Introduction to Long Term Care Insurance 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.

Why Consider LTC? “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. 888888888888888888888888888888888888888888888888888888888888888888888888 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.

Be a Smart Consumer HOW TO SHOP for LONG TERM CARE INSURANCE in NEW YORK STATE 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. 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. Long Term Care Insurance Tax Advantages For Individuals................ Federal Tax Deduction 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. Thank you for reviewing this edition. I have been a geriatric care manager in the health care system since 1982. When I first learned of LTC insurance in the 1980s, I was as skeptical as the next person. Since then, I have seen many clients benefit by having a LTC policy in place. By having LTC insurance, my clients not only preserved their personal assets, but then were able to exert their right to choose home care over nursing home care or a preferred nursing home over another. Some were able to avoid Medicaid altogether. LTC insurance policies are an acceptable and dignified way to pay for long term care costs. More and more employers offer LTC insurance as a benefit. A portion of your LTC insurance premium may also be tax deductible. I have gone from skeptic to “believer” and I now represent over a dozen LTC insurance companies as part of my elderplanning services. I am not a sales person as much as I am an advocate for my clients and their families to have the best possible plan in place to meet their future with freedom of choice and dignity. Kate