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In France, there are more than one million dependent people. They will be 1.5 million in 2030 and more than 2 million in 2060. This loss of autonomy entails expenses that income and State aid cannot always cover. Long-term care insurance provides protection against long-term care risk and anticipates its financial consequences.
What is addiction?
Dependency corresponds to the situation of people finding themselves unable to perform acts of daily living on their own, more particularly due to the loss of physical, mental or intellectual autonomy linked to old age (which differentiates dependency disability).
In France, there are six million people over the age of 75 and 86% of them are dependent, ie more than one million people. They will be one and a half million in 2030 and more than two million in 2060.
This dependence, depending on its seriousness, leads to sometimes very heavy expenses (arranging the home, hiring a home help, accommodation in a medical residence, etc.). The income of pensioners and state aid often prove insufficient to cope with it.
Dependency insurance provides protection against the risk of loss of autonomy and anticipates its financial consequences. It consists of covering the costs of personal services, care or even accommodation in a retirement home in the event of dependency, and provides for the payment of a lump sum or a life annuity.
The personalized autonomy allowance
The personalized autonomy allowance (APA) is state aid. This is an allowance intended for people aged 60 or over who are losing their autonomy. Its amount is set according to the degree of dependence and/or loss of autonomy of the elderly person. The amount of the APA is variable according to the resources of the beneficiary and is accompanied by a remaining charge.
This allowance helps finance services to keep the dependent elderly person at home. The APA makes it possible, for example, to finance the work of fitting out the home or even the delivery of meals. As of January 1, 2022, the maximum amounts of aid vary from 705.13 euros per month to 1,807.89 euros per month, depending on the level of resources.
The income of retirees and the APA may prove to be insufficient to meet all the expenses linked to the loss of autonomy. This is why insurers offer individual provident contracts aimed at financing uncovered expenses.
With a provident contract, if the insured becomes dependent, he receives the benefit provided for in the contract, in the form of a monthly annuity or capital. Dependency contracts usually offer additional services (finding a suitable establishment, setting up home help services, offering psychological support, etc.).
In return, the insured pays regular contributions. The amount of the contribution depends in particular on his age at the time of subscription. The later he subscribes, the greater the risk of dependency and the higher the contribution. Insurers generally allow subscription from the age of 40. After age 75, it is generally no longer possible to subscribe. The amount of the contribution also depends on the level of pension chosen and the extent of the cover (total or partial dependence). In addition, additional premiums may be applied depending on the state of health of the insured: the insurer bases this on the information relating to the state of health gathered by the medical advisor (medical questionnaire, medical examination).
If the insured maintains his autonomy until his death, the contributions paid are lost. They do not form part of the estate but are retained by the insurer.
To benefit from the services provided within the framework of long-term care insurance, you must have been recognized as dependent. According to the contracts, the state of dependence can either be determined by the attending physician or by the physician appointed by the insurance company.