Planning for the future eventually requires arranging for the possibility of long-term care. While many Americans prepare for retirement, relatively few plan for nursing home care, yet a significant number of elderly adults live in assisted living facilities and eventually nursing homes. Nursing homes provide around-the-clock care for elderly residents who require skilled nursing and full-time care to meet their basic living needs. Over 1.3 million elderly Americans live in nursing homes—a number that’s expected to grow with the country’s changing demographics.
Isn’t Medicare or Medicaid Coverage Enough for My Long Term Care?
When the time comes for long-term care, many elderly individuals rely on Medicare and Medicaid, which pays for long-term care for those who meet the eligibility requirements, but Medicare does not cover nursing home stays beyond 100 days for temporary care and not all seniors meet the low-income requirement for Medicaid. This leaves some seniors and their families at a loss when determining how to pay for their full-time care. Long-term care insurance protects seniors and their families from facing this transitional time unprepared.
What Is Long-Term Care Insurance?
Long-term care policies are available separately or as an additional health insurance option. This insurance reimburses policyholders for the daily cost of a nursing home or other long-term care facilities such as adult daycare and hospice. Most long-term care insurance providers have a range of options so buyers can choose the policy that best fits their anticipated future needs. The types of policies available for long-term care insurance include:
- Group policies, such as those available through an employer or association
- Federal and state government policies for government employees and active-duty or retired service members
- Individual policies purchased directly from an insurance company
- Long-term care policies provided through a state’s Medicaid program such as The Arizona Long-Term Care System (ALTCS)
Depending on the type of policy, the policyholder may have one of three typical payment structures, either a reimbursement policy which requires the policyholder to pay first and receive monthly reimbursement, a pay-on-benefit structure which pays out a one-time lump sum, or a indemnification policy in which the insurance company pays for ongoing support for as long as it’s needed.
What Does Long-Term Care Insurance for Nursing Homes Cover?
Most long-term care insurance policies provide payment for what’s commonly called “assistance for daily living” (ADL). It covers the cost of residency in a facility, medical attention, medications, daily assistance with hygiene, meals, and daily social or “quality of life” activities for nursing home residents.
How Much Does Long-Term Care Insurance Cost?
There are many options for long-term care with a variety of monthly premiums depending on the benefits. Most insurance companies base monthly premiums on the following:
- The age of the policyholder
- The maximum amount the policy pays per day
- The total number of years the policy will cover (policies typically pay out from one to five years, and others are indefinite, or for as long as the policyholder lives)
- Additional optional benefits added
It’s important to add long-term care insurance while you are still in good health. A Phoenix nursing home abuse lawyer can offer insight into options if inadequate care has impacted a loved one’s health. Individuals who are already in ill health typically don’t qualify or will be required to pay a non-standard (significantly higher) premium for coverage.
Insurance premiums shouldn’t cost more than 10% of an individual’s monthly income. The average cost of a long-term care insurance policy when purchased by a healthy individual under the age of 55 is $125 per month.