Today readers in Rochester had a story of long term care success.  We will elaborate below, and think you'll find this to be a good reason to have long-term care insurance tree.

For eight years since having a stroke, John Ozminkowski of Webster has been able to continue living at home. He gets care from his wife and their children, from home health aides and a social day program he attends.

The key to paying for the hired care has been a long-term care insurance policy the 79-year-old bought nine years ago, says Kathy McDonald of Webster, one of his daughters. "It's been a blessing," she says. The plan covers her father's in-home assistance from Visiting Nurse Service, which costs $20.50 an hour, and full weekdays of activities and support at St. Ann's Home & Heart of Penfield, where the rate is $56 per day.

The plan pays $98 per day.  By todays' standards, this is a small policy, and we generally recommend purchasing more coverage.  However, the fact that Mr. Ozminkowski is able to stay at home is what this story is all about.

Frequently Asked Questions on Long-Term Care

What in the heck is long-term care insurance? A very unique type of polciy, to be sure.  Long-term care insurance is an optional insurance that can pay for services you need down the line and into the future in order to maintain your health and independence.  Some policies will even go so far as to include things such as light housekeeping, home or facility nursing care, personal care, physical therapy and even other health and social services. The insurance gives you control to choose the type and location of care that meets your needs, whether at home, in an assisted-living setting or at a nursing home. In addition, certain states now have a plan called a "partnership" plan.  These are designed to protect part or all of your assets from the Medicaid administrators and are state-sponsored - that is, they are above board..

What's a partnership policy? In 1993, New York State was one of the first states to tackle the issue, and initiated the Partnership for Long Term Care (www.nyspltc.org).  Since then, dozens of states have added partnership plans and we expect more states to add partnership programs in the future.  Residents of states that have the plan are able to purchase a partnership-approved policy and use up its benefit and then realize the benefit of the partnership program.  Once all benefits have been used, which is a rare but possible case, you can apply for Medicaid Extended Coverage for long-term care in the state from providers who accept Medicaid. The advantage is that rather than have to spend down to the poverty line, or whatever Medicaid in your state requires, with a Partnership plan, you get to keep some or all of your assets, depending on your policy. You still contribute from your income to the cost of your care according to Medicaid income rules.  Be sure to ask a long term care specialist (such as the site you're on now, LTCtree.com) before making a decision about partnership programs.

Won't private insurance or Medicare cover such care? Yes and No.  The rules are tricky and complicated, but as a rule, private and Medicare health insurance plans will typically cover short-term rehabilitation care. To elaborate, it generally goes down like this: After an inpatient hospital stay of at least three days (not counting time in an emergency room or observation area), should your doctor make the determination that you need care in a skilled nursing facility, Medicare will cover 20 days in full and the next 80 days with a co-pay ($135 per day in 2008). Some supplemental policies will cover the copayment, so be sure to ask your supplemental provider what they do or do not cover.  But if you need ongoing help with routine activities of daily living, neither private health insurance nor Medicare will pay for it. Medicare can pay for part-time skilled nursing care in your home if you meet certain criteria, including being confined to your home.  It is because of these rules that we often recommend our clients to consider a 90-day elimination, or waiting period on their long term care policy.

Won't Medicaid pay? Rules on Medicaid vary by state.  Here's an example: In New York state in 2008, if only one spouse needs nursing home care, the married couple is allowed to keep a home, a car and assets up to $104,440. A single person who requires such care may keep assets of only $4,350.  Check with your state for current rules on how one could qualify for Medicaid.

What does a nursing home cost? Costs vary greatly from region to region.  Call local nursing providers to get an idea of what you may expect to pay in your area.

What does the insurance cost? This is the thousand dollar question, literally.  The premium you pay for a long term care policy depends on your purchase age, current health (future health has no bearing) and the coverage you choose.  For obvious reasons, the younger you are when you make the decision to purchase long-term care insurance, the lower the premiums will be.

Some example costs of LTC insurance: Ifor someone who is 50, a partnership policy with total asset protection may be about $1,300 per year. If you wait to get the policy until age 65, the yearly cost could be twice as much.  The thing is, there are lots of discounts available, so be sure to ask us about what premium discounts you could qualify for.

Once your policy is written, the premiums will not increase unless your insurance company gets state insurance department permission to raise rates across the board.  Here is where having financially stable companies can hopefully make a difference. Most policies stop charging premiums if you start needing long-term care - this is called waiver of premium.

What age is the right time to consider getting insurance? Opinions vary, and folks of all ages will purchase long term care policies every day.  Some advisors recommend that people between age 50 and 65  look into it.  The main thing is this: Don't wait until you have a medical condition that could make long-term care coverage more expensive or unavailable.  Examples would be cognitive disabilities, physical issues, severe depression, and a host of other issues.  The good news for those who are looking into it now is that an insurer can't terminate the policy if your health declines, as long as you pay the premiums on a timely basis.  Yet another reason to look into this coverage when you are happy and healthy.

Are there incentives to get insurance? You can get a New York state income tax credit of 20 percent of the premiums you pay for a qualified policy. On federal income taxes, long-term care costs and insurance premiums qualify as itemized medical deductions. You can deduct a certain amount of them, based on your age, if your total medical expenses are more than 7.5 percent of your adjusted gross income.

Who sells this insurance? For a list of 19 companies selling policies in New York state, including the five that offer partnership plans, go to www.ins.state.ny.us/acrobat/companie.pdf.