Long-term care insurance is one of those policies--like insurance against fire, flood or being stomped by elephants--you hope you never have to use. If your premiums are "wasted" (because you weren't burned out, swamped or squashed), you are, in fact, a winner.

Most people would rather be healthy and independent than have to pay someone to help them dress, eat, get out of bed or go to the toilet. Right? So long-term care insurance, for all but the filthy rich, is a no-brainer. Right?

The 85-plus group is the fastest-growing segment of the U.S. population, and as the nation ages, long-term care is becoming an increasingly important issue to elderly people and their families.

Politicians know the appeal of long-term care insurance. That's why Congress and the White House want to provide coverage, at group rates, for members of the federal civilian and military family.

The main issue: How many plans and options would be offered in a federal family program. Generally, Republicans favor a variety of choices. Democrats tend to like a one-plan-covers-all approach.

At best, a federal long-term care program (which could be the forerunner of a national program) is probably more than 1 1/2 years away. If a federal program became law today, which it won't, it would be 18 months or more before coverage was offered.

So, if you are interested in long-term care coverage, should you buy it now, on your own, or wait for Uncle Sam? At what age should you buy? Because rates are based on age at time of enrollment, premiums (which aren't supposed to go up) are less the younger you are. But buying coverage younger also means paying premiums longer. What to do?

Frank Scordato, of Silver Spring, is a retired fed. So is his wife. They are "at the age at which the buy-now-or-wait? issue is particularly relevant. . . . Please keep updating us on the status of LTC legislation." At their age, the mid-seventies, a nongroup-rate plan could cost $6,000 a year--depending on daily benefits, when those benefits kick in and the length of coverage (one year, five years, lifetime) under the policy.

Nikki J., who asked that her full name not be used (her husband works for a "sensitive" federal agency), has a different problem. Relative youth.

She is "closing in on age 40" and wants to have the "comfort of knowing" she and her husband are protected should either of them need home care or nursing home care. She could get a policy (again, depending on coverage) for less than $1,000 a year.

Many experts with a serious interest in the debate have one thing in common: They sell insurance or are otherwise associated with the insurance industry. Many companies would would love to get a piece of the pie when Uncle Sam sets up a program and begins collecting premiums (as he does for life and health insurance) for participating insurers. All insurers, naturally, prefer customers who are young and healthy.

Earlier columns have featured experts who recommend purchasing coverage at an early age. They contend that even though people who buy younger will pay premiums longer, they will shell out less over a lifetime (and have coverage) than do people who buy later. Many experts recommend that feds buy coverage now, and if the government plan is better, drop it for Uncle Sam's offering.

But Robert Pearson, chief executive of the CareQuest Work & Family Life Assistance Program, says it is a mistake for almost anyone younger than 60 to buy coverage unless there is a health concern such as a worsening illness or a family history of Alzheimer's disease. Most people younger than 60, he says, need to weigh the cost of coverage against potential need. His organization, based in Madison, Wis., advises companies and individuals on care planning and insurance needs. He recommends buying disability income insurance and investing as much as possible in 401(k) plan contributions instead of paying long-term care premiums.

Pearson says that many long-term care plans are "still evolving" and that premiums and benefits are likely to change dramatically over the next few years. Buying at too young an age, when chances of needing care are low, is "a waste of money" for most people, Pearson says.

At 9 a.m. tomorrow on WUST radio (1120 AM), Pearson will talk about the pros and cons of long-term care insurance and about who--and at what age--should have coverage.

Reinventing Government

At 10 a.m. tomorrow on WUST, John Kamensky, of the National Partnership for Reinventing Government, talks about the effect of upcoming efforts to reinvent, revamp and streamline government on the public in general and federal workers in particular.

Mike Causey's e-mail address is causeym@washpost.com

Friday, July 30, 1999