamin D. Levine, Esq.
Although trusts are frequently used today to protect one's assets against the costs of long term care, a trust may still have a role in your estate plan, even if you have insured your long term health care with a long term care insurance policy.  The purpose of the trust may go beyond long term care planning for the creator of the trust.
With a revocable trust, you can provide for continuity of estate management in the event of disability or incapacity.  You can also provide for how your trust estate will be distributed at your death.  The trust takes the place of your will as to those assets in the trust and avoids the costs and delays associated with probate.
The irrevocable trust is most often used when the creator wants to divest himself of ownership over certain assets, but doesn't want the beneficiary to receive the assets outright until some time in the future.  The trust can be created for the education of a grandchild, or to assure support for a child or other person who is not able to manage money well or who has financial problems, or who is disabled or mentally handicapped. The irrevocable trust is also often used as a means of reducing estate taxes, such as with an irrevocable life insurance trust or a charitable remainder trust.
The living trust can be a convenient estate planning tool, even if you have planned with a policy of long term care insurance.  An estate planning professional familiar with long term care insurance and trusts can help you decide how best to use this valuable tool.
Benjamin D. Levine is an attorney with the law firm Rifkin, Frankel & Greenman, PC, DeWitt, New York

DEFINING POLICY TERMS
Wading through long term care insurance policy features and keeping all the terminology straight can be a daunting task.  To help you through the process of shopping for a policy we've defined some commonly used terms here.

Daily Benefit
Amount of money the policy will pay each day for nursing home and home care costs.

Elimination Period
Waiting period before your benefits begin.

Guaranteed Renewable
A policy that cannot be can celled for any reason - even in the case of infirmity, old age, disability, etc. - as long as you pay your premiums and are truthful on the initial application.

Inflation Adjustment
Ensures that your benefits will keep pace with rising costs of health care and inflation.

Maximum Lifetime Benefit
Total amount of money available to cover costs throughout the policy's term.

Nonforfeiture Benefit
Provides a cash value which is a percent of the sum of premiums paid by you if you decide to discontinue your coverage.

Waiver of Premium
Allows you to stop paying premiums while you are receiving benefits.

While every long term care insurance product has a 30 day "free look" period where you can change your mind and get a full refund, it is best to make a wise decision regarding one of the most important investments you will ever make.
The checklist below will guide you in making your own decisions regarding which policy may be best for you.  It is always a good idea to meet with a professional who is objective and understand your needs and priorities to assist you in making this decision.

Your Personal Checklist
Underlined items will impact the total cost of your LTC policy. 
Answer these questions for each policy you're considering to compare features and choose the one that best suits your needs.  Not sure what all of these terms mean?
 See "Defining Policy Terms" on Page 2 & 3

Policy Shopping Tips

~ Research several companies  to compare benefits and prices Which can differ dramatically. ~ Be sure to only do business with  stable, established companies and  agents! ~ Ask your insurance professional  whether a "New York State  Partnership" plan may be the right  plan for you.

Additional information: NYS Insurance Department (212) 602-0203 (800)  342-3736 Insurance Counseling (800)  333-4114 CNY Elderplanning  (315) 673-9876

Long Term Care Insurance Tax Advantages

~ Qualified LTC insurance premiums can be treated and itemized as medical deductions
    provided they exceed 7.5% of adjusted gross income.

~ Qualified LTC plan benefits received are not taxable income.

For Employers...
~ Employer - paid LTC premiums are treated like regular health insurance and are tax
   deductible for S- and C-Corporations.

~ Employers  receive a tax deduction for any portion of LTC premiums paid for employees.

~ Employer contributions and paid benefits are excluded from employees' income.
~ There are group rates available; medical requirements may be waived for employee-group
   plans.