Long Term Care Insurance protects you, as well as your loved ones in the advent that extended care is needed during your life.  The chance of requiring long-term care services is roughly 50 times the chance of sustaining a major loss from an automobile accident.

Americans are becoming more sophisticated about long-term care insurance. As the knowledge of this financial product has broadened, the insurance carriers have designed additional options and riders for the more savvy customers. These additional options include accelerated pay riders, indemnity payments, enhanced daily benefit maximums, waiver of home health care elimination periods, multiple inflation protection choices, enhanced survivorship benefits, greater elimination period choices and expanded home health care benefits. Unfortunately, despite an overall knowledge of long-term care, too many Americans remain reticent to make decisions on whether they will purchase a policy. Far too often, people remark that their uncertainty is based on a perception that they "may" never use the benefits. This perception, while true in many cases, is completely irresponsible when evaluating one's financial planning.

As Americans continue to live longer and longer, long-term care insurance will become even more critical than it is today. Despite the fact that many Americans still believe that they will never require long-term care services, the statistics show otherwise. Today, the chance of requiring long-term care services is roughly 50 times the chance of sustaining a major loss from an automobile accident. Most consumers would never dream of driving an automobile without owning automobile insurance, but yet they have not planned accordingly for the time when they will require long-term care services. According to the Society of Actuaries, for every 1,000 people, nearly 600 will require some form of long-term care (LTC). Many people are relying on a flawed belief that Medicare or Medicaid will provide the care at the time of need, thereby eliminating the need for private LTC insurance. This misconception is extremely naive and quite dangerous when considering the numbers of people who truly believe that LTC insurance is a luxury. Actually, Medicare only covers six percent of long-term care costs nationally, and Medicaid provides benefits only to those people who have depleted enough assets to qualify for the aid, as reported in The Western Journal of Medicine, January 1994. This gross miscalculation will only worsen in the future, as Medicare becomes more exclusive to medical-related services, with lesser coverage for custodial care. As more facilities sell a larger percentage of their space to private-pay patients, these facilities will terminate existing relationships with federal and state programs. Ultimately, this will leave Medicaid patients with fewer options than they have today. In fact, the last nine months have already brought about significant restrictions for Medicaid eligibility in many states.

Additionally, more consumers are becoming more adamant about receiving assisted living and home-based care, which is evidenced by the fact that, for every person living in a nursing home, there are four others receiving care in the home, according to a 1998 report, "Group Long Term Care ?  Flexibility, Innovation, Experience." Unfortunately, neither Medicare nor Medicaid pay for any assisted living facility and home-based health care. Perhaps more importantly, is the fact that the federal government has made it clear that long-term care is not the responsibility of the government, so private insurance will be the only definitive assurance that benefits will be available in the future. These people, who are waiting on the "sidelines" for the government to step-in and provide coverage, will be left with few options. As the baby boomer generation will soon be retiring, the passive planning in this country is paving the way for a crisis of nightmarish proportions.

The statistics from the May 2003 Roper Study are even more alarming. According to the report, approximately 75 percent of those surveyed were families currently aware of the major long-term care options in the marketplace. Of those who were surveyed, 71 percent believed that is was very important to have some type of private or government coverage for LTC services, but only 17 percent stated that they currently have LTC insurance to cover these costs. Despite what the remaining 54 percent may believe, most of them will not be eligible for Medicaid, and few will have the assets to fully pay for these necessary services. Astonishingly, nearly 67 percent of those surveyed stated that choosing the long-term care facility for themselves or someone close to them was very important. Under Medicaid, only the government decides where the patient will receive care. Even more shocking was the fact that 46 percent of those who currently have health insurance believed that their health insurance would cover most of the costs associated with long-term care. Finally, 30 percent of the respondents were unaware that Medicaid was provided only to applicants who had depleted nearly all of their financial resources.

General Information:
 
1.  *First Name:  
2.  *Last Name:  
3.  *Phone:  
4.  *Email:  
5.  Address:  
6.  Address:  
7.  City:  
8.  *State:  
9.  *Zip Code:  
9.  County:  
We'll begin by asking for a little information about you. Your answers to the following questions will enable us to determine whether long term care is a wise choice for your present and future insurance needs.
1) What is your gender? M F
2) What is your date of birth?
MM/DD/YYYY
3) If you are age 65 or over, are you eligible for Medicaid? Yes No
4) What is your height? ft. in.
5) What is your weight? lbs.
6) Please indicate your marital status:
7) What is the highest level of education you completed?
8) Please indicate your current employment status:
9) Please select the industry that best describes your occupation:
10) How long have you been employed at your present job? Years Months
 
To help us ensure that our search delivers the most competitive quote for your insurance needs, we'll need some information about your day-to-day lifestyle, your medical history and your current health status. Please continue by answering the following set of questions to the best of your knowledge
11) In the past five years, have you used any form of tobacco or nicotine substitute?
12) If Yes, what forms of tobacco did you use? Smoke Cigarettes
Smoke Cigars
Smoke A Pipe
Chew Tobacco
Chew Nicotine Gum
'The Patch'
13) If you currently smoke cigarettes, how many packs do you smoke per day?
14) Have you used any form of alcohol in the past five years? Yes No
15) If so, what do you usually drink? Beer
Wine
Liquor
16) Have you been treated by a physician in the last year? Yes No
17) Have you been hospitalized in the last five years? Yes No
18) Are you currently taking any prescription medications? Yes No
19) Do you visit your doctor for annual check-ups? Yes No
20) Do you use mechanical devices such as:
Wheelchair Yes No
Walker Yes No
Crutches Yes No
Hospital bed Yes No
Dialysis machine Yes No
Oxygen Yes No
Stairlift Yes No
21) Do you currently need or receive help in doing any of the following activities?
Bathing Yes No
Eating Yes No
Dressing Yes No
Toileting Yes No
Transferring from bed to chair Yes No
Maintaining Continence Yes No
Within the past twelve months, have you…
22) Been confined to a nursing home Yes No
23) Custodial care facility Yes No
24) Received home health care services Yes No
25) Have you had any health symptoms relating to the conditions listed below? (If yes, please check the box next to the specific condition(s) listed below that you have been told you had or have been treated for)
Central Nervous System Skin, Bones or Muscles Mental Health, Drug Abuse
Epilepsy
Multiple Sclerosis
Alzheimer's Disease
Cancer 		Rheumatoid Arthritis
Melanoma
Cancer 		Alcoholism
 Drug Abuse
 Mental Illness
 Depression
Digestive System Respiratory System Circulatory System
Chronic Kidney Disease
Liver Disease
Kidney Stones
Gastric/Peptic Ulcers
Ulcerative Colitis or Ileitis
Neurogenic Bladder
Bowel Incontinence
Diabetes Mellitus
Cancer 		Asthma
Emphysema
Chronic Bronchitis
COPD
Cancer 		Coronary Artery Disease
Vascular Disease
High Blood Pressure
Stroke
Elevated Cholesterol
Cancer
HIV
The answer to these basic questions will help us process your information and ensure that our search delivers the most competitive quote for your long term care insurance policy.
26) What range best describes your approximate household income:
27) Do you own or rent your residence:
28) Time at current residence:
29) Please describe your credit history:
30) Best Time To Contact:
31) Additional Comments:
Please provide any additional information you feel is pertinent to the insurance coverage you need.

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