Long Term Care

Long Term Health Care

Medical advances have resulted in an increasing need for nursing home care and assistance with activities of daily living. Traditional health care plans and Medicare severely limit or exclude long-term care. Long-term health care insurance can fill this gap. Here are some questions to ask when considering one of these plans.

What type of care is covered? A policy may cover nursing home care, at-home care with the assistance of visiting nurses and therapists, or both. There may be restrictions on assisted-living facilities that provide less client care than a nursing home. In some cases these facilities are totally excluded. At-home care policies may provide coverage for homemaking assistance such as food preparation and housecleaning.

What will the benefit amount be? Most plans are written to provide a specific dollar benefit per day. The benefit for home care is usually about half the nursing-home benefit. But some policies pay the same for both forms of care. Some pay only the actual charges you incur while others pay the full daily benefit no matter what your expenses are.

What is the benefit period? It is possible to purchase a policy with lifetime benefits but this option can be very expensive. Other options for coverage are from one to six years. The average nursing home stay is about two and one-half years.

Is the benefit adjusted for inflation? If you buy a policy prior to age 60, you face a significant risk that inflation will render a set daily benefit inadequate by the time you need it.

Is there a waiting period before benefits begin? A 20 to 100 day period is not unusual.

What qualifies you for benefits? Some insurers say you must be unable to perform a specific number of these activities of daily living: eating, walking, getting from bed to a chair, dressing, bathing, using a toilet and remaining continent.