Women's Guide to Health - 40's

This time of your life can be a roller coaster of emotions as you move from the child bearing years toward menopause. This is when you officially start to age. You begin losing bone mass and your metabolism has started to slow down, resulting in a softening of the body shape.Doctor visits should include annual fecal occult tests to check for blood in the stool which is an indication of possible colon cancer. You should also begin annual mammograms. Since bone density can deteriorate as you age, you may want to undergo a bone density test before you start menopause to get a baseline reading.

Menopause may begin or be around the corner. It is like puberty in reverse. You may feel symptoms such as irritability, irregular periods, mood swings and sleep disturbances. Exercise, supplements and talking with your doctor can make this short time in your life more manageable.

Women's Guide to Health - 30's

Women are fertile longer than they were in the past. This means the 30's are the prime time for women to have children. Many of the health concerns and issues revolve around this decision. If you are planning on having a child, check with your OB/GYN and ask about a prescription for folic acid. This supplement has been shown to reduce the risk of some birth defects.

If you've been lax about visiting the dentist, get back into regular checkups and cleanings. Tooth and gum health can affect other areas of the body. By keeping your mouth healthy, you'll keep your whole body healthy.

Women's Guide to Health - 20's

Women in their 20's are at the tail end of adolescence and beginning their adult life. It is never too early to start planning for future good health. During your 20's you need calcium which is essential for bone health and strength. You should get 1000 mg daily, which can come from calcium-rich foods like dairy products and a combination of supplements.

You should get regular gynecological exams, especially if you are sexually active. A Pap test, checks for cervical cancer, and a regular exam are recommended. A doctor can show you how to perform a self breast exam to check for lumps that may be cancerous.

Even though you may be fit, think about reducing the amount of fat and increasing your intake of fruit and vegetables. Whole grains can reduce your risk for heart disease, stroke and cancer. If you don't smoke, don't start now. If you do, quit.

LTC Basics - Other Options

There are a number of other options you may have depending upon which company you are working with. Some of these may be standard on some policies and additional on others.

Restoration of Benefits - This is not usually a very expensive addition. They way it works is if you are eligible for benefits and use some of your pool of money and then get better and are not eligible for benefits for 180 days, then the amount of coverage you used is restored to your pool of money.

Survivorship - For a couple, this could mean free long term care insurance for one of you. If you have both had a policy (same type and same company) for 10 years and you have no claims in those first 10 years, then when one of you passes away, the survivor's policy is paid in full.

Spousal Waiver of Premium - Most policies have a waiver of premium that says when you are receiving benefits, you don't pay your premium. With this option, when your spouse is receiving benefits, you don't pay your premium either. Both premiums are waived when one person is receiving care.

Shared Policy - This varies widely across companies, but basically how it works is that you each have a pool of money to use. If you use all of yours, then you can access your partner's pool of money. This gives you access to more benefits that you would have had on your own. The downside is that you are taking that amount of benefit away from your spouse.

Return of Premium - There are multiple versions of this. The basic one says that if you die and have not used benefits that amount to the premium you paid, you would get the difference back (to your beneficiary). This ensures you never waste your money on the coverage.

LTC Basics - Elimination Period

The easiest way to describe the elimination period is that it is a waiting period or deductible. It is the period of time between when you are eligible for benefits and when benefits are actually paid. It can range from 0, 20, 30, 60, 90, 180 or 365 days. The shorter the elimination period, the more you reduce your risk.

Our recommendation is that you go with the shortest period you can afford. The reason being is that if the cost of care right now is $5000/month, then a 90 day elimination period means that if you are in a nursing home, you will pay $15,000 before benefits start. In 15 years this becomes $30,000 and in 30 years, $60,000. This is a big chunk of money to have to pay out prior to your policy beginning to pay.

The other and more important thing to think about is that the elimination period in most cases is measured as 'days of covered care'. What this means is that if you are at home receiving care and your elimination period is 90 days, it may take longer to satisfy it. Typically you don't get care every single day at home. It may only be 3 days per week. If that's the case, then it will take over 6 months before you've satisfied your elimination period. In our opinion, that's a long time.

Ask your specialist to show you the lower elimination periods if they only show you the 90 day option. You might be surprised at how little the difference is. What we have found is that most agents recommend the 90 day period because Medicare could pay up to 100 days. Medicare's average is less than 20 days they pay. If you're not old enough for Medicare, then your health insurance probably only covers 30 days or less. Make sure you ask the questions of your agent. If they don't know the answers or don't mention things like this, then find a more experienced one.

LTC Basics - Inflation Protection

One of the more important aspects of a long term care policy is inflation protection. What it does is grow your daily or monthly benefit each year so that in the future it will pay for the same things that it does today. It is an option that most people should add.

There are a number of choices you have available to you:

• None - This means your daily benefit does not grow at all. The amount you have today is the same amount you will have in the future.
• GPO - Guaranteed Purchase Option. Your policy does not start with any inflation protection, but you have the option of adding some every 2 to 3 years (depending upon the company). Your premium will increase each time you add to the benefit. This option is good if you are older and live longer than you thought you would.
• Simple or Equal - You benefit will increase each year by 5% of the original amount. For example: if your benefit is $100/day, then it will grow by $5 each year. Your benefit will double about every 20 years. Your premium does not increase just because your benefit is growing. The cost for these increases is built in up front.
• Compound - There are multiple flavors of compound inflation protection. The most common one is 5% lifetime. Your benefit will grow at 5% of the previous year's benefit. For example: if your benefit is $100/day, then it will grow by 5% of $100 the first year and 5% of $105 the second year and 5% of $111 the next year, and so on. Your benefit doubles approximately every 15 years. There are two variations of the compound worth mentioning. The first is 3% compound, meaning your benefit grows at 3% of the previous year's benefit. The other is Two-Times Compound. With this option, your money grows until it has doubled (about 15 years) and then stops growing.

How do you know which one to go with? Work with a long term care specialist. It's really a matter of your current financial situation and affordability of premium. A rule of thumb is that if you think you'll need care in 7 years or less, then get a decent daily benefit and go with None or GPO. If it will be less than 15 years, then simple or equal. If you think it could be 15 or more years then go with compound.

LTC Basics - Benefit Period

The benefit period is the amount of time that benefits will be paid once you begin receiving care. Typically this is stated in a number of days or months. For example, you may have a policy with a 72 month benefit period. This equates to about 6 years of time.

If you don't use your entire daily or monthly benefit (see 4/10's posting), then the benefit period may actually end up being longer than you thought. For example, if you have a monthly benefit of $5000 and you are only using $3000/month, then a 72 month benefit period will actually last 120 months or 10 years. Whatever you don't use of your monthly benefit stays available to you and lengthens your benefit period.

The average person experiences about 4 to 6 years of care. This can be a combination of home care and facility care. Your personal history and family genetics may lead you to need a longer or shorter period of time. What is affordable to you may also determine how much time you purchase.

LTC Basics - Daily or Monthly Benefit

Its been a while since we've looked at what goes into a long term care insurance policy. Here's a refresher on some of those elements.

The daily or monthly benefit is the amount you receive when you are eligible for benefits. The national average is $150-180/day or $4500-5400/month for a nursing home. Depending upon how much of your assets you want to protect, you may want to insure for the full cost of the worst case which is a nursing home.

You may on the other hand decide to insure only a portion of that risk. The key thing to keep in mind is that the difference you are responsible for will increase over time. If you did a benefit of $100/day or $3000/month, in 30 years, you're making up a $200/day or $6000/month difference.

Work with a long term care insurance specialist to make sure you understand the implications of the choices you make. Don't let your children find out in the future that you bought a policy that doesn't pay for what you need it to.

The Gift of Life

April is "National Donate Life Month". This awareness initiative reminds us that over 90,000 people are waiting for the gift of life. It gives us hope that each day, about 74 people receive an organ transplant and may go on to lead normal lives. However, 17 people die each day waiting for transplants that can't take place because of the shortage of donated organs. (http://www.organdoor.gov)

If you make the decision to become a donor, the most important step is telling your family. Most American's support donation, but few understand that their family will be consulted before donation can take place.

Just as much as you want to provide the ultimate gift and donate life, you will also want to provide the gift of your family's financial security. While you talk through your decision with your family, also take a moment to add up your monthly payments for mortgage, cars, retirement savings, insurance, utilities, groceries, credit cards, tuition and other important expenses.

Review your current income and determine if your family would be able to maintain those bills without you and your salary. Keep in mind that a moderate life insurance policy should cover five to eight times your annual income. We encourage you to sit down with your family, discuss these needs and take advantage of the life insurance programs that we offer.

It is recommended that you review your life insurance every 2 to 3 years as your needs change. As they do, so does you life insurance needs.

Earlier, Easier Diagnosis

Near the top of the list of diseases that are tricky to catch early: lung cancer and rheumatoid arthritis (RA). Doctors are working on better screening tools. Tests on the horizon include:

Lung Cancer: Researcher Bojana Turic is developing a test that uses scrapings from the inside of the cheek to detect markers of early lung cancer in smokers and nonsmokers. The test will spot subtle changes in cheek cells, which result form the presence of cancer in the lungs. The ultimate goal would be to have this included in regular physical exams.

Rheumatoid arthritis. In people with RA, the synovium, a thin tissue layer that surrounds the joints and tendons, begins expanding and then erodes bones, causing damage and pain. A new experimental test using noninvasive microscopic MR imaging may detect thickening of the synovium and bone erosions, possible signs of the debilitating condition in its beginning states. Early, aggressive medical treatment can lessen the effects of the disease.

Reader's Digest - Medical Update, March 2006, pg 59.