senior care adl assistance

Protecting Yourself with Long Term Care Insurance

When we are young, it is hard to imagine that at some point we may need long term care for ourselves.  After all, we have youth on our side, and we feel invincible!  However, as we mature the cycle of care is evident.  When we are young our parents care for us.  Then as we become adults, we begin to see the effects of aging in our parents and we begin caring for them.

Whether you are currently taking care of your parents or other family members, at some point in time it may become necessary to consider long term care.  Long term care can include at-home care, assisted living, nursing home care as well as other types of care.  All of the long term care options mentioned have costs associated with them.  Those costs, when on a fixed income, may not be affordable.

*This blog is for educational purposes only and should not be considered legal advice.  The use of the Paths Law Firm website does not constitute a client-lawyer relationship.

Preparing for long term care is essential, however, according to a poll related to long term care, 71% of individuals aged 40 and over are not prepared for the cost of care that they may need in the future.  The poll cited that 29% of people questioned had set aside funds specifically to cover long term care and only 23% of those individuals had looked into long term care insurance as an option.

The Basics of Long Term Care Insurance

Long term care insurance was originally introduced in 1980 as nursing home insurance.  The main purpose of long term care insurance is to pay for any expenses that are associated with long term care services and services that support personal care and supervisory care.  This includes services at home for assistance with activities of daily living (ADLs), as well as care at assisted living facilities, skilled nursing facilities, and rehabilitation centers.

Long term care policies will reimburse the policyholder a set amount each day up to the amount selected for the policy limit.  There are many different options for long term care insurance.  When looking for a policy, it’s important to know what you want out of a policy and the cost that is associated.  Policies that do not have the coverage and terms you are looking for are a waste of money.  Be sure to research the insurance policy company to ensure that they are reputable and the terms of the policy on coverage, premium changes, eligibility, exclusions, and protection for inflation.

long term care

Basic and Instrumental ADLs

There are two categories of ADL’s that are looked at when determining coverage for long term care assistance.  Below is list of assistance that falls into each of the categories:

Basic ADLs

  • Ambulating – The ability to move from position to position or walk independently
  • Continence Management – The ability to control bowel and bladder function
  • Dressing – The ability to dress independently
  • Feeding – The ability to feed oneself independently
  • Personal hygiene – The ability to bathe and groom independently
  • Toileting – The ability to get to and use the toilet independently

Instrumental ADLs

  • House cleaning and maintenance – The ability to clean up after themselves and maintain a clean environment
  • Communications – The ability to make phone calls and send mail
  • Finances – The ability to manage finances and pay bills
  • Medications – The ability to get one’s medications and take them on their own
  • Meal preparation – The ability to prepare a meal without assistance
  • Transportation and shopping – The ability to shop for necessities such as groceries or clothing, and drive or obtain transportation

Many long term care policies use ADLs to help determine the qualification of benefits. In addition, the policies may indicate how many ADLs an individual must require assistance in order to trigger benefits.

long term care assistance

Does Everyone Need Long Term Care Insurance?

In the United States, the population of individuals that are 65 years or older is growing exponentially each year.  And, according to the Population Reference Bureau (PRB), the number of Americans ages 65 and older will more than double by 2060 with nearly one-quarter of Americans being age 65 or older.  With our country aging at this rate, more individuals will need assistance and care than in the past. There are approximately 56 million adults age 65 and older as of 2020.  This number is estimated to grow to an estimated 98 million adults age 65 and older in 2060 according to

The National Association of Insurance Commissioners (NAIC) has reported that they estimate 70% of Americans that are over the age of 65 will need some type of long term care during their lifetime with an estimated 35% needing an average of 1 year of nursing home care.  With these statistics, the probability of care is high for the majority of Americans.

Deciding whether or not to purchase a long term care insurance policy should be based on your Income, assets, and retirement goals.  If the only source of income that an individual has is through Social Security or Supplemental Social Security Income or income is at or below the poverty level, it’s likely that those individuals will qualify for some type of assistance such as Medicaid and may not need to purchase an insurance policy.

If an individual can pay for care out of pocket, but they do not want to use all of their income or assets, they should consider a long term care insurance policy.  This can be a difficult decision as we do not know in advance whether or not we will need the coverage.  Either decision to purchase or not to purchase can be risky.

senior care adl assistance

What are the Qualifications for Long Term Care Insurance?

Long Term Care insurance policies are not guaranteed to anyone.  To obtain coverage, you first need to apply and be approved.  Many companies require that the policy have medical underwriting to ensure that the applicant is in good health at the time of the application process.  As most policies are based on health rather than age, it is advised to purchase a policy before there is a decline in health.

Some reasons for denial of coverage would be if the applicant requires assistance with any ADL, uses oxygen or a wheelchair, or is uses or needs at the time of application home health services or nursing home or assisted living care.  Additionally, applicants may be disqualified for pre-existing conditions of which there is a long list.  Some of the conditions that may disqualify an applicant are as follows:

  • Certain types of cancer
  • Cirrhosis of the Liver
  • Muscular dystrophy (MS)
  • Paralysis
  • Parkinson’s disease
  • Renal Failure
  • Sickle cell anemia
  • Alzheimer’s disease
  • Dementia
  • Schizophrenia

If you have a pre-existing condition, you may still qualify for long term care insurance.  The rules of medical underwriting change and can vary from carrier to carrier.  An Elder Law Attorney can help answer questions and assist in the application process or appeal.    Once an applicant has been qualified, the Long Term Model Care Act, created by the NAIC, mandates that insurance carriers cannot terminate a policy or refuse to renew a policy based on declining health, mental health deterioration, gender, or the age of any policyholder.

ltc insurance

What are the Different Types of Long Term Insurance?

There are many different types of long term care insurance policies available.  Each type of policy provides different benefits and has its own questions associated with qualification and approval.

Group Policy

Group policies are oftentimes provided by employers.  These policies are similar to policies that can be purchased as an individual.  Some group policies may have options that you cannot get as an individual and may also have a lower premium to start.  If you are employed and have this type of group coverage you have the benefit of being able to convert the policy if your employer cancels it.  The premiums generally go up when this happens because of the buying power through a group policy versus an individual policy.

Federal Policy

The Federal LTC program is made available to current, retired, and former employees of the federal government and their qualifying dependents.  The downside is that all premiums are the policyholder’s responsibility as the government will not pay any part of the premium.  In addition, the premiums are similar to an individual policy.  Each State may also have similar policies for their employees.

Joint Policy

A joint policy is a policy that covers multiple people.  This would be a common policy for a married couple or partners.  These policies have higher premiums than individual policies, however, they are cheaper than the cost of two individual policies.  One factor to consider regarding a joint policy is that the benefits are shared.  This can pose a risk to one or both individuals because one person could deplete the benefit funds and leave the other person with little or no benefits available to use.

Hybrid Policy

Hybrid policies are a combination of long term care insurance and permanent life insurance.  These types of policies provide an investment component for savings.  In this type of policy, the policyholder can withdraw the funds needed for care.  When the funds run out, the insurance company begins paying for care.  A popular benefit of this type of policy is that if the policyholder dies, and has not used any of their benefits, the beneficiary will receive a death benefit.

Long Term Care Policy Benefit Payout

Benefits paid out for LTC policies are generally paid based on a daily limit or based on a monthly benefit, which is established by multiplying the daily amount by 30 days.  It’s important to establish what amount is needed on a daily basis to ensure that coverage meets your needs.  This can be done by contacting local agencies to find out what the average cost for the services in the area is.  Be sure to ask questions about the cost for long term care vs other care.  It is also a good idea to ask about the rates for private rooms and semi-private rooms.

When choosing a policy, be sure to ask about inflation protection.  This ensures that your policy is still valuable even with inflation and the rising cost of healthcare.  Inflation protection increases the benefit amount through the years that the policy is active.  In addition, its good to find out what the time limit is on the inflation protection as it could be anywhere from 10 years to 25 years based on the purchase date or based on a policyholder’s age.  Inflation protection does not mean that you will pay a higher premium, as some policies have this protection included.

insurance for long term care

In Closing

People purchase insurance policies for everything from life insurance, health insurance, home insurance, vehicle insurance, and more to protect themselves from unexpected events.  At times these premiums may be looked at as a waste of money however if the time comes that you need benefits, you will be happy that you are covered.  That extra protection provides you peace of mind and can help to prevent financial stress on you or your family.

If you or a family member needs assistance with the application process or appeal process for Long Term Care Insurance, Paths Law Firm has the expertise needed to help  We understand how important it is to protect your future and the future of those you love.  We help seniors and their families plan for the future to prevent financial and heredity issues that may arise during advanced years. Contact Paths Law Firm to schedule your consultation.  Thoughtful planning today can help you secure your future.


Educational Seminar at Paths Law Firm

Paths Law Firm provides a Free Educational Elder Law Seminar every month to help you plan for your future.

Administrative Assistant

Ryan D. Foley

Ryan Foley at Paths Law

Administrative Assistant

Ryan D. Foley

Ryan graduated from the UMKC School of Law in 2018 and passed the Missouri Bar that year. Prior to law school, Ryan attended the University of Missouri – Columbia where he attained a degree in Business. He is a Kansas City native, growing up in the Northland where he achieved his Eagle Scout rank by doing a project for his high school. During his time in law school, Ryan was introduced to the practice area of Elder Law by one of his professors and has been

Ryan enjoys working with and educating clients to provide advocacy and support during the unfamiliar and often overwhelming probate process. Ryan understands the challenges faced by individuals when faced by the uncertainty and complexity of government systems or even handling a Trust during a time of grief, and he strives to make the process as easy as possible.

Administrative Assistant

Makaylee A. Morelli

administrative assistant at Paths Law

Administrative Assistant

Makaylee A. Morelli

Makaylee is currently working on her bachelor’s in political science and hopes to soon start law school as an aspiring attorney. In her free time, she loves to spend time with her friends and family but most importantly her dogs Taffyta, Tallulah Belle, and Harry. Their favorite thing to do is go on coffee dates and get pup cups.


Kathleen E. Overton

Kathleen Overton, attorney at Paths Law


Kathleen E. Overton

After starting her career as a disability attorney, Kathleen transitioned into estate planning at a mid-sized regional law firm. Kathleen joined Paths Law Firm in 2021 when she decided to return to a boutique law firm that provides excellent service and quality to clients. Because of her background as a disability attorney, she brings a thorough understanding of public benefits to each client meeting. At Paths Law FIrm, Kathleen focuses on traditional estate planning and business entity formation, providing tailored advice unique to each client’s situation.

Public Benefits Assistant

Tena K. Dooley

Public Benefits Assistant

Amanda D. Martin

I have my Associates in Applied Science and have over 20 years of office management experience. I have two daughters and one grandson.

During my time away from the office I enjoy spending time with my family.  I enjoy almost everything outdoors and my hobbies include fishing and gardening.


Sydney R. Morris

Paths Law elder law in Kansas City



Sydney is currently enrolled at the University of Missouri-Kansas City pursuing an accounting degree and plans to later attend law school.

In her free time, Sydney enjoys spending time with her nephews and volunteering at her local church.



Christy L. Phillips

client service manager at Paths Law


Christy L. Phillips

Phone: 816-640-8635
Email: [email protected]

Christy has 3 years of experience in Elder Law working for seniors and their families as a Benefits Coordinator processing Medicaid and VA applications. Prior to joining Paths Law Firm Christy worked in the finance industry for over 10 years.


Christy’s experience in the finance industry has been extremely beneficial to her role as Benefits Coordinator. There have been many influences that went into her decision to select the field of Elder Law. Christy has a special place in her heart for the elderly and attributes this to her relationship with her grandparents.

When asked why she loves what she does, Christy said that at Paths Elder law, she gets the opportunity to help clients in more ways than one. Her favorite part of her job is getting clients approved for Medicaid or VA benefits as it is a huge relief for them and their loved ones.

Christy was raised in Ogden, Utah, and moved to Independence, MO, when she was ten years old. She has two children that keep her busy and fill her life with joy! Christy’s daughter cheers for Avila University, and her son plays competitive baseball for the Bucks and races BMX locally for the Motorcycle Closeout Team.

When Christy is not working, she enjoys crafting and making homemade gifts for her loved ones and raising her kids to be healthy, happy, and positive humans.


Practice Areas

  • Medicaid Benefits
  • VA Benefits


Professionalc Memberships and Affiliations

  • Missouri Notary


René A. Fracassa

Rene A. Fracassa, Paths Law



René has worked along side Rusty for 35 years. Not only is she part of the Paths team, she is also his wife. René spends her time working with the accountant to keep all of the finances in order, as well as general office management.

In addition to helping run the office, she helps manage the family and grandkids, tries to keep everyone fed, and has a passion to teach Bible Studies. Her former career in Event Planning trained her to juggle all the activity. She understands Rusty’s passion to serve people from the first mention of law school. It is a great pleasure for her to be an important part of every area of his life.



Hilary R. Tichota

Hillary at Paths Law



Hilary plays a vital role in the daily operations of the office. In addition to her regular office duties, Hilary has a heart of gold.

For more than 5 years, Hilary has operated the front desk at Paths, running the office and catering to clients. Hilary recently moved into the role of Community Relations Coordinator. She has a passion for people and a focus to share our business practices with the community’s seniors, businesses, and clients. She especially has a heart for seniors, showing they are loved through her visits, treats, the “Pen to Pal” program, and volunteering services at various senior living communities. She is a wonderful wife and mother of two. Most activities with seniors involve her great talent for any type of craft.



Jennifer A. Bronson

Jennifer, senior paralegal



Jennifer has been in the legal field for over 25 years and considers Paths her second home.

When she’s not running the office or working for our clients, she’s spending time with her first passion – her children.


Russell A. Fracassa (Rusty)

attorney at Paths Law elder law


Russell A. Fracassa (Rusty)

Phone: 816-640-8635

When asked what he wants to do, his reply was “I just want to sit at the kitchen table and work directly with people.” Rusty enjoys working with clients providing experienced advocacy and supporting them through their unfamiliar and overwhelming situations. Due to all the challenges faced by seniors, it is essential to work with an experienced elder law attorney who has expertise in the law, issues, and concerns affecting seniors and their families.

Rusty brings nearly 30 years legal experience and expertise working for seniors and their families as an elder law attorney in Kansas City and surrounding. Prior to law school, Rusty was a practicing accountant. This provides invaluable experience in his current practice of law. Rusty decided to put his focus on helping the elderly, vulnerable adults, and their families navigate challenging life, end of life, and death events.

Rusty understands the challenges faced by individuals whose capacity is declining and how upsetting the loss of a loved one can be. He understands he may not be able to eliminate his client’s grief from loss, but he strives to provide clients with peace of mind. Rusty works directly with client’s long term care issues, including Medicaid, Veteran’s Benefits, Estate Planning, Asset Protection, and Special Needs Planning.

In 2010, Rusty’s faith and love led him and part of his family to China as Christian missionaries. He and his wife, went permanently, but ended up dedicating 3 years to that ministry. They returned to Missouri to help with grandchildren after a family tragedy and later began anew with Paths Elder Law. The goal is providing compassionate care through legal advocacy.

When Rusty is not practicing law, he enjoys spending time with his family, grandchildren, and excessive eating at local restaurants.


Practice Areas


  • Wills and Trusts
  • Estate Planning
  • Asset Protection
  • Medicaid Benefits
  • VA Benefits
  • Probate
  • Guardianship and Conservatorships
  • Education


BSBA and Master’s in Accounting, Master’s in Inter-Cultural Studies, and Doctorate in Juris Prudence

  • Rockhurst University
  • Liberty University
  • University of Missouri – Kansas City

Admissions to Practice

  • Missouri

Professional Memberships and Affiliations

  • State Bar of Missouri
  • National Academy of Elder Law Attorneys (long-time Member)
  • Elder Counsel (Charter and Ongoing Member)
  • Missouri Association of Trial Attorneys (Past Member)
  • Kansas City Metropolitan Bar Association
  • Missouri State Bar Committees – Elder Law, Estate Planning, Probate