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LONG TERM CARE INSURANCE

If you are between 50-80 years old, you could lose your life savings if you need Home Health Care or Nursing Home Care.

Life Insurance can help people avoid losing their life savings, income and dignity if someone in their family needs personal care in their golden years. Here are some of the alarming truths about Long Term Care:

  • 1 out of 2 people 65 and over will need long term care.
  • Provincial Medical care and other health care plans pay only a portion of long-term care costs.
  • The average Canadian couple will have their entire savings wiped out in as little as a few months having someone confined in a nursing home.
  • You could lose your independence and be forced to rely on your children for care and support.
  • You may have to wait months to get into a Government Subsidized facility, and when you do it could be hundreds of kilometers away.

The advancements made in the medical field today have added longevity to all our lives, however there is great concern of the quality of life that will be available in the golden years. Relying on the provincial health care system is not enough!

Long Term Care Insurance enables clients to take control of their future health and personal care services. These unique plans are designed to cover the costs of health or personal care services resulting from the insured's inability to care for themselves. This may occur due to chronic illness or a disabling condition requiring care in the home, or the use of a long-term care facility.

Many Canadians who have parents in the 50-80 age brackets are purchasing this coverage now to avoid the financial hardships which they would otherwise have to endure in the future.

Here are some Plan Highlights of how Long Term Care Insurance Plans are structured. Please contact us to obtain a customized quote or if you require further information:

Facility Care
Long-Term care policies provide a Facility Care Benefit. When health or personal care services are required on a long-term basis in a long-term care facility at the order of a physician the Facility Care Benefit will be paid. This could be the result of an injury or sickness, the inability to perform two or more activities of daily living, on the basis of cognitive impairment, or due to medical necessity caused by chronic illness.

The Benefit is available in daily units of $10.00 and is payable after the Elimination Period. Facility Care is available for persons between the ages of 40 and 80. Facility Care can be purchased on its own without the addition of Home Care or the Return of Premium benefits. Benefit payment from Facility Care will be paid in addition to any government benefits that the client may also be receiving. The benefit will be paid directly to the insured.

If the client and their partner both join the plan at the same time, they may receive a 10% reduction in the Facility Care portion (including the policy fee) for their premium.

Home Care
The Home Care Benefit is available in addition to Facility Care. This benefit will pay for the cost of a medically necessary long-term program recommended by a physician and provided by a licensed nurse or an authorized employee of a health Care Agency. This could be the result of an injury or sickness, the inability to perform two or more activities of daily living, on the basis of cognitive impairment, or due to medical necessity caused by chronic illness.

The Benefit is available in daily units of $10.00 and is payable after the Elimination Period. Home care is available for persons between the ages of 40 and 75. The Home Care Daily Benefit may be equal to or less than the Facility care Daily Benefit but it cannot exceed it. Home Care may not be purchased on its own. It must be added to a policy containing Facility Care. The Home Care Benefit will be second payer to any costs covered by a government program or other individual health care plan. Claims will be considered for Home Care after an application for benefits is first submitted under any government-sponsored or other individual health care program. The benefit will be paid to the insured.

Return of Premium
Return of Premium (ROP) is an optional rider that will reimburse all premiums paid for Facility Care (including the Policy Fee and the ROP premium) upon the death of the insured. The policy must have been in force for more than five years, and Facility Care Benefits have never been paid, and the policy must still be in force at the time of death. Home Care premium is excluded from the Return of Premium Benefit. You can receive Home Care Benefits and still be eligible for the Return of Premium Benefit. The return of Premium Benefit will be paid to the insured's beneficiary.

Waiver of Premium (included at no extra cost)
While the insured is receiving either Facility or Home care benefits under the terms of the contract, premiums will be waived. This feature is included at no extra cost. See the specimen contract for further details.

Reduced Paid-Up Benefit (included at no extra cost)
If premiums continue to be fully paid beyond the end of the fifth policy year (for a contract with a zero-day elimination period) and then cease, the policy will not terminate but instead become a fully paid-up policy providing a reduced Daily Benefit for Facility Care. This benefit only applies to Facility Care and does not include Home Care. Please see the Non-Forfeiture Benefit section (2.4) of the specimen contract for the table of Reduced Paid-Up Benefits. There are two tables: one for the zero-day elimination period and one for the ninety-day elimination period.

Guaranteed Improvability (included at no extra cost)
In the event that the insurance company should improve upon or add to the provisions offered under the Long-Term care program, they will generally guarantee the insured's ability to upgrade their policy to include the new features without evidence of insurability. Please read the Guaranteed Improvement Provision (1.7) of the specimen contract for all applicable conditions. This provision is included at no extra cost.

Guaranteed Renewable (included at no extra cost)
The policy is guaranteed to be renewable annually throughout the premium payment period as specified in the insured's contract as long as the required premium is paid. Your renewal premium is guaranteed not to increase for the first five policy years. The company reserves the right to change the renewal premium under certain circumstances to a maximum of 25% of the original premium excluding policy fee, as outlined in the policy contract. Premiums cannot be changed once they have been paid throughout the entire premium payment period (see next section).

Limited Premium Payment Period
A consumer-friendly feature of the Long-Term Care program is the limited time in which premiums have to be paid. The payment period is based on the following issue ages:

General Policy Issue age range & corresponding period premium is payable
40 to 45 …to age 65
46 to 65 … for 20 years
66 to 75 …to age 85
76 to 80 …for 10 years

Elimination Period
The Elimination Period is the period of time which must expire while under care before the benefits are payable. There are two choices each for Facility Care and Home care:

Facility Care: 0-day (payments start on day one); 90-day (payments start after 90 days)
Home Care: 60-day (payments start after 60 days); 90-day (payments start after 90 days)

E.& O.E.
Canadian Residents Only Please

Dave Pettenuzzo