1. From Origin to Excellence Long Term Care Scope:  Long Term Care.. Why?  What is long term care ?  LTC Cost worldwide  LTC Funding.. How ?  LTC Insurance  LTC in the Middle East / Egypt

2. From Origin to Excellence Long Term Care.. Why? Demographic Changes : "great triumph of civilization”  Due to industrialization prevalence and global development Increase in life expectancy over the past fifty years  Moving from High fertility, high mortality to Low fertility, low mortality Epidemiologic Changes: Changes in the patterns of diseases affecting population due to markedly improved health care and medical services.  Moving from prevalence of infectious rages affecting maternal, fetal and neonates mortality to dominance of chronic diseases which increases with age

3. From Origin to Excellence Demographic Changes : Resulting in:  Tangible decrease of economically active adults in some countries  Marked increase in elderlies with limitation of functional capabilities Where ? Worldwide, but the highest are:  Japan will continue to have the highest old-age dependency ratio in the world in 2020 at 48.8% of its population.  Western Europe in terms of the highest proportion of people aged 65+ for the highest in Finland, Italy and Germany in 2020 at 36.7%, 35.9% and 35.4% respectively  Emerging economies, the highest numbers in the world expected in China and India in 2020. China will have 25.0% of the world total, followed by India 11.6% of the global total

4. From Origin to Excellence What is long term care ? Usually 70 % of the elderly 65 + shall need TC It refers to the continuum of medical and social services designed to support the needs of people living with chronic health problems affecting their ability to perform everyday activities. Most long care is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called Activities of Daily Living (ADLs), such as:  Bathing  Dressing  Using the toilet  Transferring (to or from bed or chair)  Caring for Incontinence  Eating

5. From Origin to Excellence LTC Cost worldwide Americans spent $119 billion on long-term care services for the elderly in 2009. In 2012, The average cost of a nursing home for one year is more than the typical family has saved for retirement in a 401(k) or an IRA. In Canada, assistance in an institution costs around $60,000 per person per year. For Europe average 1.85 % of GDP is spent over LTC This kind of cost providing LTC services may quickly deplete the savings of the individual and/or their family. For all the previously mentioned factors that had changed recently in the societies, insurance has stepped in to provide long term cover for the incidence and need for long term care

6. From Origin to Excellence LTC Funding.. How ? North America:  Canada LTC is not publicly insured under the Canada Health yet, it is governed by the provinces and territories, as per the services providedCanada Health  United States: LTC is typically funded by many sources including but not limited to family members, Medicaid, LTC insurance and Medicare. Europe:  Western European countries have created a mechanism to fund formal care. Western European  Northern and Continental European countries, arrangements exist to at least partially fund informal care as well. NorthernContinental European  Some countries have put in place comprehensive national programs like Netherlands (the Exceptional Medical Expenses Act), Norway & Denmark (municipal payments to informal caregivers) and recently France and PortugalNetherlandsNorwayFrancePortugal  It is mandatory in Germany  Spain, Italy, Poland and Hungary) have not yet established comprehensive national programs SpainItalyPolandHungary

7. From Origin to Excellence LTC Insurance An insurance benefit is paid to or on behalf of the policyholder, the payments are made directly to the insured or to a service provider as long as the service is covered under the policy. Insurance benefits can be made daily, weekly or monthly or a lump sum. LTCLTC insurance offers more flexibility and options than many public assistance programs. Life Insured qualifies for covered benefits with most plans when he / she needs help with activities of daily living or when he / she needs help because you have a severe cognitive impairment.activities of daily living Most policies have an elimination period or waiting period.

8. From Origin to Excellence LTC in the Middle East / Egypt Middle-Eastern culture ensures respect for the elderly and values the natural bonds between family members. Dramatic changes in expectancy in the middle east as well as worldwide "great triumph of civilization” Economic deterioration and increased cost of long term care. The fact that pensions are less than salaries and waged Vs aggravated needs with increased expectancy. The shifting migration patterns:  This has led to the projection that the provision of long-term care will be an important part of health care planning. Governments cannot make major commitments to elderly health funding. The role of private sector is very important providing the needed cover.

9. From Origin to Excellence LTC in the Middle East / Egypt In a closer look on the old age dependency ratio in Egyptian population it was found that Egypt – Dependency Ratios – Old- age dependency ratio (ratio of population aged 65+ per 100 population 15-64) 8.47 (per 100 population 15-64) in 2015

10. From Origin to Excellence LTC in the Middle East / Egypt Looking generally at the Arab world attempts to cover LTC, United Arab Emirates, & Saudi Arabia have some governmental programs for funding being considered a part of health insurance cover without distinguished segregation Minimal official funding sources in other countries This leaves us with realizing the available opportunities in the market with very big expectations for insurance to satisfy those customer social needs with no extra burdens on developing governments