Given the tremendous changes in Long-Term Care insurance policy design within the last few years (for instance, elimination of prior hospitalization requirements, expansion of available benefits and coverage of additional sites), buyers today are clearly receiving more benefits for their premium dollars. We want to publicly express appreciation to the many companies and their representatives for providing information for this guide.
I. WHAT IS LONG-TERM CARE?
Long-Term Care involves a wide variety of services for people with a long physical illness, a disability, or a cognitive disorder (such as Alzheimer’s Disease). Long-Term Care includes many different services that help people with chronic conditions overcome limitations that keep them from being independent. Long-Term Care helps you maintain a level of functioning, as opposed to improving or correcting a medical condition. Long-Term Care services include, but are not limited to, help with activities of daily living, home health care, respite care, adult day care, nursing home care and assisted living care. If an individual has a physical illness or disability, they will often need hands-on help with their activities of daily living (ADLs). These ADLs are usually referred to as: bathing, continence, dressing, eating, toileting and transferring (see page 11 for further explanations). If someone has a cognitive impairment, they will usually need supervision, protection, or verbal reminders to do their everyday activities. The way Long-Term Care services are provided will continue to change. However, skilled care and personal care are still the terms most often used to describe Long-Term Care and the type or level of care you may need.
II. HOW MUCH DOES LONG-TERM CARE COST?
LTC includes a broad range of health and support services that people need as they age or if they are disabled. The majority of these services are personal care, or assistance with activities of daily living that many families are able to provide all, or some of, free. But, as care and support needs increase, paid care is usually needed to supplement family provided services and supports, provide respite to family caregivers, or to pay for more extensive services in a facility, such as a nursing home or assisted living, when individuals can no longer be cared for in their homes. There are variations in costs based on the type and amount of care you need, the provider you use, and where you live. Home health and home care services, provided in two-to-four-hour blocks of time referred to as “visits,” are generally more expensive in the evening, or on weekends or holidays. Long-Term Care can be expensive.
III. HOW WOULD YOU PAY FOR LONG-TERM CARE SERVICES?
Long-Term Care services are usually paid for by one or more of the following methods:
Individuals and their families pay less than one-third of all nursing home costs out of their own funds. Generally, the money is obtained from savings, investments or by selling their assets, such as land or their home, to help pay for Long-Term Care.
Medicaid pays for more than half of all nursing home care. Medicaid may also pay for some home and community-based services. To qualify, you must meet federal poverty guidelines for income and assets. You may have to “spend down” or use up most of your assets before Medicaid is able to help. Many people begin paying for nursing home care out of their own funds and then spend down their financial resources until they are eligible for Medicaid. Medicaid will then pay part or all of their nursing home expenses.
Medicare will cover the cost of some skilled care in an approved nursing home or in your own home, but only in certain situations. Medicare’s benefit in a skilled nursing facility (SNF) covers up to 100 days of care if you meet Medicare requirements. Medicare’s coverage for home health care is based on set requirements for skilled medical services in your home for the treatment of an illness or injury. Medicare does not pay for personal care (custodial care); however, it will be covered if you’re also getting skilled nursing care or therapy and the care is related to the treatment of your illness or injury. You should not rely on Medicare to pay for your Long-Term Care needs.
Medicare supplement plans help fill the gaps in Medicare’s coverage. These plans do not cover Long-Term Care expenses. However, Medicare supplement plans (D, G, I and J) pay up to $1600 per year for people recovering at home from an illness, injury, or surgery. The benefit will pay for short-term, at-home help with activities of daily living.
Long-Term Care Insurance:
Long-Term Care insurance is designed to help pay for an individual’s long-term care expenses. Depending on the plan you choose, it may pay part or all of your care. This guide will help you decide if you need a Long-Term Care insurance policy to help you pay for your Long-Term Care services. If you decide to purchase one, this guide will provide information to select the one that will best fit your needs.
All information referenced here was obtained from the Arizona Department of Insurance website and documents available online. Please click the image to the right to download the complete Louisiana LTCi Guide.
For further assistance, please contact
Scott A. Olson at 877-727-9582
or email Scott at Scott@LTCShop.com
Louisiana License #: 300484