What does Long Term Care Insurance cover in the policy?

Long Term Care Insurance is a retirement planning tool that pays for the care a person receives for the Home Health, Assisted Living Facilities, Adult Day Care or Nursing Home care.  When care is needed he or she will need help with activities of daily living (eating, bathing, dressing, toileting, transferring, and maintaining continence) due to an accident such as a fall, illness such as Alzheimer’s, or just normative old age. The major Long Term Care Insurance companies are Genworth Financial, John Hancock, Mutual of Omaha, New York Life, Mass Mutual and Transamerica.

It is important to remember that Long Term Care is not limited to the elderly.  Accidents and unexpected illnesses can happen at any time, and fate does not take one’s age into account.  Many people underestimate the risk of needing Long Term Care at an earlier age.  Financial advisers commonly advise their younger clients to consider Long Term Care Insurance.  The benefit is that younger applicants get significantly lower premiums.

What does Long Term Care Insurance cover?If you needed care tomorrow, remember what does Long Term Care Insurance cover and consider the other following important questions:

  • Who would provide your care?
  • Where would you receive it?
  • How would you pay for it?

When buying, it is important to know what does Long Term Care Insurance cover?  Also, once approved and receive your policy, you have 30 days to review it by law to ensure you are comfortable with the contract’s language and the benefits it provides. Listed below are what does Long Term Care Insurance cover:

  • Home health care services: Includes skilled care or custodial care in your home by a licensed home health agency or, with some companies, informal caregivers.  Coverage may include part-time skilled nursing care, physical therapy, and assistance with activities of daily living (custodial care).
  • Nursing home services: Care in a licensed nursing facility.
  • Assisted living services: Care in a licensed assisted living facility at 100% of your daily or monthly maximum.  Some group plans cover only 50% or 75%.
  • Adult day-care services: Care in licensed adult day-care facilities.  This is covered with most Long Term Care Insurance policies.  These programs provide daytime care to individuals who do not need to live in a nursing home. Typical benefits received in adult day care facilities include nursing or therapeutic care, social and educational activities, or personal supervision because of “cognitive impairment,” such as Alzheimer’s or a similar disease.

Other benefits or options a Long Term Care Insurance policy may cover:

  • Respite care: Care provided to give the primary caregivers time off (a vacation).
  • Recovery period benefits: Care after a stay in a hospital or other facility.
  • Home assistance service: Help with chores like cooking, cleaning, light housekeeping, and shopping.
  • Bed Reservation: should you leave for a short period of time, your facility bed can be reserved, and paid for by the insurance company.
  • Return of Premium: If you don’t use your Long Term Care Insurance plan, your estate can get all of your money back upon death.
  • Caregiver Training: Training if there is a particular person whom you would like to take care of you but who needs education.  Family members are often trained with this benefit.

Who pays for the Long Term Care bills?  You do because:

  • Many people mistakenly believe that their health insurance or Medicare will pay for Long Term Care. Currently, this is not the case;  therefore, a Long Term Care Insurance policy might be an option for your financial plan.
  • Health insurance is designed to pay expenses for medical costs such as doctor’s visits, tests, medicines, surgery, or other specific services. Health insurance will not pay the extra cost of Long Term Care.
  • Government programs such as Medicare, at present, are restricted or limited to only twenty days of nursing home care. Medicare, for instance, is designed to provide health insurance for people over age 65 and pays only 4% of Long Term Care costs annually.
  • Medicaid, which is the government welfare program, pays approximately 45% of the total spent on Long Term Care.  Individuals or their families typically carry the burden of Long Term Care expenses.  In fact, consumers and their family members pay 41% of the nation’s Long Term Care costs.  Unfortunately, most individuals will deplete their assets to poverty level before qualifying for Medicaid.

When should I apply for Long Term Care Insurance?

Because you may be denied coverage due to poor health and because rates vary with age, it is beneficial to apply for Long Term Care Insurance while you are young and healthy.  Our average client is 55 years old.

Long Term Care Insurance will help protect you and your family from financial burden and depleting your assets.  Our Long Term Care 101 class will help guide you through the maze of Long Term Care information, and it will help you make the choices that are best for you and your family.