Long-Term Care Insurance Quote

Complete the form below to receive a quote on Long Term Care Insurance. 

Contact Information:
Name: Email Address:
Street Address: City:
State: Zip:
Daytime Phone: Evening Phone:
Mailing Address (if different from home address):
Primary Applicant: 
Date of Birth (mm/dd/yyyy): Name:
Status: Gender:
Married Single Male Female
Benefit Period Desired: Tobacco Use:
Quote Requested for Spouse? Spouse's Name:
Yes (default)  No
   
Spouse's Gender: Spouse Date of Birth (mm/dd/yyyy):
  Male (default)  Female
Choose Your Daily Nursing Home Coverage Benefit: How many days after care is needed would you like the benefits to begin?
per day
Coverage for Home Care desired? If yes, (cannot exceed nursing home benefit)
Yes No 
Any Health Problems?
Yes  No (default)
Give details of health problems:
What other types of insurance do you carry?  (You may select more than one by pressing and holding the SHIFT or CTRL key on your keyboard.)

Who needs long term care?

Of the nearly 13 million people who need help with everyday activities, nearly 40% (over 5 million) are working-age adults between 18 and 64 years old.1

Who pays the bills?

In most cases, long term care recipients and their families bear the costs of long term care. About a third of all nursing home costs are paid out-of-pocket by individuals and their families.4

Medicare? It pays only about 8%, for short-term skilled nursing home care following hospitalization. Medicaid? It pays more than half of nursing home costs, but that funding begins only after the patient becomes eligible by depleting his/her own savings to national poverty level guidelines.4

Consider the Facts About Long Term Care!

Unfortunately, most major medical insurance plans offer only brief coverage, if any, for this type of care.  You could be left unprotected. Medicaid planning is now, for all practical purposes, against the law.

Long Term Care is not just for those who are older.  Stroke, heart attach, cancer, and auto accidents are just a few of life's unexpected circumstances that could generate a need for long term care.  "More than one-third of those who need help with activities of daily living are between the ages of 18 and 65." 2

People are living longer, and have more exposure to long term illness than ever before. Currently, 70% of people who are older than 65 will need long term care services. 3

Even though the annual cost of institutional care may exceed $50,000 3 (and possibly more depending on type of care, facility, and geographic location) "most Americans today do not plan adequately for their long term care needs." 2

1 EBRI, Issue Brief, July 1996, p. 6.
2 "The New 104th Congress Brightens the Outlook For Long Term Care Insurance." HIU, February 1995, p.23
3 Life Insurance Selling, December 1992, p.114
4 HIAA, Guide to Long Term Care Insurance, 1996.