Florida LTC Fundamentals

Long Term Care Fundamentals is a basic long term care course that examines the subject in four chapters. Chapter 1 considers the nature of long term care. It begins with a discussion of the typical conditions requiring long term care and looks at the differences between skilled and custodial care. The chapter’s focus then changes to the settings in which long term care is delivered and considers nursing homes, alternative care facilities, community-based services, and informal care. The chapter concludes with a discussion of the risk of requiring long term care and the social and demographic factors that have affected its delivery.

Chapter 2 addresses the issues of long term care costs and payers. The national average costs for skilled and custodial care received in a nursing home are considered and compared with similar costs in assisted living facilities, adult day care facilities and in the care recipient’s home. Population trends are discussed, and the effects on long term care of the demographic bubble caused by the baby boom generation are considered. Chapter 2 ends with an examination of the various long term care cost payers, including Medicare, Medicare supplement policies, and Medicaid.

Chapter 3 discusses long term care insurance and various alternatives to stand-alone policies for payment of long term care benefits. The chapter considers the various approaches used by insurers to deliver benefits, including the pool of money concept, reimbursement and indemnity. Benefit triggers are looked at, including the inability to perform ADLs and cognitive impairment. Basic and optional long term care insurance provisions are then examined and explained. The tax treatment of long term care insurance premiums and benefits is discussed. The chapter ends with a consideration of the various alternatives for long term financing, including accelerated death benefits, viatical settlements, integrated annuity and life insurance benefits, and long term care insurance riders.

Chapter 4 addresses the suitability and ethical issues that impact the long term care insurance sale. In this chapter, the course examines the NAIC long term care insurance suitability tests and discusses the agent’s need to know his or her customer, coverage and insurer in order to make an appropriate suitability determination. The course concludes with an examination of the ethical issues with respect to a long term care insurance sale. The topics addressed include the need to provide full disclosure to enable the customer to make an informed decision, and the requirements for making an appropriate long term care insurance policy replacement.