Services Covered by an LTC Insurance Policy
No matter who you are, it's likely that you will need some form of care or assistance later in life, and buying long term care insurance can help you prepare for when that time comes. The exact type of long term care that a given person will need varies depending on what kind of condition they have and their own personal circumstances, such as whether they have friends or relatives who will can help provide care. In some cases, you may be able to predict ahead of time what kind of conditions will develop and the care that will be needed – for example, you may know that Alzheimer’s is prevalent in your family. In other cases, though, it is difficult to know the exact type and amount of care that will be needed. Either way, it is always good to keep one’s options as open as possible.
How does LTC insurance differ from Medicare or Medicaid?
As discussed in our introductory article on long term care insurance, Medicare can cover nursing home stays or even in-home care, but this coverage is highly limited in both scope and duration. Medicaid, a welfare program that provides medically necessary services for people with limited incomes, can also help with long term care. However, like Medicare, the care available through this is very basic and limited, and one must meet specific financial requirements to qualify for it.
When planning for their future care needs, many people choose to buy a long term care insurance policy. Unlike Medicare or Medicaid, these policies can come with a wide variety of coverage options. Below is a list of care arrangements that a long term care insurance policy may cover. How many of these are available on your specific plan will vary depending on how much coverage you buy and the specifics of the plan itself. Of course, plans offering more coverage and a wider variety of services will cost more than plans that are more limited, so you will need to carefully consider what kind of care you want and how this will play into your budget.
What types of services can LTC insurance policy cover?
- Nursing homes: these facilities provide daily activities and a full range of skilled health, rehabilitation, and personal care services that are available 24/7. Note: if you are interested in nursing home-based care, look into whether the policy you are considering covers more than just room and board.
- Assisted living residences: these facilities have apartment-style units. Services such as personal care and meal delivery are close at hand and available as needed.
- Adult day care services: these programs take place outside the home and provide attendees with health and support services. They also provide valuable opportunities for socialization in a supervised setting.
- Home care: this can take many forms, but as the name suggests, this is care given in the individual’s own home. Home care may be provided by an individual or agency. Home care coverage helps pay for a visiting or live-in caregiver, companion, housekeeper, therapist, or a private duty nurse. These professionals offer help with daily activities that those in need of long term care may be unable to do on their own, such as bathing, grooming, and helping with chores and other tasks around the house. These caregivers may stop by only a few days a week, or they can be available 24/7.
- Certain home modifications: this includes things such as installing ramps for easy access or grab-bars to help give an individual support and ease of movement.
- Hospice care, specialized facilities (such as those for people with Alzheimer’s) and more
- Care coordination: these are services provided by a trained or licensed professional. This person will help determine their client’s needs, locate services to help fill those needs, and arrange for care as necessary.
- Future services: this is a type of option seen in some long term care policies. This will allow the policy to adapt and extend coverage to new forms of care services as they are developed. If this is something that interests you, check whether the policy you are interested in offers a “future service” option.
If you have the funds and want to make sure that you are prepared for any eventuality, you may want to opt for a plan with flexible options. As stated earlier, in many cases it can be difficult to predict the occurrence and progression of conditions that will require long term care, and a plan like this will allow you to adapt to unforeseen developments and ensure that you receive the kind of care you need. Plans with flexible coverage will cost more than those with more rigid terms, but it is a valuable option that is worth considering if your budget will allow it.
Why is this important?
A recent survey by Consumer Reports showed that many long term care insurance policyholders don’t know what benefits their policies offer aside from covering the most basic kinds of care. When deciding on a policy, pay attention to what is covered and what is not – after all, no one wants to pay for services that they never use, much less for services that they don’t even know are available!
More Useful Links:
The Cost of Long Term Care Insurance