What Does Long Term Care Insurance Cover?

Long term care insurance is designed to protect you and your loved ones in the event that long term care is needed. Nearly one out of every two persons who are age 65 and older will likely spend some time in a nursing home. The average dollar amount for nursing home expenses per year is $30,000. However, if you live in a major metropolitan area the average costs rises to around $60,000 and in some cases as much as $100,000.

The average stay of a senior in a nursing home is around nineteen months which means those seniors who live in a major metropolitan area would spend $100,000 in long term care in addition to medical expenses and prescriptions. If you have aging parents, or perhaps you are now a senior citizen, long term care insurance may be something you need to consider, because once consumers need the benefits of a long term care policy, they may be physically, emotionally, or mentally disabled and not in a position to assert their rights.

Understanding the jargon of the long term care insurance business and the comparing policies of different companies is essential in order to insure you get the coverage you desire.

IS LONG TERM CARE COVERED UNDER MY HEALTH INSURANCE?

Health insurance and its supplements are not designed for long term care and will not cover nursing home expenses. Medicaid is a welfare program that acts as a safety net for health care but does not address long term care and will not cover long term expenses for the average American. Medicare, although it does allow for skilled nursing care under certain eligibility requirements, also has limited care. Without long term care insurance, families and individuals must tap into their savings, assets and cash to pay the expenses incurred for long term care.

WHAT DOES LONG TERM CARE INSURANCE COVER?

Most long term care insurance policies offer coverage in the following four basic areas.

1. Rehabilitation training at home or in a nursing home
2. Skilled nursing administered either at home or in a long term care facility
3. Daily needs such as eating, bathing, dressing
4. Care of those with a cognitive impairment such as Alzheimer’s

HOW DOES LONG TERM HEALTH CARE INSURANCE WORK?

Like any insurance product, the insured pays a premium for long term health care insurance in order to protect against the high expenses of a health condition that necessitates long term care. When purchasing long term care insurance there are different options that a buyer should be aware of.

Choosing Coverage. Many Long-term Care policies offer an option that allows you to choose whether you want coverage only for nursing home care, or only for home care. Or, you can elect to choose coverage that allows for a combination of care options that includes day care for adults, nursing home, and assisted living. You may also wish to choose another option provided by some long term care policies that allows for a friend or a family member to be paid to care for an individual at home.

Choosing Benefits. The length of the benefit period in which you will receive benefits from your policy is determined by you. You may choose to receive benefits from two to six years, or you may wish to be covered for the rest of your life. Also to be considered is the amount of money an insurance company will pay on a daily or monthly basis. This is important to keep in mind as any care expenses that exceed the designated daily or monthly amount of your benefits will have to be paid out of your own pocket.

Protection against Inflation. Long term care insurance policies offer two main types of inflation protection: automatic coverage increases and the ability to add coverage at a later date to your present policy. As health care costs continue to rise year after year this is a very important feature to consider or you might find out in the future that your policy does not cover a good portion of your expenses.

Waiting Period or Elimination Period. During this period, which could last from zero to a hundred days, all long-term health expenses must be paid by you. However, the longer your waiting period is, the lower generally your premiums will be.

Protection against Insurance Cancellation. Policies that carry a Non-Forfeiture Benefit will continue to pay the expenses for your care even if you stop paying your premiums. Premiums cost could be from 10 percent to 100 percent higher if you choose this feature.

WHAT ARE SOME OTHER IMPORTANT FEAUTRES I SHOULD LOOK FOR IN A LONG TERM CARE POLICY?

- Contains a one time deductible for the life of the policy
- Permits you to choose a policy with less coverage if you cannot afford your current premiums
- Requires NO time spent in the hospital before you are eligible to receive benefits
- Cannot be cancelled as long as you continue to pay your premiums
- Has a feature which includes coverage for dementia

WORDS TO THE WISE

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What You Need to Know About Long Term Care Insurance

Long term care insurance is a type of health insurance designated to provide care for individuals living with a chronic illness or injury. Long term care insurance provides both medical and non-medical assistance to the insured, whether in a care facility such as a group home or a nursing home or living in their own home and in need of help with their daily care. It differs from other types of care that are covered by traditional insurance coverage because it pays for help with custodial care, or assistance with tasks of everyday living that most people can do for themselves.

It is often a difficult task to begin thinking and talking about long term care insurance. We don’t like to think of ourselves as no longer independent and able to care for ourselves. However, just as with car insurance, life insurance and home owner’s insurance, long term care insurance is an extremely important piece of security and protection for you and your family. You may never need long-term care, but when a disabling injury or illness affects your life it often results in long term effects that prevent you from carrying out your activities of daily living such as bathing, dressing, and using the bathroom. This is when it is often necessary to have ongoing help. It can be burdensome or even impossible for family members to provide this level of care on a long term basis. When this is the case, other long term care options may be the most logical choice for your needs.

Is Long Term Care Insurance Expensive?

Depending on the level of care that is needed and the length of time the care is needed, long term care can become extremely expensive. The costs can include supplies and medications, nursing care or direct care help, adaptive equipment, physical therapy equipment, and other needs that are not covered by traditional health insurance. These long term care needs may be a temporary situation, but are generally health care needs that the insured well have for the rest of their lives.

Like all types of insurance, it is possible you may never have a claim against your long term care insurance policy, but if chronic illness or injury leaves you unable to independently care for your activities of daily living. It is expected that this year over 9 million adults in America will need long term health care. That number is expected to rise as high as 12 million by the year 2020. As many as 70 % of elderly adults who need long term care will receive it at home from family or friends. Long term care insurance will cover the costs associated with this type of at home care.

Of adults over the age of 65, there is a 40% chance they will need to consider nursing home care. About 10% of the people who enter a nursing home will wind up staying there for five years or longer. By having long term care insurance, you don’t need to worry about whether your Medicare or primary health insurance will pay for care in the nursing home. Your long-term care insurance will cover these expenses.

What About Medicare?

Many seniors depend upon Medicare to help pay for their health care costs. However, Medicare does not pay for most long-term care. Medicare will pay for medically necessary skilled nursing care whether in facilities or home care, but you must meet eligibility requirements and most other options must be paid for by different means, such as long-term care insurance.

However, not all long term care insurance is the same. Some will pay only for nursing home care, while others will pay for a wide range of services and cares such as informal home care, adult day care centers, assisted living services or facilities, medical equipment and others.

When you are considering different long-term care plans, it can be very helpful to think about the different activities and functions you may need help with. You should consider what future needs you may have, especially any that are based on conditions or situations you are already dealing with. Consider activities of daily living such as bathing, dressing, eating, toileting, and moving in or out of bed, a chair or a wheelchair. Next, think about additional services you might need help with like shopping, preparing meals, housework and laundry, getting to appointments, handling finances and bill paying, using the telephone and home maintenance and repair work. Further, consider whether you will need help with remembering to take your medications, monitoring your diabetes, using eye drops or ear drops, getting oxygen or caring for a colostomy bag or a bladder catheter. These are all areas that a long term health insurance plan can help you pay for.

How Important is Long Term Care Insurance?

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