No one should make a decision on whether or not to buy Long-Term Care (LTC) insurance on the basis of this short summary of what is a very complicated field of insurance. The purpose of this article is to make members aware of some of the things they should know about LTC insurance policies. It cannot be emphasized often enough that persons interested in this kind of insurance protection should read the reference material available to them before shopping for any policy and should very carefully read and understand any policy they may subsequently be interested in. Another thing to bear in mind is that there is a good possibility that a government administered program may be passed into law for federal employees and annuitants or for people generally and this may affect the way benefits are "packaged" and offered. As in any insurance purchase,carefully check to see that companies you may deal with are reputable and licensed. The office of the Florida Department of Insurance can advise you about this. ( 1-800-342-2762) Do not let yourself be pressured into a quick decision. Persons who need care 24 hours a day by medical professionals need Skilled Care. This is the category of care customarily provided in a hospital setting following some kind of medical procedure, such as surgery. Those needing professional, supervised care for some period during each day need Intermediate Care. This is the category of care generally needed following release from the hospital and may be provided in your residence or during a short stay in a nursing home. But, those needing personal help in performing 1or 2 of the 6 activities of daily living(ADL's - bathing, eating, dressing, toileting, continence and transferring) or suffering impairment of thought, memory or orienta- tion may need Custodial Care. This is often provided in the nursing home setting and is the big ticket item of LTC. If this category of care can be arranged at home or a place such as an adult care center it may be much more comfortable for the patient and will cost much less. Here are some of the things to consider when looking at policies offering protection against costs of LTC: 1. Do not fail to disclose any existing medical condition if applying for a policy. Failure to do so could later void the policy. 2. Renewability. In Florida, all policies are to be guaranteed renewable. 3. How long will your coverage last? Expect a limit, such as 4 years in a nursing home and 2 years lower level care. Note that this will vary from policy to policy. 4.Daily Benefits. "Ball park" figures for benefits are $100/day for skilled, custodial care and $50/day for care at home. But, look to see what other benefits might be offered. You may not begin to receive benefits immediately. Some policies will have a "waiting period" of up to 180 days during which you will pay expenses. So, note what the Elimination Period is in any policy you are looking at. Medicare may pay for up to the first 90 days depending on the reason you have been admitted to a nursing home. It will also pay for a certain period of care at home under the same conditions. Look carefully at the Premium waiver provisions of an LTC policy. Be aware that you may be required to continue premium payments after you begin receiving services and benefits. How long do you continue paying premiums before they are waived and is there a limit to the waiver period? Companies have to offer Inflation Protection whereby benefit levels would increase by a small percentage each year until a maximum level is reached. Remember, inflation protection is an option. If you want it, make sure it is in the policy but then under- stand that your premium will increase significantly. In putting together the package of benefits and the level of coverage you desire remember, the more comprehensive the policy is the more it is going to cost. Providing inflation protection, for instance, can almost double the premium. Look at these figures for annual premiums for one person from the Florida Department Of Insurance. AGE BASIC POLICY ONLY POLICY WITH INFLATION PROTECTION 65 $1,526 $2,871 75 $3,945 $7,262 85 $7,615 $12,646 If you are looking at a policy with premiums dramatically lower than this example it would be wise to review the conditions of that policy carefully. Thus, if you are looking at LTC insurance, you have to give very careful and informed thought to answer the two big questions: (1) Do I need it? And , (2) Can I afford it? Getting complete and reliable figures about LTC and its cost is limited. Statistics for predicting the probability of your entering a nursing care home vary somewhat depending on the source. But, here are some "bottom line" conclusions from the National Association Of Insurance Commissioners, a body of state insurance regulators with the primary responsibility to protect the interests of consumers. The risk of needing nursing home care is greater for women than for men and the need for such care increases with age. Two out of three people who turned 65 in 1990 will either spend no time in a nursing home or will spend less than 3 months in one. (For details of available statistics see the references listed below and others that can be found in libraries and on the Internet) The national average cost of nursing home care will be in the neighborhood of $38,000/year whereas 6 hours of care a week, in your home would amount to about $8,400. The kind of premiums you can expect to pay has already been mentioned. If, as some experts say, you should not spend more than 5% of your income on LTC insurance then your income should be in the neighborhood of $60,000 in terms of buying average coverage - and this is probably starting at age 65. This means a premium of $250 a month. ( See below - Florida Department Of Insurance) Thus, the purchase of LTC insurance may be most appropriate for people with substantial income or considerable assets they desire to preserve. In conclusion, it should be emphasized that the decision to purchase Long Term Care insurance should be made on the basis of careful study of the subject using the many reference materials available, free of cost, some of which are listed here. The purpose of this article is not to recommend for or against the purchase of LTC insurance but to help you begin to become acquainted with a very complicated subject in view of the several pending pieces of legislation pertaining to it.