Long-Term Care Insurance: Know the facts early

Written by: Leanne Flesch

Caring for an ill family member can be emotionally, physically and financially exhausting if your resources are limited and you are not prepared. No one really wants to think about a time when they may need assistance with care. Nonetheless, an estimated 43% of Americans will spend time in a nursing home and studies estimate that 50% of 65-year-olds will likely need nursing home care in the future.

What is Long-Term Care (LTC) insurance?
Long-Term Care (LTC) insurance covers someone with a prolonged physical illness, a disability or a cognitive impairment such as Alzheimer’s Dementia. It can pay for care in a patient’s home, assisted living, board and care and in skilled nursing facilities. Many people believe that Medicare will cover all of their needs should they become seriously ill and require daily assistance. However, Medicare and regular health insurance only pay for a very small percentage of nursing home costs and generally only when you are receiving medical or rehabilitative services. The average cost of nursing home care in California can range from $150 – $200 a day depending on need.

Before you purchase a policy there are many things you ought to consider. First and foremost, can you afford the premium now and in the future? Will you still be able to eat and pay your monthly bills? A big consideration is your financial health. If you own your home outright and have money in the bank, LTC insurance can help you protect it, should you become ill and need care. You should also consider your age, status of your health and any pre-existing conditions that could disqualify you.

What to look for in a LTC insurance policy

• What is the maximum daily and lifetime benefit?
• How long is the elimination period, and is there more than one?
• What services are covered? A good policy will cover nursing homes, assisted living facilities and some home care assistance.
• How is the policy activated and how are you reimbursed, once a claim is approved?
• What is the company’s financial standing and track record?

More information
Becoming informed on the issue is the best thing you can do to protect your future. Talk to more than one agent as well as friends and family about your options. The patient advocates at Health CPA offer low cost health insurance planning and selection.

In addition
The California Department on Aging publishes a booklet on long-term care called “Taking Care of Tomorrow” that provides detailed information on long-term care issues.

The Health Insurance Counseling and Advocacy Program sponsored by the Department of Aging provides free counseling on long-term care insurance.