Get Pennsylvania long-term care insurance quotes, cost & coverage fast. PA LTC insurance helps pay for care for people with chronic illnesses, disabilities or other conditions need on daily, and over time.
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 Pennsylvania 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 PA LTC service providers in various locations according to the needs of the individual. Pennsylvania long-term care insurance can help cover the cost of these services and more.
There are several kinds of Pennsylvania 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 Pennsylvania long-term care insurance policy.
It is worth noting that there are not PA 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.
PA 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.
Following is a list of some of the most common coverages available:
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.
Long-Term Care insurance typically does not cover illness, treatment or medical condition arising out of:
How much does Pennsylvania 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 PA 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.
Request a Pennsylvania Long-Term Care quote in Anaheim, Bakersfield, Chula Vista, Concord, Corona, Elk Grove, Escondido, Fontana, Fremont, Fresno, Fullerton, Garden Grove, Glendale, Hayward, Huntington Beach, Irvine, Lancaster, Long Beach, Los Angeles, Modesto, Moreno Valley, Oakland, Oceanside, Ontario, Orange, Oxnard, Palmdale, Pasadena, Pomona, Rancho Cucamonga, Riverside, Roseville, Sacramento, Salinas, San Bernardino, San Diego, San Francisco, San Jose, Santa Ana, Santa Clara, Santa Clarita, Santa Rosa, Simi Valley, Stockton, Sunnyvale, Thousand Oaks, Torrance, Vallejo, Victorville, Visalia and all other cities in PA.
The PA Dept. of Insurance is the regulatory agency behind the insurance rules for the state of Pennsylvania. If you want to understand these rules, then this is definitely the agency that you need to focus on. Let’s start with limits within the state.
As for regular insurance regulations there are a lot of things that Pennsylvania provides that you can look up. For example, there are deadlines for the insurer to pay the claim or deny it, deadlines for submitting paperwork to prove a loss for insurance reimbursement, specific information your insurance company is required to give you and regulations on what information you have to provide to your insurance company.
One of the Pennsylvania regulations calls for you to be treated by your insurance company in good faith. This means that your insurer must be considered of your needs and must communicate completely and honestly with you about your policy and everything that you need to know about it in order to make a good decision. In turn, you are legally obligated to be honest and cooperative with your insurance company when it comes to your claim.
You should also be aware that your insurance company is required to offer prompt, honest and complete communications. The company and all of its representatives must respond to your communications within 15 calendar days with a complete response based upon the facts that are known.
Finally, be aware that your insurance company is required to have a fair claims process. Unless it is specified in your policy, you do not have to use the forms that are provided to you by your insurance provider in order to make a claim. You can create a list of losses on your own if you need to. In addition, insurers are not able to ask for unreasonable proof of loss. If you provide photographic evidence or video of items that you lost, insurers are not able to ask you to provide additional information.
If you are looking for state specific Pennsylvania Long Term Care Insurance insurance quotes, costs and information:
