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  • Top Articles - Long Term Care Insurance (LTCi): Features of a Good Policy

    Don't let your LTCi be a disappointment "I have $100 a day for life," Gloria, one of my clients, complained. "Why do they only give Carolyn $25.00 a day?"

    Gloria owns several policies with my company. However, her LTCi, which she is currently using, is with a different company. Carolyn, her home health aid, receives limited pay because Gloria's policy i
    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
    ncludes only 50% home care. While Gloria would receive $100 a day indefinitely in a nursing home, she can only get $50.00 a day for home-care. Furthermore, since Carolyn does not work through an agency, she is considered "non-professional" and will be paid no more than $5.00 an hour. To make matters worse, Gloria is still paying her full monthly premium b
    ; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

    Examples of combination products may in
    ecause her policy does not include a waiver of premium unless she is in a nursing home! This situation could have been avoided.

    Take action to protect your interests
    Long Term Care insurance, a type of protection that pays the bills when a person needs extended care either at home or in a nursing home, should be part of senior planning for every adu
    lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

    lt who owns property, investments or savings–or who simply wants to protect freedom of choice, independence, and family harmony. Nevertheless, 65% of adults over 40 admit to having made no plans for long term care for either themselves or a spouse, according to Genworth Financial.

    Put the excuses on the table
    The first excuse for putting off the pur
    here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
    hase of LTCi is money, but the real reasons are usually a matter of denial–you don’t really believe you will ever need it–and confusion over the mountain of information. Numerous companies offer LTCi insurance, and while the policies are similar, the language can vary significantly from one company to another. Make one inquiry, and multiple packets cramme
    d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

    Combination pro
    d with information will soon fill your mail box. You don't know what to do, so you do nothing.

    LTCi: Basic coverage and features
    Fortunately, understanding LTCi is not as difficult as it seems. However, it is not a one-size-fits-all program, so doing it on your own or over the phone is not a good idea.

    Basic coverage
    All LTCi begins with the b
    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
    asic coverage–a maximum dollar amount per day multiplied by the number of days of coverage. The actual premium is then based on your age. For example, a three year, $100 per day benefit would give you 1095 days times $100, or a "pot of money" of $109,500 to spend. Even though most nursing homes charge more than $100 a day, your pot will last at least thre
    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
    e years because you can't spend more than $100 per day. Once the company has paid $109,500, your policy is exhausted, and you will have to pay for additional care yourself.

    The other part of your basic coverage is the elimination period, a deductible consisting of a set number of days that you must pay for care before your policy will start paying. Some
    nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
    ompanies go strictly by the calendar, others go by the actual days you received care. A longer elimination period reduces your premium.

    Feature 1: Home care
    Features are benefits included with no extra cost. For example, most companies can offer a choice of whether you want to include care in your home. It may be included at a slightly higher premi
    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
    um, or it could be a rider, depending on the company. You can also choose 50% or 100% home care. If you choose 100%, you can spend your maximum of $100 per day for care in your home. Furthermore, while nursing home care has to be calculated on a daily basis, most companies calculate home care by the month. You could thus spend $50 one day and $200 another
    ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
    day, so long as you do not go over $3100 per month (in our $100 per day example).

    Feature 2: Waiver of premium and discounts
    Most companies will waive your premium when you have to start using your coverage. Some waive the premium from day one while others require you to be on claim for at least 90 days first. If you should get well and go off of c
    ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

    Following aspects would a
    laim, your premium would resume. Some companies waive the premium for both spouses if just one goes on claim. However, nearly all companies give a discount if husband and wife are on the same policy.

    Feature 3: Restoration of Benefits
    The best companies include a restoration of benefits feature, meaning that if you only need care for a few months an
    dd to the challenges in developing combination products:

    Which markets to tap where the combination products can do fairly well?
    Which combination prod
    are able to go off of claim, your entire pot of money is "restored," giving you the full policy to use again when you need it. However, the pot can only be refilled if it has something left in it–even as little as $50.00.

    Feature 4: Home modification
    Many companies will pay several times your monthly benefit to modify your home with things like whe
    cts are meaningful and rational?
    Which therapeutic categories to select?
    Which Combinations can address unmet needs of the patients?
    Do combin
    el chair ramps, widening of bathroom doors, or rails in the bathtub or around the commode.

    Feature 5: Caregiver training
    Do you have a family member who is able and willing to participate in your care? Some companies will pay several times your daily benefit to train that person who will then take care of you at their own expense, making your policy
    tions increase the patient compliance?
    What would be the developing cost?
    How to tackle the risks encountered during combination product developmen
    benefit last much longer.

    Feature 6: Respite care
    Respite care is simply a vacation for a family member who has agreed to help take care of you. For a certain number of days each year, a company will put you in a nursing home or find someone else to take care of you, and the company will foot the bill up to your maximum daily benefit.

    Feature 7: E
    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
    quipment rental
    Equipment rental is simply the rental of hospital equipment–such as a hospital bed–usually up to the purchase price of the equipment.

    Feature 8: Adult day care
    The better companies include adult day care where you can get therapy and interact with other seniors. Usually transportation, meals, therapy, and help with activities
    ping new procedures for reviewing their safety, efficacy and quality.

    Professional from academic institutions, pharmaceutical industries, health care indust
    f daily living are included.

    Feature 9: Prescription drugs
    The inclusion of prescription drugs–of the type given in a nursing home or hospital–is a very important feature, but many companies only include drugs with a rider. Ask about it.

    Feature 10: Room reservation
    What if you get sick while you are in the nursing home and have to go to the h
    y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
    ospital? The room reservation feature reserves your bed for a certain number of days each year.

    Feature 11: Hospice and ambulance
    Medicare pays for the nursing needed during hospice as well as for a certain number of ambulance trips per year. However, most LTCi policies offer some additional ambulance dollars as well as the home health aid and domes
    .

    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
    tic services if you are on hospice.

    Feature 12: Patient Care Coordinator
    Companies have different names for this, and many don't offer it at all. A patient care coordinator is a person who will work with you to find the agencies in your area. The person will find out what the agencies charge, and will help you choose the appropriate agencies to meet
    elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

    Companies that provide selfless information through particip
    your need. The coordinator can also help you file claims by explaining how to correctly complete the paper work.

    Remember, features of a policy are included without extra charge. It's worth paying a bit more for a policy that includes a lot of features rather than buying something cheap only to find out that benefits you would have liked aren't included


    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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