Specialist in Life, Disability and Long Term Care Insurance
G. R. Reid Consulting Services, LLC
Long Term Care: Government Coverage Shortcomings and Long Term Care Insurance Coverage Advantages
Government Coverage:
Medicare
Medicare's skilled nursing facility benefit ("SNF") does not cover most nursing home care. Medicare will pay the cost of some skilled care in an approved nursing home or in your home, but only in specific situations. The SNF benefit only applies if a medical professional says you need daily skilled care after you have been in the hospital for at least three days and you are receiving that care in a nursing home that is a Medicare-certified skilled nursing facility. Medicare MAY cover up to 100 days of skilled nursing home care per benefit period, after 20 days beneficiaries must pay a coinsurance fee, in 2008 that fee was $128 per day. Medicare does not pay for homemaker services. In addition, Medicare doesn't pay for home health aides to give you personal care unless you are homebound and are also getting skilled care, such as nursing or therapy. Furthermore Medicare Supplement Insurance does not cover long-term care costs.
Medicaid
Medicaid is a government-funded program that pays nursing home care only for individuals who are low income and who have spent most of their assets. Most people who qualify for Medicaid have low income and have spent most of their assets and with the recent economic hardships the government will strictly adhere to Medicaid qualification so as to not overpay for care.
Long Term Care Insurance
Long Term Care Insurance is one other way you may pay for long-term care. This type of insurance will pay or reimburse you for some or all of your long-term care.
Tax Advantages:
Medicaid
Medicaid is a government-funded program that pays nursing home care only for individuals who are low income and who have spent most of their assets. Most people who qualify for Medicaid have low income and have spent most of their assets and with the recent economic hardships the government will strictly adhere to Medicaid qualification so as to not overpay for care.
Long Term Care Insurance
Long Term Care Insurance is one other way you may pay for long-term care. This type of insurance will pay or reimburse you for some or all of your long-term care.
Tax Advantages:
Individual Care:
The Health Insurance Portability and Accountability Act of 1996 or HIPAA, gives some federal income tax advantages to people who buy certain long-term care insurance policies. These policies are called Tax-Qualified Long Term Care Insurance Contracts. New York State also rewards individuals who purchase long term care insurance policies with an additional state tax advantage, up to 20%.
Group Long Term Care Coverage:
For the corporate client, creating a group Long Term Care plan for employees, partners, or administrators could be extremely beneficial. Depending on the corporate structure, Group Long Term Care Plans can be tax deductible for the employer, if the corporation pays the benefit. Secondly, in the state of New York an added tax benefit of 20% will be granted to the corporation.
What Services Are Covered?
It is important that you understand what services your long term care insurance policy covers and hot it covers the many types of long-term care services you might need to use. Policies may cover the following:
- Nursing Home Care
- Home Health Care
- Respite Care
- Hospice Care
- Personal Care in your Home
- Services in assisted living facilities
- Services in adult day care centers
- Services in other community facilities
Our G.R. Reid Consulting Insurance team is always available to discuss Long Term Care Insurance needs and benefits, how they apply to our clients, and how to apply them so our clients are optimally protected.
The Health Insurance Portability and Accountability Act of 1996 or HIPAA, gives some federal income tax advantages to people who buy certain long-term care insurance policies. These policies are called Tax-Qualified Long Term Care Insurance Contracts. New York State also rewards individuals who purchase long term care insurance policies with an additional state tax advantage, up to 20%.
Group Long Term Care Coverage:
For the corporate client, creating a group Long Term Care plan for employees, partners, or administrators could be extremely beneficial. Depending on the corporate structure, Group Long Term Care Plans can be tax deductible for the employer, if the corporation pays the benefit. Secondly, in the state of New York an added tax benefit of 20% will be granted to the corporation.
What Services Are Covered?
It is important that you understand what services your long term care insurance policy covers and hot it covers the many types of long-term care services you might need to use. Policies may cover the following:
- Nursing Home Care
- Home Health Care
- Respite Care
- Hospice Care
- Personal Care in your Home
- Services in assisted living facilities
- Services in adult day care centers
- Services in other community facilities
Our G.R. Reid Consulting Insurance team is always available to discuss Long Term Care Insurance needs and benefits, how they apply to our clients, and how to apply them so our clients are optimally protected.
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