Welcome to the thirteenth edition of Long-Term Care in the News. We, at Custom Care Solution, LLC, want you to be on the cutting edge of changes and updates within the Long-Term Care industry. We will accomplish this through these email bulletins distributed each week to our brokers, agents and their staffs.

Long-Term Care In The News …….

John Hancock Underwriting Update

John Hancock will now consider insulin dependent diabetics who are being treated with less than 50 units of insulin daily. Though earlier findings had indicated a strong correlation between diabetes and long-term care, further investigation has enabled them to determine that certain well-controlled diabetic conditions are less of a risk. It is important to note that while they are willing to consider this risk; it is critical that the following criteria are thoroughly evident in your applicant’s medical records:

• Condition is stable and well-controlled for a period of 12 months.
• Documented, favorable Hemoglobin A1C levels
• No signs or symptoms of diabetic complications (i.e. neuropathy, neuropathic ulcers, retinopathy, kidney abnormalities)
• No history of diabetic co-morbid conditions (i.e. Coronary Artery Disease, Peripheral Vascular Disease, Carotid Artery Disease, Obesity, Tobacco Use)

They have also updated their Build Table to reflect expanded height and weight ranges within the Preferred/Select risk classifications.

For copies of the new Diabetic Guidelines and Build Table, please give us a call.

Corporation for Long-Term Care Certification

A CLTC Master Class is scheduled at the Bridgewater Manor in Bridgewater, NJ for August 12 and 13, 2004. CLTC graduates praise the CLTC Program for giving them the knowledge and confidence needed to be successful in the LTC insurance market and with effectively meeting their clients’ needs. As a CLTC graduate, you are entitled to ongoing valuable benefits, including regular legislative and industry updates and newsletter – which will enable you to provide ongoing value to your clients. The Master Class is a two-day class conducted by a certified national instructor, preparing you for the CLTC exam. The cost of the Master Class is $995 which includes all course material and examination fee. To register, visit the CLTC website at www.ltc-cltc.com or call 866-383-2075. Seating is limited to the first 30 students so if you are interested, register today !!

Georgia to bill estates for Medicaid

According to The Atlanta Journal-Constitution, dated 5/24/04, if Georgia’s Medicaid program pays for nursing home care, the state plans to collect that cost from your estate. Starting in August, the state will seek repayment for Medicaid services by going after the homes and other assets of individuals who receive long-term care. In some cases, the state also will place liens on homes before recipients die. State officials say a tight budget prompted them to take this step, and that they are doing what’s required by federal law. Georgia will seek repayment of Medicaid benefits received by individuals 55 and older, as well as younger recipients who lived in a nursing home or other institution for at least six months. To qualify, an individual can have no more than $1690 per month in income and a maximum of $2000 in the bank. They can own a car and home and still qualify for Medicaid. Medicaid is by far the biggest payer of nursing home bills in Georgia. Georgia officials say they expect to collect $5 million the first year from the estate of Medicaid recipients. The state spends an average of $20,000 per Medicaid recipient each year on nursing home care, and about $6,900 for other long-term care. Georgia won’t pursue the estates of people who have $10,000 or less in assets. Estates will not be touched while a Medicaid recipient’s spouse is alive or if they have children under age 21. For a complete copy of this article, please give us a call.

Prudential LTC by Design

Effective Monday, June 7, 2004, the new Prudential Long-Term Care product, LTC By Design, will be approved for sale in Texas. The current LTC insurance product will be available for sale in Texas until Friday, June 18. LTC applications for the current product must be signed and dated no later than Friday, June 18, and received in LTC Operations no later than Friday, June 25. LTC By Design is a very competitive product. It offers a wide range of benefits from daily benefits, monthly benefits and a Cash Benefit plan. Prudential offers some unique inflation options such as a 5% Automatic Compound Inflation Benefit – 2x maximum which is very attractive alternative to the expensive 5% Compound Inflation Rider. Call us today to learn more about LTC By Design.

Troubled Conseco Offers 3 Policy Options to FL Policy Holders

According to the South Florida Sun Sentinel, about 18,000 Floridians have started to receive letters from the financially troubled insurer, noting that policyholders must choose one of three options related to their coverage in the near future. In all three cases, premiums will rise or benefits will shrink. Ultimately, policyholders will have to make one of the following choices ordered by the Office of Insurance Regulation after it denied a rate increase of 212% last month:

• Option 1: Keep the current policy with no benefit changes by face a maximum 50% rate increase the first year with no limit on increases in future years.
• Option 2: Choose a replacement policy from Conseco that would have a maximum 25% rate increase the first year and a 15% maximum increase for the lifetime of the plan.
• Option 3: Select a “paid-up” amount equal to the sum of all premiums paid to Conseco to date.

You may start getting calls from your clients and prospects regarding this situation. Call us today and we will walk you further through the 3 options and help you advise these clients.

Have LTC Cases that Have Been Declined??

Don’t forget about Penn Treaty, they not only have 5 rate classifications that allow them to accept more risk than other insurance carriers – but they also offer the Secured Risk policy that is available in many states. Call us today to discuss these declines!!!