Long-term care may be necessary at any age. An older adult may gradually find that day-to-day activities are becoming increasingly difficult without assistance. Someone younger may have a stroke, a heart attack, or a disabling accident.
Since health insurance and Medicare are not primarily designed to encompass long-term care services, LTC coverage provides a way for you to pay for these services. This guide offers a general introduction to long-term care insurance and the essential information you need to know about this type of insurance protection.
Most long-term care isn’t medical care, but help with basic personal tasks of daily life. Some services offer assistance with daily activities for individuals with chronic illnesses or cognitive impairments. Others follow a period of rehabilitation for individuals who continue to require aid to perform day-to-day operations.
Many people often think that LTC refers to services offered at nursing homes. However, it encompasses more than that. Most LTC is delivered at home by friends and family (informal care). Some individuals may require more attention than families can provide, and additional resources may be necessary (formal care).
Formal care may be provided by LTC service providers in various locations according to the needs of the individual. Long-term care insurance can help cover the cost of these services and more.
There are several kinds of long-term care insurance policies available. Most are referred to as expense incurred or indemnity policies. An indemnity policy or ‘per diem’ policy pays up to a fixed benefit amount. It does not matter what you spend. In an expense-incurred plan, you select the benefit total as you purchase the policy, and you are reimbursed for the expenses for LTC services. You are afforded a specified dollar amount per month, week or day.
Many insurance companies also sell integrated policies. These are also referred to as insurance plans with pooled benefits. This kind of policy offers a sum dollar amount that can be used for various types of LTC services. There is often a monthly, weekly or daily limit for the covered expenses in the long-term care insurance policy.
It is worth noting that there are not long-term care insurance policies that guarantee full coverage of all expenses. Typically, you will have a choice of daily benefit sums ranging from $50 to over $300 a day for formal care coverage. The daily benefit for informal care will often be less than the benefit for formal care. It is crucial to note that you are liable for your actual home care or nursing home costs that go beyond the daily benefit sum you bought.
Since the per-day benefits you purchase today probably will be insufficient to cover increased costs years from now, the majority of long-term care insurance policies provide adjustments for inflation. For instance, in many plans, the initial benefit amount will increase automatically every year at a specific rate compounded over the policy’s life.
LTC services are offered when an individual is unable to complete specific activities of daily living (ADL). It is also the case when they are cognitively impaired due to Alzheimer’s disease or senile dementia. The most common ADLs that determine service needs are bathing, dressing, toileting, transferring (getting from a seat to the bed), eating and continence.
Long-term care insurance policies cover custodial, intermediate and skilled care in nursing homes that have been licensed by the state. The plans often also include home care such as non-skilled or skilled nursing care, home health assistance and physical therapy. Most policies also include assisted living, alternate care, adult daycare and respite care.
Nursing Home: A facility that provides skilled health care, rehab, personal care and daily activities around the clock.
Assisted Living: An apartment style residence that makes personal care and other helpful services available when needed.
Adult Day Care: An outside the home service that provides health, social and support services in a supervised setting.
Home Care: An agency or person who comes to the home who performs services likes bathing and helps with chores.
Home Modification: Handicap ramps, grab bars, easier to enter baths to make your home more accessible.
Care Coordination: Services provided by a licensed professional who helps with determining needs, locating services and arranging for care.
How much does long-term care insurance cost? The premiums vary depending on the company and their underwriting rules, and it depends on the coverages and deductible selected.
Before buying a LTC insurance policy, remember that all insurance plans are considered legal contracts. Ensure that you read and review the plans under consideration before purchasing. You should understand all the provisions before making a decision. It is advisable to discuss the policies with individual who can offer a professional opinion such as a financial advisor or your physician.
If you are looking for state specific Long Term Care Insurance quotes, costs and information:
