Frequently Asked Long Term Care Policy Questions
Q: What is long-term care?
A: Under age 65 the chance of requiring
long-term care is approximately 1 in 4. For those 65 and older the
percentage increases to 50 percent. In any specific case it is difficult to
predict who will need long-term care, but studies point out the likelihood
of needing such care. Women outnumber men in nursing homes according to this
specific study. Thirteen percent of the women as compared to 4% of the men
were projected to spend five or more years in a nursing home. And obviously
the risk of needing nursing home care increases with age.
Q: How is long-term care paid for?
A: The answer is simple: it comes from your cash and your
assets, your family's assets and, for those without assets, it is paid by
Medicaid programs administered by state government. More than half of
nursing home bills are paid out-of-pocket by individuals and their families,
and somewhat less than half are paid by state Medicaid programs. Insurance,
and that includes Medicare, Medicare supplemental coverage and health
insurance provided by employers, does not pay for most long-term care
expenses.
Only in certain cases will Medicare cover the cost of some skilled nursing
care in approved nursing homes or in your home, but there is no coverage for
custodial or intermediate care or prolonged home health care.
Q: How long is the average stay in a
nursing home?
A: The average stay is 2.6 years.
Q: Is long-term care insurance for
everyone?
A: Long-term care insurance is not for everyone. For a
limited population, a long-term care policy makes sense as an affordable and
worthwhile form of insurance. Buying long-term coverage should not cause
financial hardship and force you to forego other financial needs.
Long-term care policies are for people with significant assets they want to preserve for family members, to assure independence and not burden family members with nursing home bills. If you have existing health problems that will result in the need for long-term care, such as Alzheimer's or Parkinson's disease, no company will sell you a policy.
Q: How much does long-term care
cost?
A: Nationally the cost of nursing home care is $55,000 per
year and more in major cities.
Q: What are my chances of needing
long-term care?
A: Under age 65 the chance of requiring long-term care is
approximately 1 in 4. For those 65 and older the percentage increases to 50
percent. In any specific case it is difficult to predict who will need
long-term care, but studies point out the likelihood of needing such care.
Women outnumber men in nursing homes according to this specific study.
Thirteen percent of the women as compared to 4% of the men were projected to
spend five or more years in a nursing home. And obviously the risk of
needing nursing home care increases with age.
Q: What benefits should I get from a
long-term care insurance policy?
A: It's best to look for a policy that provides for a
range of services, including home care services, since the nature and extent
of the care to be required in the future is at best a guess. Benefits are
usually described in terms of the amount the carrier will pay per day for
care in a nursing home. Gain familiarity with the general charges for
nursing homes in your area before you buy a policy. Keep in mind that prices
will increase by the time you will need care, so all you are obtaining is a
reference level to familiarize yourself with the market.
All policies allow you to specify how long you desire benefits to last.
Benefit periods range from one year to life.
Most policies do not pay benefits until after a waiting period, commonly
called an elimination period. That means benefits begin 20, 30, 60, 90 or
100 days after you are admitted to a nursing home. Some policies have no
elimination period and they naturally cost more.
Q: Who determines if you are
entitled to benefits?
A: All policies have "gatekeepers" who have the power to
decide if you are eligible for benefits. One rule limiting your right to
benefits requires that you be unable to perform a certain number of
"activities of daily living," commonly referred to as ADLs. These normally
include bathing, dressing, walking, moving from bed to chair, toilet,
maintaining continence, and eating. Diminished mental functions are also a
means to qualify for benefits.
Insurance companies do not sell policies without first determining your
insurability. This is called "underwriting" and it means the company
evaluates your health before it will sell you a policy.
Go back to the Long Term Care Coverage homepage.
Get a no-obligation Long Term Care Insurance quote by clicking here.