Types of LTC insurance in the state of California
Californians have two major options to choose from when looking to purchase long term care coverage. One of our licensed and highly professional consultants can provide precise details and help you choose the right type of insurance for your situation.
- Traditional LTC coverage – this is the conventional arrangement whereby you pay annual premiums in exchange for coverage (should you need it). Traditional long term care insurance makes for about half of all LTC policies sold. These policies can come in handy and provide a lot of value if you end up needing long term care assistance. However, in the event that you do not need long term care, the entire premium will be lost. This use-it-or-lose-it notion of traditional long term care insurance has paved the way for a more adaptive type of coverage (below).
- Hybrid LTC coverage – hybrid long term care policies have become increasingly popular not just in California but also across the country. This type of insurance combines the benefits of an annuity or life insurance with long term care benefits. You may subscribe to this coverage by paying a single lump-sum premium, or multiple premiums over a defined duration of time. If you do not need long term care, the policy pays a death benefit or LTC annuity value to your beneficiaries. However, if you need long term care, the hybrid will pay a sum of money that’s often higher (even several times over) the death benefit value. Hybrid insurance policies offer tremendous leverage of premium dollars, which explains their increasing popularity over the last few years.
California Long Term Care Partnership
The California Partnership for long term care is an innovative alliance between the State’s Medi-Cal Program, select private long term care insurers, and Californians who are interested in planning for their potential long-term care needs. This program works with only a few insurance companies that meet stringent standards to create policies that protect citizens from the devastating costs associated with long term care. Each partnership-certified policy features high-quality benefits to pay for long term care expenses, as well as inflation protection to make sure that your benefits are at par with rising care cost. These policies will also include an asset protection function that is guaranteed by the state and that protects policyholders from impoverishment due to rising cost of care, even if you exhausted your policy benefits.
NOTE: Only partnership-approved long term care policies come with automatic inflation and Medi-Cal asset protection. This means you will not have to exhaust all your assets on long term care.
Types of policies available under the California partnership for long term care
There are two types of policies available under the state partnership program:
- Residential care and nursing facility policies– these are policies that cover skilled, intermediate or custodial care either in a nursing home or a similar facility. This type of partnership-approved policies will also cover for care received in a residential care facility.
- Comprehensive LTC policies – these are long term care plans that will cover care received at a nursing facility, residential care facility, home as well as community-based facility. Such policies include multiple benefits, some of which include nursing facility benefits, RCF benefit, adult daycare, home health care, personal care, homemaker services, respite care, and hospice services.
Additional Consumer Protection Features in State Partnership Policies
All partnership-approved long term care policies in California are endorsed by the state and come with additional protection features:
- Built-in inflation protection – because California long term care costs tend to rise, inflation protection helps make sure that the benefits you receive are at par with future costs.
- Minimum levels of benefits – this ensures that your long term care insurance will foot a significant proportion of care costs and thus minimize your out-of-pocket expenses.
- Monthly home and community-based care benefits – this provision means that policyholders may receive benefits that exceed the amount available under fixed daily or weekly disbursements.
- Special agent training – California partnership-approved plans are only marketed by insurance professionals who are licensed and trained by the state.
- Waiver of premiums – this provision means that policyholders need not pay premiums while they’re receiving benefits at a residential care facility or nursing home.
- Elimination period – to maintain reasonable out-of-pocket expenses, state partnership-approved policies prohibit against requiring policyholders to meet multiple elimination periods in a lifetime.
- Prior reviews – another important feature of State partnership policies is a prior review of each policy’s premiums to make sure that they are reasonable, as well as special rules reducing the likelihood and/or amount of premium increases.
- Medi-Cal Asset protection – this protects assets equal to what the policy paid out in benefits if you ever need to use Medi-Cal to continue receiving long term care.
NOTE: insurance companies may sell many different types of LTC policies. But only policies bearing either the Partnership logos or the statement below BOLDLY displayed on the first-page qualify for Medi-Cal asset protection
“THE BENEFITS PAYABLE BY THIS POLICY/CERTIFICATE QUALIFY FOR MEDI-CAL ASSET PROTECTION UNDER THE CALIFORNIA PARTNERSHIP FOR LONG-TERM CARE.”
California partnership for long term care review
The California state long term care partnership combines LTC insurance with Medi-Cal asset disregard. This program – fronted by the state’s Department of Health Care services, allows policyholders to keep all or part of their assets if the need for long term care outlives their policy benefits value. While California partnership policies are desirable in many ways, some features such as the age-related inflation protection can limit flexibility and increase policy cost. For this reason, it still may count to compare partnership-certified plans with regular LTC policies. You’ll be able to expand your wealth of choice so as to better meet your needs this way.
California Long Term Care Costs
The cost of nursing home care in California averaged at $260/day in 2015. Although facilities in rural areas tend to be cheaper than those in suburban and urban regions, it’s easy to spend over $7,800 for a short 30-day stay. Given that nearly 50 percent of individuals who go into a nursing home stay for almost a year, this would drive costs up to around $94,900. A significant 12 percent of people who go into a nursing home will stay for over 5 years, spending around $474,500.
Keep in mind that care in your own home may be even more costly than it is at a residential care facility or nursing center. For the average Californian family, this devastating cost would likely deplete your nest egg or threaten to undermine your asset base. The fact that costs are expected to increase by 5 percent annually in the future does not seem to make anything better, which all underscores the need to plan ahead for long term care expenses.
Based on a Genworth Financial study, here’s a projection of California long term care costs in 2018:
|Long Term Care Cost California – 2018 (Monthly)
||PRIVATE NURSING HOME ROOM
||SEMI-PRIVATE NURSING HOME ROOM
||ADULT DAY HEALTH CARE
||ASSISTED LIVING FACILITY (PRIVATE ROOM)
||HOME HEALTH AIDE (at 44 Hours Weekly)
|San Luis Obispo
California Long Term Care Premium Costs
The cost of long term care insurance in California will vary depending on your age and health history at the time you procure the insurance. It happens that the younger and healthier you are, the lower the cost of LTC insurance premiums. Your LTC insurance premiums will also be influenced by the benefits you select when purchasing the policy:
- Benefit period – this is the duration of time through which you will receive benefits for qualifying long-term care costs. When selecting your benefit period, it’s important to consider your particular needs as well as your existing resources so you can estimate how much coverage you may need.
- Daily benefit – this is the amount that your LTC policy will reimburse for qualifying long term care expenses each day. It’s important to select a daily benefit that is close to covering the estimated care cost in your California locality.
- Elimination period – this refers to the period between when the need for long term care arises, and when you actually start receiving benefit payouts from your policy. Longer elimination durations can mean slightly cheaper premiums.
- Inflation protection – when selected, inflation protection adjusts for inflation to make sure that the amount of benefits you receive is at par with the cost of care at that time. Selecting this policy feature can slightly increase the cost of premiums.
Sample Premium Calculations for California Citizens
→ 50 years old man
Let’s take a 50-year-old male from the Los Angeles area. Based on the 2018 Genworth survey, the average cost of care at a private nursing room in this region is $305. Assuming that the policyholder elects to receive daily benefits of $300 over a benefit period of 2 years, and assuming a 90-day elimination period, then they’ll need to contribute annual premiums of $3,145.
For a woman of the same age, under the same policy parameters, the applicable annual premium for long term care would be $3,985. Evidently, long term care insurance premiums tend to be more expensive for women.
→ 55 year old woman
A 55 year old woman looking to receive daily benefits of $200 over a 4 year benefits period would need to contribute about $3,812 in annual premiums. A man of the same age receiving the same daily benefit over the same benefit duration would need to purchase annual premiums at about $2,954.
→ Couple (60 year old husband and 60 year old wife)
Let’s take the example of a couple both of whom are 60 years old and looking to receive a daily benefit amount of $200 (each) over a 4-year duration. Each spouse would need to contribute $2,761 in annual premiums to their policy. If the husband purchased their plan separately, he would pay $3,238 in annual premiums while the wife would pay $4,958. This essential means that by purchasing long term care insurance jointly as a couple, they are able to save ($3,238 + $4,958) – ($2,761 + $2,761) = $2,674 in annual premium costs.
→ 65-year-old man
A 65 year-old Californian senior citizen looking at daily benefits of $200 over a 4-year benefits duration would need to contribute $4,314 in annual premium costs. The premium cost for a woman of the same age under the same policy parameters would be $6,733.
From the sample premium calculations above, it’s clear that women pay more for long term care coverage. It’s also evident that premium costs increase with age, and that a couple can secure a huge discount by purchasing their policy jointly (as a spouse). Our insurance specialists have the knowledge, skills, and experience to help you compare Long term care insurance California quotes and make sound policy choices to suit your circumstances.