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Uncle Sam's plan

(An article from Kiplinger Magazine by Mary Beth Franklin, July 2002)

Federal employees can now buy long-term-care insurance

In one fell swoop, the number of Americans who can buy long-term-care insurance through an employer just jumped by 20 million. That's what happens when the Feds add a group policy as a fringe benefit. Federal employees, retirees, postal workers, military and other uniformed services (such as the Public Health Service) and their families are all eligible. The federal plan will no doubt raise public awareness about the need for insurance to pay for nursing-home care, which can cost $50,000 a year or more. But many of those who are eligible - particularly healthy people under 60 and those who are married - can find a better deal in the private market.

Employees can sign up for the coverage, which the government is sponsoring but not subsidizing, from July 1 through December 31. Government workers and their spouses, retirees and their spouses, surviving spouses, adult children 18 and over, and parents, parents-in-law and stepparents of living employees can also apply, too. Divorced spouses of employees are not eligible.

Seven questions. Coverage can begin as early as October 1, but only applicants who do not currently need assistance because of physical or cognitive impairment will qualify. Employees must answer seven questions about their medical history, and their spouses must answer an additional two, to determine whether they currently need help with daily activities, such as meal preparation and taking medication. All other applicants must answer a lengthier questionnaire about specific mental and physical ailments as well as alcohol and tobacco use. Once coverage is approved, annual renewal is guarantee, even if you leave government service, as long as you pay the premium.

Premiums are based on your age when you sign up (the younger you are, the cheaper it is) and the options you select, such as length of coverage, waiting period before coverage begins, daily benefit and inflation protection. For example, a 55-year old, purchasing a federal policy for three years of coverage at $150 a day with a 90-day waiting period and 5% automatic computer inflation protection would pay $1,368 a year. The same policy would cost a 65-year old $2,131 a year, and a 75-year old $4,410 a year. But a 75-year old, who is more likely to use the insurance sooner than someone younger, may not need to buy inflation protection, which would reduce the premium by more than $1,000 a year.

To calculate your own cost, visit the federal long-term-care Web site or call 1-800-582-3337 to speak to a consultant. Before you make a decision, be sure to shop around.

That's what Martin "Buck" Burch, a Department of Agriculture employee from Plattsburg, MO, did. After carefully reviewing the federal plan and comparing private-policy benefits, Burch decided to buy a policy from Unum Life Insurance Company for himself and his wife, Carolyn. The Unum policy offered the flexibility that Burch wanted at a better price, thanks to preferred-health and marital discounts not available in the federal program.

Burch, 57, has learned from experience the value of such policies. "I've spent the past 20 years securing elder care for my aunt and my mother," he says. Although his aunt has died, he 90-year-old mother has lived in a nursing home for more than eight years. "It's just devastating financially for people who don't have coverage. With my family history, buying long-term-care insurance was a no-brainer."

Comparison shopping. The federal long-term-care insurance program allows applicants to choose from three different packages, or select from a list of options to customize a policy. You can choose three-year, five-year or lifetime coverage with benefits starting after a 30-day or 90-day waiting period. You can select a daily benefit ranging from $50 to $300. The federal plan will reimburse the cost of care in a nursing home or assisted-living facility at 100% of the daily benefit. Home care will be reimbursed at 75% and may be provided by an informal caregiver, such as a relative or neighbor. The insurance will pay for long-term care anywhere in the world - a real advantage for military and embassy personnel who retire overseas - at 80% of the daily benefit.

The main reason Burch decided to buy long-term-care insurance was to be able to stay at home as long as possible. So he wanted a policy that would pay 100% of daily benefit for home care rather than the 75% rate under the federal plan. His policy has a 60-day waiting period and will pay benefits for up to six years - two options that are not available with the federal plan.

Because Burch is in good health, Unum's preferred rate for his $100-a-day policy is $814 a year. For Carolyn, 54, who smokes and does not qualify for the best rate, a similar policy will cost $918. The closest comparable federal policy, with five years of coverage and a 90-day waiting period, would cost him $1,209 and her $1,028 a year.