Paying For Care Matters

SCREENING – Step 1

Is the person needing care (or their legal representative) in one of the states in green below?(Required)

The state in which you reside or will receive care is not one of the states that have approved this solution to date.

There is no need to continue any further.

Is the client between the ages of 70 and 95?(Required)

YES

You are outside the normal age-bracket for this solution.

I am sorry we cannot be of service to you.

Are you currently receiving out-of-pocket care, or likely to be in the very near future?(Required)

YES

This solution is only available to folks who are imminently in need of care.

Please return when you are closer to needing long term care services.

ARE YOU LIKELY TO APPLY FOR MEDICAID ASSISTANCE or VETERANS BENEFITS(Required)

YES

This solution is an income-generating product. When you are applying to a means-tested program like Medicaid or Veteran’s benefits, this product would negatively impact your ability to qualify for those programs.

There is no need to continue any further.

SCREENING – Step 2

Please mark all of the concerns that apply:(Required)

Concerned about outliving the assets available to pay for care.

Would like to have a stop-loss (a known max out of pocket) in place for the cost of care.

Would like to leave a financial legacy

Other

Other Concern:

Can you pay out of pocket for Long Term Care for 2 or more years?

YES

Details of Person who needs care:

Name:(Required)

First Last

Age:(Required)

State Where Care will Happen.(Required)

Type of Care you are planning on:(Required)

Primary Contact Person

Name:(Required)

First Last

Email(Required)

(please give an email you check – giving a junk email does not help you solve this quickly)

Phone(Required)

State of Residence.(Required)

Is there a Durable Power of Attorney, Guardianship, or Conservatorship in place?

YES

Any other info you would like to share ?

Need an Income Stream for Life?

We are committed to helping families.

This solution creates an income stream for life to help pay for long term care. It may not be right for everyone. By answering and few questions, you can know if it is worth exploring further.

ANSWER QUESTIONS BELOW

SCREENING – Step 1

The state in which you reside or will receive care is not one of the states that have approved this solution to date.

There is no need to continue any further.

You are outside the normal age-bracket for this solution.

I am sorry we cannot be of service to you.

This solution is only available to folks who are imminently in need of care.

Please return when you are closer to needing long term care services.

This solution is an income-generating product. When you are applying to a means-tested program like Medicaid or Veteran’s benefits, this product would negatively impact your ability to qualify for those programs.

There is no need to continue any further.

SCREENING – Step 2

Details of Person who needs care:

Primary Contact Person