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					OREGON LONG-TERM
CARE INSURANCE:
COMPANIES & CONSUMER TIPS



                                                SHIBA

OREGON SENIOR HEALTH INSURANCE BENEFITS ASSISTANCE PROGRAM
  Table of Contents
An introduction to long-term care ....................................................................................1
Paying for long-term care ..................................................................................................1
Long-term care insurance ..................................................................................................1
Long-term care insurance resources...................................................................................2
Oregon consumer protection laws for long-term care insurance........................................2
Is long-term care insurance right for you? ..........................................................................3
Companies authorized to sell long-term care insurance in Oregon ............................... 4-5
Long-term care insurance personal worksheet...................................................................5
Glossary of insurance terms ........................................................................................... 6-8
About the Senior Health Insurance Benefits Assistance Program (SHIBA) ....................9

  Where to call for help
Oregon Department of Consumer & Business Services
Insurance Division
  • Senior Health Insurance Benefits Assistance (SHIBA) ..............(503) 947-7984 or (800) 722-4134
    — Information about Medicare and other health insurance                                                                 (toll-free in Oregon)
    — Publication requests
  • Consumer Protection Section ...................................................... (503) 947-7984 or (888) 877-4894
    — Complaints about insurance companies or agents                                                                        (toll-free in Oregon)
    — Publication requests
  • Authorized insurance companies ................................................................................ (503) 947-7982
  • Licensed insurance agents ........................................................................................... (503) 947-7981
  • TTY access .................................................................................................................. (503) 947-7280
  • E-mail ............................................................................................................. dcbs.insmail@state.or.us
  • Web site ........................................................................................................... www.cbs.state.or.us/ins

Oregon Department of Human Services
Senior & Disabled Services Division ...............................(800) 232-3020 (toll free)
  • Licensed long-term care facilities
  • Medicaid (state and federal help for low income and medically needy)
Long-term Care Ombudsman .........................................(800) 522-2602 (toll free)
  • Complaints about long-term care providers


                        In compliance with the Americans with Disabilities Act
                        (ADA), this publication is available in alternative
                        formats. Call (503) 947-7980 or (503) 947-7280 (TTY).
    Long-term care insurance: companies & consumer tips
An introduction to long-term care                     and Disabled Services Division office or Area
                                                      Agency on Aging to see if you qualify for
Long-term care helps people with chronic
                                                      Medicaid.
conditions, such as illness or disabilities,
compensate for limits on their ability to live        Veterans may be eligible for service-related care
independently. A variety of medical, personal,        covered by the Veterans Administration.
and social services are available, ranging from
in-home-care to care at a skilled nursing facility.   Long-term care insurance
Oregon has developed one of the most compre-          A long-term care insurance policy may pay most
hensive long-term care programs in the nation,        of the costs for your care in a nursing home,
based on the belief that Oregonians have a right      assisted living facility, adult foster care, or home
to the most independent living situation pos-         care.
sible. The least-restrictive service is home care;    You may be able to deduct qualified long-term care
other available services include:                     insurance premiums from your income taxes in the
•   Custodial nursing care                            same way medical expenses are now deducted. To
                                                      see if your policy qualifies for the deduction, con-
•   Intermediate nursing care
                                                      tact one or more of the following:
•   Skilled nursing care
                                                      • Your insurance agent or company
•   Assisted living
                                                      • Your tax consultant
•   Adult foster care
                                                      • The Internal Revenue Service
•   Residential care
                                                      • The Oregon Department of Revenue
•   Adult day care
                                                      • The Senior Health Insurance Benefits
•   Respite care                                         Assistance (SHIBA) program, (503) 947-
Long-term care is most often provided by a               7984, or (800) 722-4134 (toll-free in Oregon)
family member. Other long-term care providers
can supplement or replace it.

Paying for long-term care                                It’s OK to change your mind
Long-term care can be expensive. Medicare                If you aren’t satisfied with the long-term
and Medicare supplement policies don’t pay for           care insurance policy you purchase, you
most long-term care services. If you are 65 or           always have a 30-day “free look” period
older, find out what Medicare and Medicare               during which you can cancel the policy for
supplement policies cover.                               a full refund without penalty. If your insur-
                                                         ance company denies you this “free look”
Most private health insurance policies don’t pay         period, call our Consumer Protection
for long-term care. Find out if your health insur-       Section, (503) 947-7984, or (888) 877-
ance covers any long-term care services.                 4894 (toll-free in Oregon).
Medicaid pays most long-term care expenses for
eligible beneficiaries. Contact your local Senior


                                                                                                             1
      Long-term care insurance resources
    Free publications available                          A Shopper’s Guide to Long-term Care, published
                                                         by the National Association of Insurance
    SHIBA published this booklet to help you decide
                                                         Commissioners (NAIC), provides additional
    if long-term care insurance is right for you.
                                                         information to help answer your questions about
    It includes:
                                                         long-term care. You should have received a
    • General information about long-term care           copy with this booklet. If you didn’t, please call
        insurance                                        (503) 947-7984, or (800) 722-4134 (toll free).
    • A summary of Oregon laws relating to long-
        term care insurance                              Volunteers provide one-on-one help
    • Names and phone numbers of companies
        approved to sell long-term care insurance in     The SHIBA program uses trained volunteers to
        Oregon                                           help Medicare beneficiaries with their health-
                                                         insurance questions. SHIBA volunteers also can
    • A worksheet to help you decide if you need
        long-term care insurance                         help you understand your long-term care insur-
                                                         ance options. For a referral to a volunteer near
    • A glossary of common long-term care insur-         you, call (800) 722-4134 (toll-free in Oregon).
        ance terms




      Oregon law protects insurance consumers
    Policy requirements                                  • Have the same (or less restrictive) eligibility
                                                           standards for home care benefits as for nurs-
    Each long-term care insurance policy sold in           ing home stays.
    Oregon today must do the following:
                                                         • Not require you to go to a hospital before it
    • Provide benefits for custodial nursing care,         pays for long-term care services.
      intermediate nursing care, and skilled             • Not require you to receive a higher level of
      nursing care.                                        care before it pays for a lower level of care.
    • Pay for treatment of Alzheimer’s disease and         For example, some older policies state that
      related dementias diagnosed after the policy         you will not qualify for home-care benefits
      is purchased.                                        unless you have received skilled nursing care
    • Base benefits on an impairment of your               and intermediate care in a nursing facility.
      cognitive ability and ability to perform ac-       • Cover pre-existing conditions after six months.
      tivities of daily living (ADLs), such as eating,
      bathing, walking, toileting, and dressing.
    • Pay for adult foster care, stays at assisted-
      living facilities, and home care, as well as
      nursing home care.




2
  Is long-term care insurance right for you?
Questions before you buy a long-term               Check out agencies and companies
care insurance policy:                             before buying insurance
• How much insurance do you need? Don’t buy        • Is the agent licensed in Oregon?
  more coverage than you need.                       Call our Agent Licensing Unit, (503) 947-
• Do you understand the policy? Don’t buy any        7981, or check the insurance agent search
  policy you don’t understand.                       page on our Web site.
• How do you feel about your adult children        • Is the company authorized to sell long-term
  or other relatives caring for you?                 care insurance in Oregon?
• How do you feel about living with your adult       See Page 4 for a list of companies authorized
  children or other relatives?                       to sell long-term care insurance in Oregon.
• Are your adult children or others available      • Is the company financially strong?
  and willing to care for you?                       Insurer rating services provide information
• How do you feel about receiving Medicaid?          about a company’s financial strength. Find
  (If you are eligible for Medicaid, you don’t       this information at the public library or on
  need to buy a long-term care insurance             the Internet.
  policy.)                                         • How does the company treat its policyholders?
• How much can you afford to pay for long-           The Insurance Division publishes the Con-
  term-care insurance? (Completing the personal      sumer Guide to Oregon Insurance Complaints,
  financial worksheet on Page 5 will help you        which rates insurers based on the number of
  decide if you can afford long-term care            consumer complaints received by the Insur-
  insurance.)                                        ance Division. The booklet also explains how
• Are your adult children or others able and         to find out if a company is financially strong.
  willing to help pay the premiums?                  To request a free copy, call (503) 947-7984, or
                                                     (888) 877-4894 (toll-free in Oregon), or
• Do you have friends or peers you can ask about
                                                     write to:
  their long-term care insurance policies? Other
  consumers can be an excellent resource.
                                                     Publications
• What is your personal and family health            Oregon Insurance Division
  history?
                                                     350 Winter St. NE, Room 440
• Do you prefer to buy insurance through a           Salem, OR 97301-3883
  local agent or directly from an insurance
  company?
• Do you have a friend or relative who can go
  with you when you meet with an insurance
  agent? (Having a third party present may          Visit our Web site for the Consumer Guide to
  discourage use of “scare tactics” by an agent        Oregon Insurance Complaints and other
  and help you remain objective.)                              insurance publicatons:
                                                             www.cbs.state.or.us/ins



                                                                                                       3
      Companies offering long-term care insurance in Oregon
    The following companies have met Oregon Insurance Division requirements to market long-term
    care insurance in Oregon. The Insurance Division does not recommend one company over another.
    This list is subject to change without notice. Some plans are available only to limited groups and
    aren’t included here.

    Aid Association for Lutherans                         Equitable Life and Casualty Insurance Co.
    (800) 225-5225                                        (800) 352-5150
    AIG Life Insurance Co.                                Farmers New World Life Insurance Co.
    (800) 710-9876                                        (206) 236-7752
    Allianz Life Insurance Co. of North America           Federal Home Life Insurance Co.
    (800) 423-5304                                        (800) 876-4582
    Allied Life Insurance Co.                             First Penn-Pacific Life Insurance Co.
    (800) 366-5463                                        (888) 378-7366
    American Family Life Assurance Co.                    Fortis Benefits Insurance Co.
    of Columbus                                           (800) 377-7311
    (800) 992-3522                                        Fortis Insurance Co.
    American Family Mutual Insurance Co.                  (800) 377-7311
    (608)-249-2111                                        General Electric Capital Assurance Co.
    American Fidelity & Liberty Insurance Co.             (800) 456-7766
    (800) 755-2881                                        Great American Life Insurance Co.
    American Travellers Life Insurance Co.                (800) 854-3649
    (800) 441-3978                                        Hartford Life Insurance Co.
    Bankers Life and Casualty Co.                         (800) 243-5433
    (800) 621-3724, ext. 4900                             IdeaLife Insurance Co.
    Bankers United Life Assurance Co.                     (800) 696-1939
    (800) 322-1434                                        IDS Life Insurance Co.
    Catholic Order of Foresters                           (800) 862-7919
    (800) 552-0145                                        John Alden Life Insurance Co.
    Combined Insurance Co. of America                     (888) 503-8104
    (503) 588-9978 or (541) 912-2509                      John Hancock Mutual Life Insurance Co.
    or (916) 568-1133                                     (800) 543-6415
    Continental Casualty Co.                              Life Investors Insurance Co. of America
    (800) 275-4582                                        (800) 338-0257
    Continental General Insurance Co.                     Lincoln Benefit Life Co.
    (800) 545-8905                                        (877) 525-4582
    Country Life Insurance Co.                            Massachusetts Casualty Insurance Co.
    (888) 211-2555                                        (800) 462-9897
    CUNA Mutual Life Insurance Co.                        Medico Life Insurance Co.
    (800) 548-9390                                        (800) 228-6080

4
Metropolitan Life Insurance Co. (AARP)                    Southwestern Life Insurance Co.
(800) 233-5824                                            (800) 792-4368
Monumental Life Insurance Co.                             Standard Life and Accident Insurance Co.
(800) 325-5823                                            (888) 290-1085
Mutual of Omaha Insurance Co.                             (888) 487-7414 (Oregon Director)
(800) 877-1052                                            State Farm Mutual Automobile Insurance Co.
Mutual Protective Insurance Co.                           (970) 395-6006
(800) 228-6080                                            State Life Insurance Co.
National States Insurance Co.                             (818) 867-2224
(800) 868-6788                                            Teachers Insurance & Annuity Association
New York Life Insurance Co.                               (800) 223-1200
(800) 723-5555                                            Transamerica Occidental Life Insurance Co.
Northwestern Long Term Care Insurance Co.                 (800) 227-3740
(414) 271-1444                                            Travelers Insurance Co.
Pacific Life Insurance Co.                                (800) 334-4298
(949) 219-3011                                            Trustmark Life Insurance Co.
PFL Life Insurance Co.                                    (800) 237-7988
(800) 338-0257                                            Union Labor Life Insurance Co.
Physicians Mutual Insurance Co.                           (800) 431-5425
(800) 228-9100                                            United American Insurance Co.
Prudential Insurance Co. of America                       (972) 529-5085
(800) 843-7625                                            Unum Life Insurance Co. of America
Pyramid Life Insurance Co.                                (800) 227-4165
(800) 777-1126


  Long-term care insurance personal worksheet
What is your annual income?                               Could you afford to keep this policy if the com-
u Under $10,000               u $30,000 to $50,000        pany raised your premiums by 25 percent?
u $10,000 to $20,000          u Over $50,000              u Yes        u No       u Don’t know
u $20,000 to $30,000
                                                          Not counting your home, what is the approxi-
It may not be a good idea to buy a policy if the premi-   mate value of all of your assets (savings and
ums will be more than seven percent of your income.       investments)?
How do you expect your income to change over              u $0 to $20,000               u $30,000 to $50,000
the next 10 years?                                        u $20,000 to $30,000          u Over $50,000
u No change u Increase u Decrease                         It may not be a good idea to buy this policy if your
Where will you get the money to pay each year’s           assets are less than $30,000.
premium?                                                  How do you expect your assets to change over
u Income                                                  the next 10 years?
u Savings                                                 u No change u Increase u Decrease
u Other family members will pay

                                                                                                                 5
      Glossary
    Active assistance: The “hands-on” help of                 Attained age policy: Insurance for which premi-
    another person in performing activities of daily          ums will increase as you grow older. Some compa-
    living (ADLs).                                            nies increase the rate annually; some use “age
    Activities of daily living (ADLs): Daily activi-          bands.” For example, premiums may increase every
    ties such as getting out of bed, walking, going to        five years.
    the toilet, bathing, dressing, eating, and taking         Benefit period: The period of time for which
    medications.                                              benefits are payable.
    Acute: A medical condition that begins suddenly           Chronic: A medical condition that lasts for a long
    and doesn’t last very long.                               time or recurs frequently.
    Adult day care: Temporary daytime care provided           Cognitive impairment: Deterioration of intellec-
    for frail and isolated persons who seldom leave           tual capacity as shown by measurable loss in the
    their homes. Day care includes social contact and         areas of memory, orientation, and reasoning.
    health monitoring. This can be a source of respite        Co-insurance: The amount of a covered expense
    care when care providers need a break from pro-           that an individual is required to pay. Also known
    viding 24-hour in-home care.                              as a co-payment.
    Adult foster care facility: A state-licensed facility     Compound: Used to describe inflation protection,
    for five or fewer adults who need assistance with         when the amount of increase in benefits is com-
    bathing, medications, grooming, dressing, eating,         puted based on the current benefit amount (the
    etc. See “Residential care.”                              original amount plus any subsequent increases).
    Age at issue: The age of a person at the time the         Covered expenses: Those medical expenses
    application for insurance is made or on the effec-        that your policy pays for under the terms of your
    tive date of an insurance plan. Premiums based on         contract.
    age at issue will not automatically increase when-
    ever the insured has a birthday.                          Custodial care: Care that assists an individual in
                                                              the activities of daily living (see “ADLs”). This
    Assisted living facility: A state-licensed facility       care can be provided by those without professional
    providing home and community services in a                licenses or extensive training. Oregon does not
    comfortable, homelike environment. Residents              license custodial care facilities, although custodial
    have medical staff available 24 hours a day. They         care is provided in many licensed facilities.
    live in their own apartments with their own
    belongings. Meals are generally served in a central
    dining room.

          About the Oregon Insurance Division
          The mission of the Insurance Division is to protect the insurance-buying public by administering and
          enforcing the Insurance Code. We ensure the financial soundness of insurers, the availability and
          affordability of insurance, and the fair treatment of consumers by doing the following:
          • Serving as an advocate for consumer interests on insurance issues
          • Resolving consumer complaints
          • Investigating and penalizing violations of insurance law
          • Reviewing insurance policies and premium rates for compliance
          • Licensing insurance companies and agents
          • Monitoring insurers for solvency and marketplace conduct
          • Educating the public about insurance issues

6
Deductible: A predetermined amount of money           Intermediate care: This care is less specialized
to be paid by the insured before the insurance        than skilled care and may involve more personal
policy begins to pay.                                 care. It is provided under a doctor’s orders.
Directional assistance: Help by instruction or        Lifetime benefit: The maximum total benefits
reminder help in performing activities of daily       that an insurance policy will pay over the life of
living.                                               the policy.
Effective date: The date the policy begins. This      Long-term care: A range of medical, personal,
date is used to determine when coverage begins for    and social services designed to meet the needs of
eligible expenses.                                    people with disabilities and chronic illnesses.
Elimination period: See “Waiting period.”             Loss ratio: Claims divided by premium. A loss ratio
Endorsement: See “Rider.”                             represents the percentage of premium dollars paid
                                                      out in benefits by an insurer. For example, a loss
Exclusion: Specific conditions or circumstances       ratio of 60 percent means 60 cents of every dollar
for which the policy will not pay. Typical exclu-     in premium has been paid in the form of benefits.
sions include suicide attempts, losses related to     Oregon law requires individual long-term care
alcohol and drug use or abuse, and mental illness.    policies to maintain at least a 60-percent loss ratio.
Grace period: The number of days after your           Maximum benefit: A time limit or dollar amount
premium due date in which it can still be paid        that an insurance policy will pay for covered
without cancellation, usually 31 days.                services in a benefit period.
Guaranteed renewable: A policy that can’t be          Medicaid: The state and federal medical assis-
canceled as you grow older or if your health wors-    tance program for low-income people.
ens, unless you fail to pay your premiums.
                                                      Medicare: The federal health insurance program
Guaranty association: An organization created by      for people 65 and older, people of any age with
Oregon law to protect consumers when an insur-        permanent kidney failure, and certain disabled
ance company becomes insolvent.                       people under 65. There are two parts: hospital
Home health care: Assistance that allows people       insurance (Part A) and medical insurance (Part B).
to stay in the most independent of all long-term      Medicare + Choice: New health-care options
care settings. Advances in medical technology         created by the federal Balanced Budget Act of 1997.
mean that some ill and frail people can receive
skilled medical care at home. Home care includes      Nonforfeiture benefit: A cash value to a long-term
personal hygiene/bathing, housekeeping, skilled       care insurance policy that may be paid if the long-
nursing care, social or emotional support, mobility   term care benefits are not used or if the policy lapses.
and activity assistance, nutrition and feeding,       Nursing facility (nursing home): A state-
assistance with self-administered medication and      licensed facility where care ranges from acute care
other needs, meal preparation, shopping, laundry,     follow-up with skilled nursing care to custodial
dressing, and money management. Home care also        care providing assistance with ADLs and other
may include personal care. That means a certified     nonmedical services.
nurse assistant provides care under a doctor-pre-     Option to buy: An opportunity to buy additional
scribed plan. Personal care services may include      insurance benefits in the future.
bowel and bladder care, first aid, emergency care,
and assistance with feeding, bathing, and dressing.
Indemnity: A fixed dollar amount paid to the
policyholder for a covered service without regard
to the actual cost.


                                                                                                                 7
    Glossary, continued

    Pre-existing condition: A medical condition or         SHIBA: The acronym for the Senior Health
    problem diagnosed, treated, or needing treatment       Insurance Benefits Assistance program. This
    prior to the purchase of an insurance policy. A        program trains volunteers to provide one-on-one
    policy may exclude pre-exising conditions for a        assistance to Medicare beneficiaries who need
    specific period of time, not to exceed six months.     help with Medicare, Medicaid, Medicare supple-
    Premium waiver: An allowance of some insur-            ment, Medicare + Choice, and long-term care
    ance plans that means premiums are not due             insurance.
    while benefits are being paid; when the benefits       Simple: Used to describe inflation protection.
    stop, the insured resumes premium payments.            It means that the increase in benefits will be
    Qualified Medicare Beneficiary Program (QMB):          computed on the original daily benefit.
    A federal Medicaid program that pays Medicare          Skilled care: Care for medical conditions that require
    premiums, deductibles, and co-insurances for           care by skilled medical staff, such as registered nurses
    qualifying low-income beneficiaries eligible for       or professional therapists. It’s ordered by a physician
    Medicare.                                              and delivered under a plan of treatment.
    Rating organization: An independent organiza-          Specified Low Income Medicare Beneficiary
    tion that reviews the financial condition of insur-    (SLMB): A federal Medicaid program that pays a
    ance companies and provides a rating based on its      beneficiary’s Medicare premium. It’s available to
    review. The organization may charge insurance          low-income individuals.
    companies to perform this review and also may          Supervisory assistance: Stand-by help from
    charge consumers who want rating information.          another person when an individual is performing
    Residential care facility: A state-licensed facility   activities of daily living.
    with six or more adults and/or seniors with dis-       Underwriting: A company looks at a person’s
    abilities. Residents receive room and board and        health history and physical condition to decide if
    personal and supportive assistance with bathing,       that person is an acceptable risk. Many companies
    grooming, dressing, eating, socialization, survival    ask health-related questions to help determine an
    skills, transportation, and self-care training.        applicant’s insurability.
    Respite care: Care provided to a patient in a          Usual and customary charge: The fee most
    hospital, other institutional setting or in the        commonly charged by physicians or providers for
    patient’s home for a specified period of time to       a particular service, treatment, or supply. This fee
    provide the regular caregiver a chance to take care    may vary from area to area throughout the state.
    of personal business and relax. People who provide
    full- or part-time care to family members or friends   Waiting period: The amount of time that must
    can be emotionally and physically exhausted.           pass at the beginning of a loss before benefits will
    Respite care provides a needed break to assure that    be paid.
    care will continue to be of high quality.
    Return of premium: An insurance benefit that
    provides a death benefit in the amount of total
    premiums paid minus any claims paid. This ben-
    efit may be subject to limitations.
    Rider: An endorsement attached to a policy to
    increase, decrease, or otherwise change policy
    benefits.

8
  Senior Health Insurance Benefits Assistance Program (SHIBA)
What is SHIBA?                                               What are SHIBA’s services?
SHIBA is a program of the Insurance Division of              SHIBA provides the following services through
the Oregon Department of Consumer & Business                 a statewide network of volunteers and a toll-free
Services. SHIBA can do the following:                        hotline:
• Help Medicare beneficiaries make better                    • Information
  health insurance decisions.                                  Medicare beneficiaries have access to a range
• Provide confidential, uniform, and objective                 of information and materials through
  health insurance assistance to Medicare                      SHIBA’s toll-free hotline. SHIBA staff also
  beneficiaries.                                               conduct seminars for groups interested in
• Support and recognize the efforts of volunteers.             senior health insurance issues.
                                                             • Counseling
Why was SHIBA created?                                         SHIBA volunteers provide one-on-one
Health insurance and the wide array of state and               counseling at community sites or in homes.
federal programs confuse some seniors. Many                    Volunteers help Medicare beneficiaries de-
Oregon seniors have too much or inappropriate                  cide if they’re eligible for benefits, compare
health insurance. Others don’t get all their                   insurance policies, file claims and make
                                                               effective appeals and complaints.
medical claims paid because they’re over-
whelmed by the paperwork. Many Medicare                      • Assistance activities
beneficiaries pay too much out of their own                    SHIBA volunteers also are trained to make
pockets and don’t participate in programs that                 referrals to federal, state and county agencies, and
may help them.                                                 to identify potential insurance law violations.
SHIBA helps Oregon Medicare beneficiaries
                                                             How can I get more information?
avoid these pitfalls and enjoy the benefits to
which they are entitled.                                     Call SHIBA: (503) 947-7984 or
                                                                         (800) 722-4134 (toll-free in Oregon)
SHIBA is funded by the federal Health Care
Financing Administration’s Senior Health
Insurance Assistance Program and the State
of Oregon.


               Be a SHIBA volunteer!
               SHIBA’s success is built on a statewide network of trained volunteers.
               A good SHIBA volunteer candidate:
               • Enjoys helping others
               • Is dependable, understanding, patient, and compassionate
               • Has good communication skills
               • Can protect client confidentiality
               • Has no conflicts of interest
               • Wants to provide SHIBA services
               Interested? Please call SHIBA, (800) 722-4134, and ask for a volunteer application.

                                                                                                                      9
Oregon Insurance Division – 2
350 Winter St. NE, Room 440
Salem, OR 97301-3883




440-2322 (3/00/COM)

				
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