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Top Adding - Long Term Care Insurance (LTCi): Riders or Not
The last thing you need from an insurance company is a packet of confusing brochures and tables. The best companies know that sending you more “stuff” will just add to your trash can without helping you figure out the intricacies of LTCi. It isn't as difficult as it seems, but understanding a company's language and procedures is crucial to getting the policy that fits your ne
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
eds. To help simplify this language I have compiled–in plain english–many of the basic definitions of the features and optional riders of a LTCi policy.
LTCi basics
Long term care insurance, an insurance program that pays the bill when you need extended care in your home, assisted living facility or nursing home, consists of basic coverage and features plus riders. The
LTCi basics
Long term care insurance, an insurance program that pays the bill when you need extended care in your home, assisted living facility or nursing home, consists of basic coverage and features plus riders. The
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
basic coverage is the maximum dollar amount per day times the number of days of coverage for which your company will pay for care. It includes an elimination period–which is simply the number of days that you will have to pay for care. Basic coverage should include nursing home and assisted living along with an option of receiving care in your own home.
LTCi features
F
LTCi features
F
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
atures are benefits that are included with your basic coverage. A feature–with the exception of home care–neither adds to your cost nor takes anything out of your "pot of money." The following benefits should be included in your policy as features, not riders. You might pay a few dollars more, but it will be worth the cost when you need care.
Home health care at 50% or 100%.
Home health care at 50% or 100%.
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
HHC is the only feature that should add cost to your policy.
Help with activities of daily living, various therapies, skilled nursing, assistance from home health aid or medical social worker
Domestic services
Waiver of premium/spouse discount
Restoration of benefits
Adult day care
Prescription drugs of type given in nursing home or hospit
Help with activities of daily living, various therapies, skilled nursing, assistance from home health aid or medical social worker
Domestic services
Waiver of premium/spouse discount
Restoration of benefits
Adult day care
Prescription drugs of type given in nursing home or hospit
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
l
Rental of hospital equipment
Care giver training
Respite
Hospice/ambulance
Patient Care Coordinator
Home modifications
Bed reservation
LTCi Riders
A rider is an extra benefit that will increase the premium on your policy, often substantially. A certified agent can be indispensable as he/she will help assess your situation
Rental of hospital equipment
Care giver training
Respite
Hospice/ambulance
Patient Care Coordinator
Home modifications
Bed reservation
LTCi Riders
A rider is an extra benefit that will increase the premium on your policy, often substantially. A certified agent can be indispensable as he/she will help assess your situation
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
to determine which, if any, riders you need.
Don't refuse LTCi insurance just because you can't afford the riders. If the initial price seems too high, ask the agent what riders he has included, as agents often include inflation riders without asking. Also, be aware that companies that appear to have lower premiums may simply be listing several of the features as riders. If
Don't refuse LTCi insurance just because you can't afford the riders. If the initial price seems too high, ask the agent what riders he has included, as agents often include inflation riders without asking. Also, be aware that companies that appear to have lower premiums may simply be listing several of the features as riders. If
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
so, by the time you include those benefits, you will be paying as much as you would to a company that simply includes them as features.
Waiver of premium for spouse
Nearly all legitimate companies waive the premium for the person who goes on claim. However, only the best waive the premium for both when one person needs care. Others add the second waiver as a rider.
Inf
Waiver of premium for spouse
Nearly all legitimate companies waive the premium for the person who goes on claim. However, only the best waive the premium for both when one person needs care. Others add the second waiver as a rider.
Inf
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
lation rider
All companies will urge you to include an inflation rider with your policy. This rider will increase your daily maximum as well as your total pot of money by 3%, 4%, 5% compounded, or by 5 percent simple each year. On a 5% compounded, if you start with a $100 per day benefit, you will have $200 per day in 15 years without increasing your premium each year.
All companies will urge you to include an inflation rider with your policy. This rider will increase your daily maximum as well as your total pot of money by 3%, 4%, 5% compounded, or by 5 percent simple each year. On a 5% compounded, if you start with a $100 per day benefit, you will have $200 per day in 15 years without increasing your premium each year.
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
ince nursing home costs increase faster than inflation, it's a good idea to take some sort of inflation rider if you can afford it. It does nearly double the cost of the policy. An alternative is to start with a higher daily benefit in the first place; for example, starting with $200 a day will be much less than $100 a day with an inflation rider. The draw back is that your c
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
eiling is then $200 a day.
If your health is still good, you will have the option of adding the inflation rider at a later date. Keep in mind, however, that the price of it will be based on your attained age. Your agent can do the math to help you determine which approach will save the most money. LTCi without the inflation rider is better than not having LTCi at all.
Optio
If your health is still good, you will have the option of adding the inflation rider at a later date. Keep in mind, however, that the price of it will be based on your attained age. Your agent can do the math to help you determine which approach will save the most money. LTCi without the inflation rider is better than not having LTCi at all.
Optio
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
nal Increase
Even if you cannot afford an inflation rider, some companies will offer as much as a 15% increase in your benefit every three years. This will increase your premium at the time you add the increase, and you will not receive the offer again once you have turned it down. The increase will be based on your attained age but will not require medical underwriting.
Even if you cannot afford an inflation rider, some companies will offer as much as a 15% increase in your benefit every three years. This will increase your premium at the time you add the increase, and you will not receive the offer again once you have turned it down. The increase will be based on your attained age but will not require medical underwriting.
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
Return of Premium
Return of premium gives your money back after a certain number of years if you have never needed care. If you do not claim it yourself, the premium goes to your beneficiary. However, this rider increases your premium substantially–as much as double or triple the basic premium. Furthermore, neither you nor your beneficiary will receive the entire premiu
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
m in one lump sum. It is given back over time at approximately the same rate at which you paid it. Most people do not purchase the ROP rider.
Shared benefit
The shared benefit rider is only for a married couple. With some companies, it simply allows a spouse who has spent all the money in his policy to draw out of his wife's policy, providing she is not on care herself.
Shared benefit
The shared benefit rider is only for a married couple. With some companies, it simply allows a spouse who has spent all the money in his policy to draw out of his wife's policy, providing she is not on care herself.
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
With others, the rider purchases a third pot of money, equal to the pot of one spouse, that either spouse can draw from when his or her own pot is exhausted. The spouses must have equal benefits to get this rider, and the extra pot does not receive the "restoration of benefit" if the user goes off claim. An inflation protection option will usually apply to the shared benefit
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
amount, however.
Paid-up Survivor benefit
The survivor benefit is one of the best riders a married couple could choose and is very inexpensive, adding as little as $5 or $10 to the basic premium. If husband and wife are on the same policy, and have owned it for at least 10 years, the remaining spouse will receive a life time waiver of premium–with no reduction in benefi
Paid-up Survivor benefit
The survivor benefit is one of the best riders a married couple could choose and is very inexpensive, adding as little as $5 or $10 to the basic premium. If husband and wife are on the same policy, and have owned it for at least 10 years, the remaining spouse will receive a life time waiver of premium–with no reduction in benefi
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
s–when the first spouse dies. This waiver is priceless to the living spouse, but not all companies offer it.
Non-forfeiture rider
The non-forfeiture rider provides you with a reduced benefit if you should ever become unable to pay your premium and be forced to drop your coverage. Generally, if you have owned your policy for a certain number of years–depending on the com
Non-forfeiture rider
The non-forfeiture rider provides you with a reduced benefit if you should ever become unable to pay your premium and be forced to drop your coverage. Generally, if you have owned your policy for a certain number of years–depending on the com
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
pany–what you have already paid will be applied toward a paid up policy of up to three years. This prevents you from losing several years of premium and is a relatively inexpensive rider.
Survivor maximum benefit increase
Upon one spouse's death, a company will increase the surviving spouse's maximum benefit by one half the deceased's maximum benefit at the time of his
Survivor maximum benefit increase
Upon one spouse's death, a company will increase the surviving spouse's maximum benefit by one half the deceased's maximum benefit at the time of his
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
r her death. This one is usually less expensive than an inflation rider or a shared benefit rider, but more than a paid-up survivor benefit.
Don't assume that any rider can be added to your policy later. Any company will require proof of insurability unless you have a clause that says otherwise; for example, the guaranteed purchase option does not require medical underwritin
Don't assume that any rider can be added to your policy later. Any company will require proof of insurability unless you have a clause that says otherwise; for example, the guaranteed purchase option does not require medical underwritin
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
g. The inflation rider can be added later, with proof of insurability, with some companies. If you choose to try to sort out various company brochures on your own prior to sitting down with an agent, be sure to write down a list of questions. There is a lot to know about LTCi; understanding what you are getting in the beginning will save you both dollars and frustration later
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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