What does long-term care insurance cover?


Long-term care insurance covers the costs of care that aren't provided for by a health insurance plan. A long-term care insurance plan can pay for assisted living, hospice care, therapy, skilled nursing, and daily needs. Long-term care coverage can be purchased as a separate policy or as a rider on a life insurance policy.

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Written by
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UPDATED: 2022-01-06T21:05:23.308Z
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Long Term Care

What You Should Know:

  • Nearly 60% of Americans will need assistance with essential tasks such as dressing and making meals at some point in their lives
  • Most policies begin providing benefits when any two of six activities of daily living, or ADLs, cannot be performed without assistance
  • The American Association for Long-Term Care Insurance recommends that people begin applying in their mid-50

When it comes to personal coverage, nearly everyone knows about the benefits of a quality health insurance or life insurance policy. But how many of us are familiar with long term care insurance?

According to the US Department of Health and Human Services Administration for Community Living, nearly 60% of Americans will need assistance with such essential tasks as dressing and making meals at some point in their lives. Despite such a prevalence in need, long term care expenses are not usually covered by private health insurance policies or Medicare Insurance.

If you’re considering taking out long term care insurance, the first step is understanding what long term care policies might cover. This is your guide to understanding the ins and outs of long term care coverage.

If you'd like to see how much long-term care insurance will cost for you, enter your ZIP code above for free quotes.

Who Can be Covered by Long-Term Care Insurance

You can take out long term care insurance at any time. However, most policies begin providing benefits when any two of six activities of daily living, or ADLs, cannot be performed without assistance. These are needs that are not met by health insurance.

So, what does long-term care insurance cover? Using the guidelines set forth by health professionals, long term care insurance policies typically recognize the six basic ADLs as:

  • Ambulating – To move from one place to another
  • Dressing – To clothe oneself
  • Hygiene – To adequately clean one’s body
  • Feeding – To eat without assistance
  • Toileting – To use the bathroom without assistance
  • Continence – To control bladder and bowel function

When two or more of these ADLs cannot be met for whatever reason, long-term care may be the best option to maintain a person’s quality of life.

Long-Term Care Insurance Provides Care Where You Need It

Now you know when long-term care insurance kicks in, but what kind of care could it provide?

Because aging can present a wide array of unique personal challenges, there’s no such thing as a one-size-fits-all solution to long-term care. While some people might need help with day-to-day life at home, others may require more extensive care at specialized facilities.

So what types of coverage does long-term care insurance provide, and where can you expect to receive the help you need?

At-Home Care

If you find yourself in need of help with the activities of daily living and are still healthy and independent enough to remain at home, long-term care coverage can provide some essential services to support you.

The following are some of the most common types of care an insured individual can receive from the comfort of their own home:

Nursing – Long-term care insurance can provide you with at-home nursing to assist with whatever personal health needs you might require. Having a trained health professional nearby is an invaluable asset and a major comfort to seniors in need of at-home care.

Therapy – If you require occupational, speech, or physical therapy, long-term care insurance can help you pay for a specialist who will work with you from the comfort of your own home. This kind of care could be temporary and intended to help you regain some of your independence. Or it could be ongoing to alleviate physical and cognitive impairment.

Personal Care – At-home care can also be as simple as getting a non-medically trained professional to assist with fulfilling such ADLs as feeding, dressing, and ambulating. Help with such daily activities can be a major boost to your quality of life as you age and begin to lose control of basic functions. However independent you might be, it’s important to take advantage of assistance when you need it most.

Long-Term Care Facilities

Should you find yourself in need of more specialized treatment and assistance, long-term care insurance can be used to get you to the skilled nursing facility you need. Here are some types of long term care facilities typically covered:

Assisted Living – An assisted living residence provides care to people with disabilities and seniors who struggle to fulfill their needs independently. Many residents of assisted living facilities continue to lead active and community-oriented lifestyles.

Nursing Homes – Similar to assisted living facilities, a nursing home provides care to disabled people and seniors but tends to offer more specialized medical care. The range of care can often vary between and within facilities. Still, it is typically designed to assist those whose ability to live independently has been affected by age-related health issues.

Alzheimer’s Care Facilities – These specialized facilities focus on the needs of individuals suffering from any stage of Alzheimer’s disease. Because of the unique cognitive and physical challenges faced by these patients, Alzheimer’s care facilities are designed to ensure comfort and security while providing families peace of mind as to the safety of their loved ones.

Hospice – In the event of a terminal illness, hospice facilities can provide around-the-clock care focusing on pain management and the patient’s emotional and spiritual needs. By alleviating pain and suffering, hospice care can help patients and their families during some of life’s most difficult hours while ensuring dignity and respect.

Depending on the specifics of your long-term care policy, you might take advantage of both at-home and long-term care throughout your lifetime.

The Benefits of Long-Term Care Insurance

Is another insurance policy worth it? Or does it make more sense to tackle challenges as they arise?

People around the globe are living longer on average. In addition, there are now more Americans aged 65 or older than at any other time in history. That makes long-term care insurance more important than ever.

Aging can be difficult both for seniors and their loved ones. But that doesn’t mean you need to shoulder the financial burden of old age alone. A good long-term care policy can provide insurance coverage for at-home care, nursing home care, and assisted living. These benefits can make a huge difference in quality of life and peace of mind as you grow older.

Regardless, many people tend to overlook long-term care insurance as an essential protection for one of life’s most vulnerable stages. To that end, consider the following:

For those of us fortunate enough to lead long and eventful lives, there will likely come a time when we require assistance with our daily activities.

While spouses, children, and other family members could help ensure our wellbeing, there’s always a possibility that our needs will prove too specialized, financially burdensome, or physically taxing to be fulfilled without the attention of trained professionals.

The good news is that you don’t need to wait to get covered. In fact, the American Association for Long-Term Care Insurance recommends that people begin applying in their mid-50s, the point in life when personal health generally begins to decline.

If you’re someone who likes to prepare for the future, a long-term care insurance policy is something you might want to consider.

When should you apply for long-term care coverage?

It’s perhaps unsurprising that long-term care insurance tends to be overlooked by most people. Yet, when we’re young—and if we’re fortunate enough to be healthy—planning for life’s eventual age-related challenges can seem like a problem to be dealt with in the distant future.

However, the fact of the matter is that it’s much better to apply at a younger age and before any health issues present themselves.

According to the American Association for Long-Term Care Insurance:

At 55, an individual might pay around $1,084 per year in order to receive $172,600 in benefits.

Because of rising health care costs, this individual can expect that their plan’s benefit value will increase to $276,000 by age 65.

In comparison, a 65-year old American applying for long-term care insurance for the first time can expect to pay around $3,275 per year to receive a benefit amount of $276,000.

Keeping in mind that these values were determined using actual rates from 2010, it’s important to note that the long-term care cost has already increased to match the rising costs of healthcare over the last decade.

Additionally, age-related health issues can often prevent individuals from successfully applying for the long-term care insurance they need, making it even more important for Americans to apply in their mid-50s.

Long-Term Care Insurance: The Bottom Line

The future can be difficult to envision, but that doesn’t mean you shouldn’t start preparing while you’re able to. If health insurance covers you in your daily life, and if life insurance provides for your loved ones after you’re gone, then why shouldn’t long-term care insurance cover whatever lies in between?

It’s important to consider your options ahead of age-related health issues. Whether you find yourself in need of at-home care or the specialized attention of an assisted living facility, long-term care insurance will be there to ensure your wellbeing and your loved ones’ peace of mind.

If you’re not sure where to start, our free online tool can help you compare long-term care insurance quotes right now for free. Just enter your ZIP code to get started.

References:

  1. https://www.aaltci.org/long-term-care-insurance/learning-center/best-age-to-buy-long-term-care-insurance.php
  2. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-life-expectancy-and-healthy-life-expectancy
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