L O N G T E R M C A R E. Safe. Sound. Secure.

Transcription

1 L O N G T E R M Safe. C A R E I N S U R A N C E Sound. Secure.

2 LONG TERM CARE Long term care is the care you receive when you cannot take care of yourself for an extended period of time. This care can come from a number of sources such as an adult day care center, assisted living facility, community care, home care, hospice care facility, hospital long term care unit, or nursing home. Long term care insurance enables you to transfer some of the financial risk of long term care costs to an insurance company so that you may protect your accumulated wealth from this potentially devastating expense. WHAT ARE THE CHANCES OF NEEDING LONG TERM CARE? More than 50% of the U.S. population will need some form of long term care during their lives. (Americans for Long Term Care Security, 2002) 60% of all Americans age 65 and over will require care in a convalescent/nursing facility sometime during their lifetime. (Congressional Report, 6-01) 43% of all long term care claims are for individuals under age 65. (National Underwriter, January, 2001) HOW MUCH DOES LONG TERM CARE COST? According to a study conducted in 2000 by the American Council of Life Insurance, the cost of Long Term care services will more than quadruple by Costs shown below are averages and may vary widely across the country. LONG TERM TODAY S ESTIMATED CARE SERVICES AVERAGE COST** COSTS BY 2030 Home Health Aide $18.00 per hour $72.00 per hour Assisted Living Facility $28,548 per year $114,192 per year Nursing Home Care $66,153 per year $264,612 per year ** MetLife Mature Market Institute,

3 WILL MEDICARE PAY FOR LONG TERM CARE? Medicare primarily focuses on hospital stays and physician visits. Medicare is not designed nor intended to cover long term care. It will not cover more than a few days of skilled nursing home care. WILL MEDICAID PAY FOR LONG TERM CARE? Medicaid is a government welfare health care program for indigent persons, established by the federal government, but administered by the states and funded by both federal and state governments. Benefit levels and eligibility requirements vary with the states. When a person requires long term care and does not have private insurance, funding for the care must first come from the individual s own income, savings and assets. Only when the person has spent down or exhausted his her income, savings and most assets to a minimal amount, will Medicaid funding become available. In addition, Medicaid limits your choice of facilities and often pays too little to cover the cost of high-quality care. WHAT IS A SOLUTION? Long term care insurance enables you to transfer some of the financial risk of long term care costs to an insurance company. In exchange for premium payments, long term care insurance enables you to preserve your accumulated wealth from this potentially devastating expense. WHO SHOULD CONSIDER BUYING LONG TERM CARE INSURANCE? People who: don t want to burden their children or family; want to protect their assets; want to avoid going on Medicaid; want to have peace of mind; want to have control of their care; or want to maintain their independence. HOW DO YOU BECOME ELIGIBLE FOR BENEFITS? You must be certified as a chronically ill individual by a licensed health care practitioner. Chronically ill means you are unable to perform two or more of the six activities of daily living for an expected period of at least 90 days or you require substantial supervision to protect yourself from threats to your health and safety due to severe cognitive impairment. The six activities of daily living include: bathing; dressing; toileting; the ability to move in and out of bed, chair or wheelchair; eating; and continence. Written certifications must be renewed or updated at least every 12 months. 2

4 LONG TERM CARE INSURANCE Auto-Owners offers three simple, easy-to-understand programs. BASIC This long term care coverage will provide 100% of your selected facility daily benefit amount while a resident in a state approved facility. Also included is seven-day bed-reservation coverage which pays to reserve your bed in the facility for seven days if you must temporarily leave for hospital confinement. ADVANCED This long term care coverage will provide 100% of your selected facility daily benefit amount while a resident in a state approved facility or 100% of your selected facility daily benefit amount while residing at home and/or receiving community care. Also included is 21-day bed-reservation coverage. INTERMEDIATE This long term care coverage will provide 100% of your selected facility daily benefit amount while a resident in a state approved facility or 50% of your selected facility daily benefit amount while residing at home and/or receiving community care. Also included is 14-day bed-reservation coverage. OPTIONAL COVERAGES (available on all three programs) Compound Benefit Increase Rider For an additional premium, this rider provides that on each policy anniversary, we will increase your selected facility daily benefit amount. This rider may help you keep pace with the rising cost of long term care. An example of how a $60 facility daily benefit amount would increase for a duration of 20 years is illustrated in the chart below. Facility Daily Benefit Amount Without Compound Benefit Increase Rider With 5% Compound Benefit Increase Rider With 3% Compound Benefit Increase Rider $ Policy Duration In Years 3

5 Non-Forfeiture Benefit Rider For an additional premium, this rider will provide benefits equal to the greater of the sum of all premiums paid for the policy while this rider is in force; or 30 times the facility daily benefit amount in effect when premiums cease. This benefit will not include any premiums waived under the waiver-of-premium provision of the policy or any unearned premium returned to you. No further benefit increases will occur under a compound benefit increase rider, if attached to the policy. Payment of this benefit will be subject to this rider being in force for three years or more, and premium payments are discontinued for any reason other than being waived under the waiver-of-premium provision of the policy. SPECIAL FEATURES FINANCIAL STRENGTH Auto-Owners Life Insurance Company has been awarded an A.M. Best rating of A+ (Superior). This rating refers only to the overall financial status of Auto-Owners Life Insurance Company and is not a recommendation of the specific policy provisions, rates or practices of Auto-Owners. A.M. Best Company is a leading independent organization for rating financial strength of insurance companies. INDEMNITY POLICY ADVANTAGES At the time of application you may choose a facility daily benefit amount of $50 minimum up to $250 maximum, subject to your state minimum requirement. Once you have been determined to be eligible for benefits, are receiving qualified long term care, and have satisfied your waiting period, we will pay your selected facility daily benefit amount or home and/or community care benefit amount directly to you, regardless of the cost of your care. You decide how to use the money to meet the needs you believe most important. TAX QUALIFIED This policy is intended to meet the requirements of a Tax-Qualified Long Term Care policy under current federal tax laws. 4

6 ELIGIBILITY Coverage is available for individuals age BENEFIT PERIOD You may select a benefit period of two, four, six, or ten years. The benefit period and the facility daily benefit amount you select will determine the maximum lifetime benefit shown in the policy. WAITING PERIOD You may choose a waiting period of 30, 60, or 90 days. This means the number of days at the beginning of a continuous period for which you have been certified as a chronically ill individual and for which benefits are not payable. The waiting period needs to be satisfied only once during the lifetime of your policy. WAIVER OF PREMIUM We will waive your premium payments while you are receiving qualified long term care benefits from Auto-Owners. GUARANTEED RENEWABLE Premiums are level and are based on your age at the time you purchase the policy. The younger you are, the lower the premium. The premiums may change, but only if we change the premium rates for all persons in the same rate class. As long as you pay your premiums on time the policy cannot be cancelled. Coverages ceases when your maximum lifetime benefits have been paid. 30 DAY FREE LOOK You have up to 30 days to review your coverage after the policy has been issued. If the policy is not satisfactory for any reason, simply return the policy and we will refund the premium you paid. PREMIUM PAYMENT OPTIONS You can choose to pay your premium annually, semiannually, quarterly, or monthly via Electronic Funds Transfer (EFT). 20% PREFERRED DISCOUNT * This discount will be applied if your health meets our underwriting criteria. 20% SPOUSAL DISCOUNT * This discount will be applied when a husband and wife, residing in the same household, obtain coverage at the same time. If either dies, the beneficiary will receive any unearned premium from the deceased s policy. * Maximum policy discount is 25%. NO EXCLUSIONS DUE TO PRE-EXISTING CONDITIONS Once you have been accepted, and your policy has been issued, there are no restrictions or exclusions or coverage due to pre-existing conditions. 5

7 EXCLUSIONS AND LIMITATIONS This policy will not pay a benefit when: care is provided by immediate family members, or for care the insured is not obligated to pay; care is provided outside the United States of America or its possessions; care is given for which no charge is normally made in the absence of insurance; care results directly or indirectly from an intentionally self-inflicted injury; care is provided free of charge by or in a Veteran s Administration or federal government facility; care results from mental illness or nervous disorders without demonstrable organic disease. (This policy will cover disorders with demonstrable organic causes such as Alzheimer s disease or similar forms of senility or irreversible dementia that results in Severe Cognitive Impairment.); care results from alcoholism or drug addiction, (but we will cover addiction to drugs administered in accordance with the advice and written instructions of a physician); illness, treatment or medical condition is caused by the commission of a crime; illness, treatment, or medical condition results from war or an act of war, declared or undeclared; illness, treatment, or medical condition arising out of participation in a felony, riot, or insurrection; care is provided during the waiting period; care is not included in your plan of care set forth by a health care professional; or care is not qualified long term care. P lease allow your agent to run a Long Term Care proposal for you. Your proposal can be customized to your specific needs and affordability. Auto-Owners Long Term Care proposal can be created to include different pricing options such as: 3% Compound Benefit Increase Rider 5% Compound Benefit Increase Rider Non-Forfeiture Benefit Rider Preferred Rate Discount Spousal Discount This is not an insurance contract, but only a summary of coverage. Only the individual policy contains governing contractual provisions. 6

8 ABOUT THE COMPANY Auto-Owners Life Insurance Company has been awarded an A.M. Best rating of A+ (Superior). This rating refers only to the overall financial status of Auto-Owners Life Insurance Company and is not a recommendation of the specific policy provisions, rates or practices of Auto-Owners. A.M. Best Company is a leading independent organization for rating financial strength of insurance companies. Auto-Owners Life Insurance Company is one of six companies that comprise the Auto-Owners Insurance Group. All companies operate under the same management team and philosophy. Our products may be purchased through the same independent insurance agencies that sell our property and casualty products. Auto-Owners Insurance Group of companies is recognized for exceptional financial strength and stability among the nation s largest insurers. Our investment philosophy is a vital part of our success and can be summed up in three words... Auto-Owners Life Insurance Company also offers... Perma Term 2 and Perma Term 3 Universal Life Insurance Whole Life Insurance Simplified Issue Whole Life Insurance Simplified Issue Children s Advantage Plan Plus Simplified Issue Five Year Level Term Insurance Level Term Insurance Continuous Term 2 Life Insurance (YRT) Decreasing Term Life Insurance Disability Income Coverage Deferred Annuities Immediate Annuities Individual Retirement Annuities (IRA) Roth Individual Retirement Annuities (Roth IRA) Simplified Employee Pensions (SEP) Savings Incentive Match Plan for Employees (SIMPLE) Money Purchase/Profit Sharing Plans See your independent Auto-Owners agent today for more information on these products. Safe. Sound. Secure (10-05)