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Long Term Care Rider vs Chronic Illness Rider [Which is Best for Me?]

Long Term Care Insurance

In the following article we will break down the differences between a Long Term Care Rider vs Chronic Illness Rider. The differences are subtle, yet important to understand so you can formulate the right plan for you from among the best long-term care insurance companies. We will also address the common objections we get regarding both riders, and towards long term care insurance in general. If you have not taken the steps to protect your wealth from the potential threat of long term care costs, this article is for you.

Life Insurance with Long Term Care Rider or Chronic Illness Rider

Fidelity Investments reports that the average couple that retires at age 65 can expect to pay approximately $240,000 in medical expenses during retirement. Keep that number in mind, because Fidelity also reported that only 20% of workers over the age of fifty-five have managed to set aside $250,000 or more for retirement. Do you see the problem? Let me spell it out.

80% of the population over 55 has less money saved for retirement than they will likely need to cover their medical expenses alone.

That’s bad. But it gets worse. That number ($240,000) doesn’t include Long Term Care costs. And of course it doesn’t include rent, food, gas, utility costs, or that sweet vacation to visit the children and grandchildren.

Below we discuss two solutions to the problem that are available to almost everyone. A Long Term Care Rider and a Chronic Illness Rider can be be added to a cash value life insurance policy and provide financing options for the medical costs that will come during retirement.

How Does a Long Term Care Rider or Chronic Illness Rider Work?

Years ago the life insurance companies started adding terminal illness riders to their policies at no extra charge. These accelerated benefit riders would give a portion of the death benefit to the policy owner prior to the death of the insured, based on the requirement that the insured was terminally ill with less than 12 months to live. In other words, the insured was likely to die soon, and so a portion of the death benefit was given in advance to make the final months more tolerable.

This living benefits rider is called an “accelerated death benefit” rider, because it allows the death benefit to be — that’s right — accelerated. It is a wonderful thing to have when a person is terminally ill. For some it provides the money to go on one last vacation, or to visit family, or to provide gifts to grandchildren.

These accelerated death benefits became a selling point, and others were added. The Long Term Care rider and the Chronic Illness rider are both accelerated death benefit riders. They allow the insured to gain access to their death benefit prior to death. In some cases many years prior to death.

There are typically two types of LTC riders on the market. Traditional long-term care insurance policies and asset based long-term care insurance policies. There are advantages and disadvantages to both, depending on your financial situation and your planning needs.

Long-Term Care Insurance Policies

A stand alone long-term care insurance policy is separate from life insurance. These stand alone policies offer more flexibility than hybrid long-term care insurance. If you are looking for the best long term care insurance possible, a stand alone policy is usually the best choice.

However, the one problem that needs to be addressed with this product is the increasing premiums associated with the stand alone LTCI policies. Although older policies are most in danger of having the insurance company raise the premiums, newly issued policies still do not allow for a premium rate lock. This uncertainty of rising premium payments finds a remedy with asset-based long term care insurance.

Asset-Based Long Term Care Insurance

The asset-based policies are also referred to as a combination policy or hybrid policy because they are structured to offer two distinctions. They offer an Accelerated Death Benefit – When you meet the criteria and file your long term care insurance claim, you are pulling funds from your death benefit.

The second distinction is the Extended Death Benefit – Once the death benefit has been fully exhausted (paid out), the policy will optionally continue to pay an extended benefit.

Each company offers different benefit period lengths, elimination periods, and maximum benefit amounts. There are also some companies that offer a cash indemnity benefit policy and some that offer a reimbursement benefit policy.

The one distinct advantage between stand alone LTCI and LTCI+LIFE insurance policies are the hybrid long term care life insurance policies provide fixed premiums. Typically you can choose single premium universal life insurance or whole life insurance, that build cash value, as your asset based vehicle. You can also choose 5, 7, and 10 pay limited pay life insurance with some companies.

Alternatively, a life insurance company may also offer hybrid annuities. With an annuity, you can add a long term care rider that works in the same way the rider would when connected to a life insurance policy.

Chronic Illness Accelerated Benefit Rider

Life insurance with chronic illness rider provides fixed premium payment with an additional rider that can be accessed if you are diagnosed with a qualifying chronic illness. The cash indemnity income benefit is an accelerated benefit derived from your policy’s death benefit. Depending on the insurance company, you can access virtually all your death benefit in advance if you qualify for the chronic illness rider.

Long Term Care Rider vs Chronic Illness Rider Comparison Table

Life Insurance with Living Benefit RiderLong Term Care RiderChronic Illness Rider
What is the Benefit?Accelerated benefit via advancement from death benefit that may be further supplemented by an extension of benefits rider.Pays an accelerated benefit which is an advancement of the death benefit
Eligibility RequirementsLicensed health professional certifies insured cannot perform 2 of 6 ADLs or severe cognitive impairment, both temporary and permanentLicensed health professional certifies insured cannot perform 2 of 6 ADLs for last 90 days or severe cognitive impairment with likely no potential for recovery
Benefit Payment Reimbursement or Cash IndemnityCash Indemnity
Benefit Payment RequirementMay require evidence of actual expenses paid or may be used for any purposeGenerally, can be used for any purpose
Is Benefit Payment Taxed?*Typically not taxable (see IRC Section7702B)Typically not taxable (see IRC Section 101g), but may be taxed if per diem limit is exceeded
Elimination PeriodVaries but typically 0, 90, 180 or 365 daysVaries but typically 0-90 days
Benefit Amount2% to 4% of DB or IRS Per Diem Limits with potential increasing benefits over time due to inflation protection rider, up to full death benefit, with additional extension of benefits possibleGenerally based on lesser of 2% to 4% of policy DB or IRS per diem limits
Return of PremiumTypically included. 100% ROP after specified period. Not typically included.
Increasing Death Benefit?Some insurers allow for Option B, increasing death benefitSome insurers allow for Option B, increasing death benefit
Inflation Protection RiderIncluded at an additional costNot Available

Top 10 Best Companies offering Long Term Care Riders and Chronic Illness Riders

The following table of companies is our current list of insurers that provide either long term care or chronic illness riders. There is no one best company. The right company for you will be based on your specific goals and objectives.

CompanyType of Rider
AIGChronic Illness
AXA EquitableLong Term Care
Lincoln NationalChronic Illness
Long Term Care
Life Insurance of the SouthwestChronic Illness
MassMutualLong Term Care
Minnesota LifeLong Term Care
North AmericanChronic Illness
Pacific LifeChronic Illness
Penn MutualChronic Illness
PrincipalChronic Illness
PrudentialChronic Illness
State LifeLong Term Care
VoyaChronic Illness

What is Long Term Care?

Long-term care (LTC) is a combination of services which provide the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for a long period of time. Oddly enough, the reason LTC is so expensive is not because it pays for highly skilled medical professionals. The opposite is typically true.

See: What is long-term care insurance?

LTC is usually paying for rather unskilled care providers, but it is costly because the care needs to be provided around the clock – seven days a week, such as in-home care, assisted living facility or nursing home. Qualifications for long term care benefits usually necessitate being unable to do two of the six basic tasks for everyday living. These tasks are called activities of daily living (ADLs).

ADLs (Activities of Daily Living)

  1. Feeding.
  2. Toileting.
  3. Bathing.
  4. Selecting proper attire (Dressing).
  5. Maintaining continence.
  6. Walking and transferring.

In other words, if two of the above ADLs are something you can’t do for a long period of time (typically 90 days), you would qualify for long-term care insurance benefits.

In addition to the ADLs there are other “instrumental” activities of daily living (IADLs). These are the complex skills required to live an independent life. It’s possible to joke and say that many of our friends have likely never known how to do some of these things. But the point remains, these IADLs are required for living on your own.

IADLs (Instrumental Activities of Daily Living)

  • Managing finances
  • Handling transportation (public transit or personal driving)
  • Shopping
  • Preparing meals
  • Using the telephone
  • Managing medications
  • Housework and basic home maintenance

For many patients with serious cognitive impairment, such as Dementia or Alzheimer’s Disease, the IADLs are an assessment that determines the need for LTC, even though they may not have any problem with the ADLs. Specifically, if your cognitive impairment is so severe that you are seen as a potential danger to yourself, you will qualify for your long term care rider benefits.

What is a Chronic Illness?

A chronic condition or illness is one that lasts a long time, typically longer than 3 months, and has no medical cure and does not disappear on its own.

Examples of chronic illness include:
  • Heart disease
  • Stroke
  • Diabetes
  • Arthritis
  • Kidney disease
  • Multiple sclerosis
  • HIV/AIDS

The ideal situation for anyone looking for a LTC rider or Chronic Illness rider is to apply before you have the need for the insurance policy. Once the illness or mental condition arises it is much more difficult to get Long term care insurance coverage.

However, it is important to note that those that have a life insurance policy can frequently acquire the rider without undergoing a medical exam – a phone interview is usually all that is needed.

And there is a growing trend among life insurance companies where the chronic illness accelerated benefits rider is already included in newly issued policies in states where the rider is approved.

Life Insurance with Long-Term Care and Chronic Illness Rider Quotes

Long-term care insurance costs vary based on the company and policy you are considering. If you are interested in long term care life insurance quotes or life insurance with chronic illness rider quotes, please enter your information below or give us a call today. We can create illustrations for you based on your specific need, goals and objectives.

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Medicaid Will Pay For It…or will it?

Don’t count on Medicaid if you anticipate enjoying your retirement to any degree. It’s really an option of last resort. The financial requirements for eligibility are strict.

There are some exceptions, but in general an individual must have less than $2000 in countable assets before Medicaid will pay for LTC.

And married couples living in the same house are only allowed $3000 in countable assets. This means that you will have to sell or liquidate many of your assets before Medicaid will pay for your LTC expenses.

Now it’s true that your primary residence and one car are not considered countable assets. But if you own any other income producing assets such as real estate, have more than one car, have life insurance valued at over $1,500, or if you have stocks and bonds of any amount, you won’t get any help from Medicaid until those assets are liquidated.

FAQS on LTC Riders or Chronic Illness Riders

  1. I doubt I’ll qualify with my poor health.
    1. Often, asset-based LTC riders require a phone interview without a medical exam.
  2. I’m sure the long term care insurance premiums will increase and I won’t be able to afford it.
    1. Asset-based long term care riders can be purchased with a single premium, so you don’t ever have to make another payment. In other cases there are premiums that are guaranteed to remain the same. Certain companies offer 5 pay, 7 pay, 10 pay limited pay life insurance policies, so after the long term care life insurance premium payment period, you no longer need to make premium payments.
  3. I doubt I’ll need it.
    1. 68% of individuals over age 65 will become cognitively impaired or unable to complete at least two “activities of daily living” (ADLs). About 7 our of 10 will need some type of long term care insurance.
  4. I’ll lose it if I don’t use it.
    1. Not true. With asset-based LTC the insured either uses it, or passes the benefit along to the beneficiaries with the rest of the death benefit. Many companies also offer a return of premium option that allows you to terminate the policy and get all your premiums back.
  5. I would rather have a LTC policy that is separate from my life insurance so I can have benefits for life if needed.
    1. As mentioned earlier, there are combo, or hybrid long term care insurance policies that do exactly what is being asked. They provide LTC benefits even after the death benefit has been completely exhausted.
  6. I want a policy that covers me and my spouse and my life insurance policy is only for me.
    1. There are riders that will specifically add a spouse to the long-term care insurance coverage even if the underlying life insurance policy is insuring just one person.
Final Thoughts on LTC Riders and Chronic Illness Riders

The statistics don’t lie, most people will need long term care services as they age. And yet most people are unprepared.

The LTC rider or Chronic Illness rider options are a significant way to safeguard your family from financial ruin in the event of a serious illness.

These riders also provide wealth and legacy preservation, so all your assets you diligently created in life are not depleted in the end.

Insurance & Estates is committed to connecting you with the best company and the best features, based on your unique need and goal. If you want to talk about your long term care insurance options, please contact us today to speak to a financial professional who can help you put together a strategy for your long term care needs.

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