Employee Matters

Staff of the Employee Compensation and Benefits Services office prepare this column.

LONG-TERM CARE
(Some information for this article is taken from the Mr. Long-Term Care Web site)

What is long-term care?
It is care that primarily involves providing assistance in activities of daily living or supervision of an individual with a degenerative condition (e.g. Parkinson’s, stroke, etc.), a prolonged illness (cancer) or a cognitive disorder (Alzheimer’s).

What is long-term care insurance?
Many think of long-term care as “nursing home” insurance. Most plans provide benefits for nursing home stays, but they may also cover short- and long-term home health care, assisted living and community-based care.

How does long-term care insurance work?
Long-term care benefits may provide:

• A daily (scheduled) benefit to cover the cost of a nursing home or skilled nursing facility, or custodial care in your home.
• A per-visit (scheduled) benefit to cover the cost of in-home visits by a qualified caregiver.

Does my health insurance or Medicare pay for these expenses?
No. Private or group health insurance plans and Medicare provide benefits for covered expenses that are medically necessary. Most health insurance plans and Medicare exclude benefits for supportive or custodial care (long-term care).

Then, who pays for it?
The patient or patient’s family pays, either with cash, welfare benefits or long-term care insurance plans.

Should I consider purchasing long-term care insurance?
Purchase of a plan is based on individual need. It’s not for everyone. However, consider these facts:

• “A year in a nursing home now averages more than $40,000 and can exceed $100,000 annually in some parts of the country.” — The Wall Street Journal, March 31, 1999.
• The cost of home-health services is also very costly. Monthly care can cost up to $7,200 per month.

Does the university offer long-term care insurance?
Yes. The university offers three plans.

How do I apply?
You can apply at anytime. However, all applications are subject to medical underwriting. Some illnesses or pre-existing conditions may disqualify you from a plan. Once your policy is issued, coverage will not be limited or excluded for any pre-existing conditions or illnesses. The university also offers the option of payroll deduction to pay premiums.

Where can I get more information?

• HealthChoice (underwritten by John Hancock): call 800-833-5823 (toll free) or 833-5823 (Madison area); or visit http://www.healthchoice.com.
• HealthChoice (underwritten by Life Investors Insurance Company of America); call 800-833-5823 (toll free)or 833-5823 (Madison area); or visit http://www.healthchoice.com.
• Senior Care Insurance Services (underwritten by John Hancock); call 877-578-8400 (toll free) or 273-3443 (Madison area); or e-mail: seniorcr@terracom.net.

Before making a decision

• Read “Guide to Long-Term Care” (PI-047),” offered free by the Office of the Commissioner of Insurance to help you evaluate your needs. Call (800) 236-8517 or access a copy at: http://oci.wi.gov/pub_list/pi-047.htm
• Visit the Mr. Long-Term Care Web site: http://www.mrltc.com/ltc_info/ ltc101.html.