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 longtermcarepoll.org.

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:

  • AIDS/HIV
  • 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.

 

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Community Relations

Jeane M. Fracassa

Community Relations

Jeane M. Fracassa

Jeane Fracassa – a dedicated and accomplished professional who retired with an impressive 38-year service record from the Kansas City Missouri Police Department. Throughout her illustrious career, Jeane served as a Civian Supervisor in the Communications Unit, where she played a pivotal role in ensuring efficient and effective communication within the department.

Even in retirement, Jeane’s commitment to community service remains unwavering. Currently, she serves in various capacities within Community Relations at Paths Law Firm. Actively engaged in the Lee’s Summit and Overland Park communities, she proudly represents the law firm.

In all aspects of her life, Jeane Fracassa exemplifies the values of community, compassion, and family. Her commitment to making a difference and her love for exploration make her a remarkable individual, whose presence brightens the lives of those she encounters. Whether at work, with family, or during her travels, Jeane’s genuine care for others and her zest for life make her a truly remarkable and inspiring person.

Administrative Assistant

Laura E. Messer

Administrative Assistant

Laura E. Messer

Laura is the Law Firm’s marketing assistant, supporting all marketing tasks, including managing calendars, researching upcoming events, updating marketing software and spreadsheets, and partnering with organizations to maintain relationships that benefit Paths Law Firm’s clients.  Laura is also the law firm’s professional photographer as she provides the professional photographs for the headshots, organizations, events, and networking.

Laura has over 10 years of experience as a professional photographer.  She is also Adobe and Microsoft Certified.  She graduated from Columbia College, Columbia, Missouri with her Bachelor of Arts degree, Magna Cum Laude, in Behavioral Psychology (minors in Social Work and Criminal Justice), and her Photographic Craftsman degree from Professional Photographers of America. She is certified as a Qualified Mental Health Professional, Certified Gentle Teacher, Medicaid Billing Certified, Crisis Intervention Counselor, and a Missouri Notary.

Laura has been married more than 26 years and has a daughter and a son. She has four brothers, a niece, and a nephew. Her four spoiled pets that love her attention. A lot of Laura’s off time is spent taking photos and she is an internationally published photographer. Laura owns a studio on the historic Independence Square. 

Administrative Assistant

Holly D. Bramble

Administrative Assistant

Holly D. Bramble

Holly is our newest member of the administrative team. She is hardworking, has proven organizational skills and excellent communication skills. Holly has transitioned to the Estate Planning field from healthcare administration where she gained valuable knowledge that has contributed to her success here at Paths.

Holly enjoys spending time with loved ones, cheering for the Chiefs, and relaxing on the beach.

Administrative Assistant

Tressa L. Purdy

Administrative Assistant

Tressa L. Purdy

Tressa has the important role of being a client’s initial point of contact as the law firm’s receptionist for all locations.  She also welcomes, assists, and cares for clients at the Lee’s Summit office. Additionally, she provides support in an administrative capacity for the attorneys, staff, and clients.  When you meet Tressa, the first quality many note is her readiness to be of assistance.

 

Tressa is a graduate of Park Hill High School with extensive administrative experience and executive level management. Tressa brings a stability and comfort to the law firm experience having worked in a variety of industries and having lived in six different major metropolitan cities.

 

Tressa has a daughter, two sons, and one grandchild.  In her free time, she enjoys her family and friends, loves being outdoors, gardening, bike riding and bird watching. Indoor hobbies include scrapbooking, painting cookies, and cheering on Chiefs football. She is a Kansas City native but enjoys traveling but is always happy to be back in her hometown.  

Attorney

Kathleen E. Overton

Attorney

Kathleen E. Overton

Kathleen Overton is an attorney and owner at Paths Law Firm. She has more than 17 years of experience advocating for those with special needs and navigating the state and federal agencies formed to help the disabled and elderly. At Paths Law Firm, Kathleen’s practice focuses on helping the elderly qualify for nursing home Medicaid, creating estate plans to protect beneficiaries, as well as a lot of time planning and forming businesses. Kathleen also enjoys helping clients form non-profit organizations and obtain 501(c)(3) tax exempt status.

 

After attending law school at the University of Oklahoma, Kathleen began representing clients before the Social Security Administration. Eventually her practice switched to federal court appeals and Kathleen spent years representing clients before the Eastern and Western District of Missouri, the District of Kansas, and the Eighth Circuit Court of Appeals. Kathleen has since focused her practice on estate planning and elder law after watching clients struggle to find ways to financially care for loved ones with special needs or aging parents.

 

Kathleen lives in the Northland with her husband and four children. She spends her free time attending soccer matches and ballet performances with her children and starting endless home improvement projects with her husband. 

Medicaid paralegal

Tena K. Dooley

Medicaid Paralegal

Tena K. Dooley

Tena is a Medicaid Paralegal.  She is very meticulous and organized.  She works closely with the attorneys, clients, and State representatives. 

Tena has an associate in applied science and has over 20 years of office management experience. She has two daughters and one grandson.

Tena enjoys spending time with her family.  She enjoys everything outdoors and her hobbies include fishing and gardening.

PARALEGAL & ACCOUNTANT

Sydney R. Morris

PARALEGAL & ACCOUNTANT

Sydney R. Morris

Sydney is the law firm’s internal accountant and one of their experienced paralegals having been with Paths Law Firm since 2017. She is a primary point of contact for estate planning and business planning.

Sydney graduated with honors from the University of Missouri Kansas City in 2022 with her Bachelor of Science Degree in Accounting. She is a Bloch Launchpad, Phi Theta Kappa, and National Honor Society alumni.

In her free time, Sydney enjoys spending time with her husband, reading, baking and going on long walks. 

SENIOR ADMINISTRATIVE ASSISTANT

Christy L. Phillips

SENIOR ADMINISTRATIVE ASSISTANT

Christy L. Phillips

Christy has three years of experience in elder law working for seniors and their families. She is currently the Senior Administrative Assistant and organizes the day to day functions of the office and makes sure everything runs smoothly. When asked why she loved what she does, Christy said at Paths Law Firm, she gets the opportunity to help clients in more ways than one. Her favorite parts of the job are getting to know the clients and helping them get their questions answered. 

Christy’s experience in the finance industry has been extremely beneficial to her role as the Senior Administrative Assistant. Christy has a special place in her heart for the elderly and attributes this to the relationship she had with her grandparents. 

Christy was raised in Ogden, Utah and moved to Independence, MO, when she was ten years old. She has been with her high school sweetheart for 25 years and they have two beautiful children together. Her daughter works in the medical industry, and her son currently attends High School and plays Baseball. When Christy is not working, she enjoys crafting and spending time with her family and friends.

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

FINANCIAL MANAGER

René A. Fracassa

Rene A. Fracassa, Paths Law

FINANCIAL MANAGER

René A. Fracassa

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

 

In her spare time, René is currently quite active managing multiple generations of her family, including parents and grandkids.  René has had great impact on the lives of many women teaching discipling and teaching and abundance of Bible Studies. Her former career in management and event planning trained her well to juggle all the activity.

MARKETING MANAGER

Hilary R. Tichota

MARKETING MANAGER

Hilary R. Tichota

Hilary plays a vital role in managing the Marketing Department at Paths Law Firm.  She is excellent at bringing new ideas and sharing valuable resources with the law firm and our community. Hilary has been with the law firm since the beginning, working in nearly every role which is invaluable in her marketing endeavors as she brings a unique set of skills into the Marketing Department.

Hilary is nearly complete in her Bachelor’s of Arts Degree in Marketing at Park University.  She has earned the honor of being listed in National Honors Society, Phi Theta Kappa, and the Dean’s List. Hilary is always looking for new and innovative ways to share the law firm’s message.

While not working, Hilary spends her time with her family at their rural home. They tend to their chickens and honeybees and enjoy the solitude of country living.

SR. PARALEGAL & OPERATIONS MANAGER

Jennifer A. Bronson

SR. PARALEGAL & OPERATIONS MANAGER

Jennifer

Jennifer is the Sr. Paralegal and Operations Manager at Paths Law Firm.  She oversees the firm’s probate department as well developing, implementing, and managing all the firm’s administrative processes having been with the law firm almost from the beginning.  She enjoys client contact as well as behind-the-scenes operations.

 

Jennifer began her legal career in 1990 as a legal secretary.  She has worked in small and medium sized firms, as well as court operations.  She has her Paralegal Certificate from Boston University, Law Office Management Certificate from University of Central Missouri, and she is a Master Financial Coach. 

 

Jennifer has two daughters, twin sons, and twin grandsons.  She spends as much time as she can with them.  She enjoys reading, listening to podcasts, and tending her yard. 

ATTORNEY

Russell A. Fracassa (Rusty)

ATTORNEY

Russell A. Fracassa (Rusty)

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 more than 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 an accountant and his first couple years practicing law was as a tax attorney. This provides invaluable experience in his current practice of law. Rusty’s focus is helping protect seniors’ assets from taxes and long-term care costs, benefit qualification, and navigating more complex family scenarios in their estate planning.

Rusty has personally experienced the loss every parent fears, caring for a spouse suffering with cancer and the treatment, and working with aging parents through all stages of their lives.  He intimately understands the challenges faced by individuals and their caretakers when capacity or health declines, how to prepare for it, and the legal matters while in the midst of it.  He may not be able to eliminate his client’s grief, but he strives to provide clients with peace of mind.

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.

Rusty has multiple degrees and advanced study spanning his Bachelor’s of Arts in Business Administration – Accounting at Rockhurst College (now Rockhurst University), Masters of Arts in Accounting and in Intercultural Studies, as well as his Juris Doctorate from the University of Missouri at Kansas City School of Law.

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