Your Best Life, Long-Term Care, Health Insurance


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Rebecca Bloomfield, partner at Jerry S. Pearlstein Insurance Ltd., holds a national Certification in Long-Term Care (CLTC). Her mother, who requires 24/7 care lives with her. Professionally and personally, Rebecca, understands how to get the best Long-term Care insurance to fit your needs.

“Whether you are caring for a loved one or are concerned that you will need care for yourself, the emotional and financial costs can be life-altering. It’s critical to be prepared.”

What Qualifies as Long-Term Care?

Long-term = beyond 100 days

Care= help because health or mental impairment cause an inability to do at least two of the Activities of Daily Living.

  1. Ability to get up out of a bed or chair
  2. Ability to transfer (walk) from one place to another
  3. Ability to use the toilet or deal with continence
  4. Ability to bathe yourself
  5. Ability to dress yourself
  6. Ability to feed yourself

Underlying medical issues may be addressed in a hospital. The above issues of daily living are addressed through a Skilled Nursing Facility, Assisted Living Facility, Home Care, Adult Day Care Center.

The cost to provide non-medical care in-home is $60,000 to $80,000 annually. Non-medical care in a facility can be well over $100,000.

Where will the money come to pay for long-term care?

Medicare Does Not Pay for Care Over 100 Days

Medicare is health insurance for most US citizens over the age of 65. Medicare does not pay for Assisted Living, Adult Day Care Centers, In-home care, or transportation services.

Medicare will pay for hospice care in the case of a terminal diagnosis to the end of life.
The care is “palliative”, it is not meant to treat the condition, it is meant to keep the patient comfortable through the passing. Care may be in a facility or in home.

Medicaid is Available Based on Strict Financial Need Standards and Care Availability.

Granting of benefits from this state/federal program is based on medical criteria certified by a doctor and meeting strict financial requirements based on the income and asset holdings of everyone living in the household. There is a 5-year look-back from the time of application confirming eligibility and transfer of assets.
Since Medicaid payment is about 72% of market, not all long-term care providers will take Medicaid recipients.

Veteran’s Benefits

The VA offers health care to persons with military service related injuries within Priority Levels based on the percentage of disability the injury causes.VA Nursing Home is available for person’s whose service related injury causes 70% disability or more. Aid and Assistance Pensions are available to those who have served and their spouses based on economic need and regardless of service related injury. The VA suggests contacting the Social Work Department at the nearest VA facility for information.

Long-Term Care Insurance: Lifesaver for You and Your Loved Ones

The need for care longer than 100 days can occur at any time in life due to illness or injury. The cost is enormous financially and emotionally. No person, young or old, wants to have their spouse or child give up their life to nurse them. No one wants to see their spouse’s or children’s money exhausted for their care. Long-term Care: Who Pays for What?

Long-Term Care insurance provides the money you need to be in charge of your care.
An individual pays for the insurance (premiums) based on age, health, family history and the amount of money (dividends), the Long-term Care insurance makes available (benefits).

Long-Term Care insurance policies are not standardized. Some are freestanding. You pay premiums whether you ever use the insurance or not. Some are part of a Whole Life insurance policy. If you don’t use the Long-term Care benefit, the Life Insurance benefits still exist.

Free-standing Long-Term Care Insurance policies use five different methods of payment

  1. Expense Incurred Method of Payment:
    The insurance company must decide if you and your claim are eligible for benefits. They pay the provider’s billing based on the expense and dollar limit of your policy. They may give the money to you or to the provider. Most stand-alone policies today pay benefits this way.
  2. Indemnity Method:
    The insurance company decides if you are eligible for benefits and if the services you are receiving are covered by your policy. They then pay a set amount t for those services (despite what the provider charges) directly to you up to the limit of the policy.
  3. Disability Method:
    You are only required to meet the benefit eligibility criteria. Once you do, you receive a set daily benefit, even if you are not receiving any long-term care services.
  4. Joint Policies:
    These cover more than one person, such as a husband and wife, or two partners, or two or more related adults. If one of the covered individuals collects benefits, that amount is subtracted from the total policy benefit.
  5. Pooled Benefits:
    This policy provides a total dollar amount that pays up to a daily, weekly, or monthly dollar limit for one of more covered services. You can combine benefits in ways that best meet your needs. Like home care plus adult day care.

Long-Term Care insurance that is part of a Whole Life Insurance policy pays up to 90% of your death benefit to you. When you qualify for long-term care, you may use the money for whatever care you determine you need.

It is Never Too Early to Start Long-Term Care Insurance.

Because Long-term Care insurance premiums are based on your age and health, the younger and healthier you are, the more insurance you will get for the premium you pay.

Today’s Whole Life insurance policies make it easy get protection, world-class savings and liquidity during your lifetime while knowing that the funds for long-term care will be there should you need them. Check out 15 for Life .

If you are single, believe you will be the surviving spouse or that your family will be scattered, Long-Term Care Insurance is an essential investment in yourself.

Online quoting for long-term care insurance is rarely accurate. There are many variables involved in getting the best plan for you. We are experts in Long-Term Care planning and insurance. Let us help you design a plan that meets your needs with a conversation that is free and without obligation. Call us to begin: 847.362.8888.


What Clients Say

Jerry S. Pearlstein Insurance, Ltd.
From day one they made me feel as if I was getting service as a family member would, always there, happy to hear from me and always follow up to make sure I was satisfied!
Jerry S. Pearlstein Insurance, Ltd.
900 Skokie Blvd, Ste 105,
Northbrook, IL 60062
O: 847.362.8888 | F: 847.362.9999
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