Women Will See Long-Term Care Rates Increased by
Women's premiums may increase by 20 to 40 percent
under the new pricing policy: they live longer than men
Michelle Andrews, KHN, Insuring Your Health
27, 2013 - Starting next year, the Affordable Care Act
will largely prohibit insurers
who sell individual and small-group health policies from charging women
higher premiums than men for the same coverage.
Long-term-care insurance, however, isn't bound by
that law, and the country's largest provider of such coverage has
announced it will begin setting its prices based on sex this spring.
"Gender pricing is good for insurance companies,"
said Bonnie Burns, a policy specialist at California Health Advocates, a
Medicare advocacy and education organization, "but it’s bad public
policy and it's bad for women."
Financial says the new pricing reflects the fact that women receive two
of every three claims dollars. The change will affect only women who buy
new individual policies, or about 10 percent of all purchasers,
according to the company. The new rates won't be applied to existing
policyholders or those who apply as a couple with their husbands.
"This change is being made now to reflect our
actual claims experience and help stabilize pricing," Genworth Financial
spokeman Thomas Topinka said in an e-mail.
10, 2012 - Editor’s Note: Too often baby
boomers and senior citizens ignore the Medicaid program, assuming they
will never need that medical assistance for the poorest. It also happens
too often that many who thought that find they do, as medical, housing
and long-term care expenses devour their nest egg. Medicaid becomes the
last resort for survival. It has become a real focus of controversy as
federal and state governments struggle to fund it. This report focuses
on possible solutions for those seniors who qualify for Medicare and
Medicaid – the “dual-eligibles,” they are called - as well a younger
patients who cannot afford care.
Read more, see
Women's premiums may increase by 20 to 40 percent
under the new pricing policy, said Jesse Slome, executive director of
American Association for Long-Term
Care Insurance. The average annual premium for a 55-year-old
who qualified for preferred health discounts and bought between $165,000
and $200,000 of coverage was $1,720 last year, according to the
Experts say they expect other long-term-care
insurers will soon follow suit.
Long-term-care insurance provides
protection for people who need help with basic daily tasks
such as bathing and dressing. It typically pays a set amount for a
certain number of years -- say, $150 daily for three years -- for care
provided in a nursing home, assisted living facility or at home. Never a
very popular product with consumers, many of whom found it unaffordable,
in recent years the
industry has struggled
and many carriers have raised premiums by double digits or left the
Consumer health advocates say they aren't surprised
that women's claims for long-term-care insurance are higher than men's.
Because women typically live longer than men, they
frequently act as caregivers when their husbands need long-term care,
advocates say, thus reducing the need for nursing help that insurance
might otherwise pay for. Once a woman needs care, however, there may be
no one left to provide it.
"Women live longer alone than men," Burns said. "If
you don't have a live-in caregiver when you start needing this kind of
care, you’re in big trouble."
LuMarie Polivka-West knows the potential problems
all too well. Polivka-West, 64, is the senior director of policy and
program development for the Florida Health Care Association, a trade
organization for nursing homes and assisted living facilities. (I first
spoke with Polivka-West two years ago, when she
discussed the financial challenges
she and her two brothers faced caring for their aging parents.)
About 15 years ago, she bought a long-term-care
policy. The company went out of business after five years, and she let
her policy lapse rather than switch to another plan with higher premiums
and less comprehensive coverage. But she's reconsidering that decision.
Polivka-West's husband is four years older than she is. Her mother died
of Alzheimer's disease at age 89 after struggling with it for eight
years. What if a similar fate awaits her?
Polivka-West thinks insurers shouldn't be allowed
to charge her more just because she's a woman.
"The Affordable Care Act recognized the gender bias
in health insurance," she said. "The same [rules] should apply to
The federal health overhaul sought to eliminate the
coverage and price discrepancies in the larger health insurance market.
2012 study by the National Women's
Law Center found that 92 percent of top-selling health plans
in the individual market practiced sex-based pricing in states where the
practice was allowed. (Fourteen states banned or limited the practice,
according to the report.) Nearly a third of plans charged women at least
30 percent more than men for the same coverage, even plans that did not
include maternity benefits, the study found.
Insurers that sell individual and small-group
health policies on the state-based health insurance exchanges or outside
them on the private market in 2014
will be able to vary premiums
based only on geography, family size, age and tobacco use. (Plans that
have grandfathered status under the law are exempt from these
Under federal laws against sex discrimination in
employers are generally prohibited
from charging women more than men for the same health insurance
Meanwhile, Genworth Financial says it won't switch
to gender-based pricing for long-term care in two states—Colorado and
Montana--that prohibit varying premiums based on gender in
all health insurance products.
As states move to bring their laws into conformance
with the gender rating requirements under the Affordable Care Act, some
advocates see an opportunity.
"Any state with a strong advocacy group could be
advocating for a very broad-based prohibition against gender rating" in
all insurance products, says Donna Wagner, the associate dean for
academic affairs at the College of Health and Social Services at New
Mexico State University who also chairs the policy committee for the
Older Women’s League, an advocacy group.