Long Term Care Insurance

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Levels of Long Term Care | Do I Need Long Term Care Insurance? | Am I eligible for Long Term Care? | What's Long Term Care? | Benefits of Long Term Care

Levels of Long Term Care

A good long term care insurance plan should cover all of these areas : How does yours match up?

Adult day care:

Facilities that provide personal and skilled care, and recreational services.

Assisted living facilities:

Living quarters that give individualized personal care and health services for residents who need help with personal care.

Facility care services:

Licensed agencies that give skilled nursing care, speech, physical, or occupational therapy, or assistance from health aides.

Nursing facilities:

Residential sites for those who need daily medical care. Many nursing home stays are for a short rehabilitative time period after an acute illness or injury such as a hip fracture.

Make sure you know exactly what types of services and facilities are covered by your long term care policy. If you don't go to the right kind of facility, your insurance company can deny payment for your care.

Do I Need Long Term Care Insurance?

Not quite sure if you should have long term care insurance?

Who should consider purchasing long term care insurance?

You should consider buying long term care insurance if:

You have large assets and income.
You want to protect some of your assets or income.
You want to pay for your own long term care.
You want to stay independent from support of others.

Who should NOT consider purchasing long term care insurance?

You should not buy long term care insurance if:

You can't afford the insurance premiums.
You have limited assets.
Your only income is a Social Security benefit or Supplemental Security Income (SSI).
You often have trouble paying for your basic needs, such as food, medicine, housing, or utilities.

Source:
The National Association of Insurance Commissioners

Am I Eligible for Long Term Care?

Eligibility requirements for long term care will vary by insurance company.

The inability to perform a certain number of "activities of daily living," or ADLs, is the most common way insurance companies decide when you're a candidate for long term care benefits. Usually, a policy pays benefits when you can't do either two or three of them. The most commonly used ADLs are:

Bathing
Continence
Dressing
Eating
Toileting (moving on and off the toilet)
Transferring (getting in and out of bed)

Note: Studies have shown that bathing usually is the first ADL a person can't do, according to the National Association of Insurance Commissioners (NAIC). Qualifying for benefits under a policy that only uses five ADLs may be hard if bathing isn't one of the five.

Source:
The National Association of Insurance Commissioners

What's Long Term Care?

Long-term care is day-to-day care that a patient (usually over age 65) receives in a nursing facility or in his or her residence following an illness or injury, or in old age.

The need for long-term care goes up gradually as an individual ages and needs more assistance with daily living. For a segment of the population, long-term care insurance is a good idea. However, it should not cause financial hardship and force you to put off other financial needs. A long-term care insurance policy is only for people with large assets that they want to preserve for family members or for those who want to assure independence and not burden family members with nursing home bills. One should not buy long-term care insurance if the only source of income is social security, or if paying utilities, food, or Medicare already stretches a budget.

When should I buy a long term care policy?

When purchasing long term care insurance, your age is a main factor in determining its cost. The younger you are when you get the policy, the less money your premiums will be. Of course, you also will be paying those premiums for a longer period of time before taking any benefits.

A rule of thumb in buying long term care insurance is between ages 50 and 55, according to the American Health Care Association (AHCA), a federation of 50 state health organizations representing assisted living, nursing facility, long term care, and subacute care providers.

Benefits of Long Term Care

Comparing long term care policies is difficult because many policies provide different levels of coverage.

Most insurance companies offer to pay a fixed price every day you receive care. Others offer to pay a portion or percentage of the cost of services or a specific amount of money to cover the actual charges for care.

There are no "standard" benefits when it comes to long-term care insurance. So, be sure to always read the fine print on any policy. Generally, nursing home coverage pays for skilled custodial care. Some policies offer to pay for any care required, as long as all eligible requirements are met. Some companies pay for care in your home but only if care is provided by RNs, licensed practical nurses, or licensed rehabilitation therapists. However, most will not pay for home health aides.

Benefits are typically described in terms of the amount the carrier will pay per day for care in a nursing home and varies from $80 - $300. Check around for what nursing homes in your area are charging. Keep in mind, prices will increase by the time you need care.

Long-term care insurance allows you to choose the length of time you want to be covered. It ranges from one year to life. Obviously, the longer your coverage is for, the larger your premium will be.