Long Term Care FAQs - Allboc Insurance Solutions

A: Long term care refers to assistance with the very basic, activities of daily living (ADL) that the general population can do with no assistance. As a result of illness, injury or advanced age, many people need assistance in order to eat or dress or bathe. The need for long term care may also result because a person has cognitive impairment. Some people need supervision or reminders to accomplish ADLs, such as using the toilet, eating, bathing, dressing, and so forth.

Q: Who pays for Long Term Care?

A: About half of all long term care expense is paid by state Medicaid programs. About one-third is paid out of pocket by individuals and their families. Medicare only provides for some skilled care in some limited situations. Neither Medicare supplemental insurance nor major medical coverage provided by most companies pays for long term care. This leaves approximately one sixth of the total cost to be covered by other government programs and private insurance.

Q: Who should consider purchasing long term care insurance?

A: Anyone who is age 45 or older should consider long term care insurance when planning his or her insurance needs. "Consider" does not necessarily mean "purchase". Depending upon a person's particular insurance budget, there may be other insurance needs that deserve priority. Certainly, the purchase of long term care insurance should never create a financial hardship.

Q: Why should someone 45 years old worry about long term care?

A: It is difficult to know in advance who among us is going to need long term care. Also, it is difficult to predict who will develop a medical condition between the ages 45 and 60 that would preclude the purchase of long term care insurance -- when the potential need for assistance with ADLs is just a few years away. Another consideration is the premium, which is generally lower at younger ages. Early purchase can make long term care coverage affordable later on, particularly after retirement.

Q: Should We Purchase Long Term Care Insurance?

A: Income and assets will decide whether to consider insurance for Long-Term Care as well as how much is appropriate. If you have two-thirds of the cash flow needed to pay for the costs for a worst case scenario nursing care situation, you would only need the other third to be provided by Long-Term Care insurance. If you could produce one third of the costs from income and interest on assets, the other two thirds could come from Long-Term Care insurance.

Q: Does Medicare cover long term care?

A: Medicare will only provide for some skilled care in very limited situations. It was not designed to cover activities of daily living. Rather, it was designed to cover acute care or skilled care such as that provided during a short hospital stay.

Q: Does Medicaid cover long term care?

A: Yes, but in very limited situations. Medicaid will generally apply only to those with very low incomes and very few assets. Even then, there is only limited choice of what and where benefits will be provided. For example, there might be limited choice of physician and facility, no control over the number of people sharing a room, or no ability for the family to pay for any extras.

Q: Does medical insurance cover long term care?

A: Although medical insurance has some aspects of long term care, they are not the same thing. For example, some medical plans may pay for the services of a nurse while you are recovering from an illness or an injury that requires medical attention. This medical benefit is very limited. Once you are better or reach the maximum benefit for nursing services, this benefit would cease to be available. Medical insurance is not designed to cover activities of daily living. Long term care is designed to cover activities of daily living.

Q: I can buy nursing home insurance. Is that the same as a long-term care insurance?

A: Nursing home insurance is generally thought of as the predecessor of long term care insurance. Today it is possible to purchase a long term care insurance policy that only provides benefits when the insured is confined in a nursing home. It’s important to consider, however, if that is where the policyholder would want to be if he or she were well enough to stay at home and receive care.

Q: Why is it important to know how much nursing facilities charge in your area and the type of care you will receive?

A: The daily cost of staying in a nursing facility varies widely from one city to another. Also, the physical setting, ratio of care givers to patients, and the credentials of the staff members may also vary from nursing home to nursing home, even within the same city.

Q: Where can I get long term care insurance?

A: Please contact us.

* Contacting us via any of our phone numbers will connect you with one of our employees and/or agents. Allboc Insurance Solutions is not connected with or endorsed by the United States government or the federal Medicare program.

Long Term Care FAQs - Allboc Insurance Solutions - Allboc