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Understanding Long-Term Care Insurance for Home Care


Our bodies serve us well throughout our lifetimes, yet, the day will come when many of us need assistance for a long period or the rest of our lives. At some point, normal activities such as getting dressed, taking a shower, and eating become too difficult to do without help. 

Senior services such as adult day care, nursing home care, or assisted living care may be needed to keep seniors healthy and safe. Long-term care insurance can help pay for these types of services. Everyone should understand how long-term care policies work. 

Who Needs Long-Term Care Insurance?

According to the Administration on Aging, abo

Family members generally help with long-term care costs, yet about half of people will need some type of financial assistance. Nearly 25% of people will require long-term care for over two years, and around 15% of seniors will be living in nursing homes for two years or longer. 

Some health plans, such as Medicare and Medicare Advantage plans, cover certain services for a short period. Medicaid funds long-term care services for low-income families. Nonetheless, seniors must exhaust most of their savings and assets other than their vehicles and primary homes to get governmental assistance for long-term care. 

How Long-Term Care Helps Pay fo Home Care

You might think about long-term care insurance in much the same way as your home or car insurance. You apply for a policy and pay the premiums. When you need long-term care services, you file a claim and the insurance company pays for them. 

A long-term care insurance policy pays a certain amount daily or monthly up to the maximum listed on the policy for a specified number of years. The policy covers specific amounts for different types of care. The amounts are lower for in-home care and higher for nursing care or assisted living care. 

Considering these issues, nearly everyone needs long-term care insurance. When you need to file a claim, be aware that most policies have a waiting period of 30-90 days before the policy will pay. 

What Does Long-Term Care Insurance Cover?

Traditional long-term care insurance policies will cover most types of illnesses and injuries. However, they also carry exclusions. 

Most policies exclude issues related to treatment for alcoholism, substance abuse, or issues related to war. 

Individuals who have pre-existing health conditions such as heart disease, cancer, or Alzheimer’s may qualify for long-term care insurance. However, the policy may exclude care that’s related to the preexisting condition.  

Long-term care benefits typically apply when an insured individual cannot perform activities of daily living such as toileting, eating, dressing, or bathing. 

After you file a claim for home care services or other senior care services, the premiums are usually waived for the period of time you need care. 

As a note of caution, long-term care benefits are only available as long as you continue paying the premiums. If you stop paying the premiums, the coverage is no longer in force. 

Types of Home Care Services Long-Term Care Insurance Covers

Advancements in healthcare allow people to live longer than in the past. People who live with chronic, long-term illnesses often have difficulty caring for themselves safely and properly. 

As a result, there is a more significant chance individuals will need help with their activities of daily living to continue living safely in their homes. 

Long-term care insurance covers the following types of services:

  • In-home care
  • Assisted home care
  • Nursing home care
  • Memory care

Long-term care insurance is triggered when individuals can no longer bathe or dress themselves, manage their hygiene care, or when they have issues with toileting or incontinence. Services may also be covered when a senior needs assistance due to memory loss. 

Understanding Hybrid Policies

Certain types of life insurance policies and annuities provide coverage for life insurance and long-term care. These policies are considered hybrid policies. 

With this type of policy, the insurance pays either a lump sum or fixed amount that’s spread out over several payments annually. This premium pays for long-term care services similar to traditional long-term care insurance policies. 

The death benefit for policyholders who use their long-term care benefits will be reduced. Depending on the policy, the death benefit to beneficiaries for those who don’t use their long-term care benefits may be increased. 

For most hybrid policies, the premiums will remain the same throughout the life of the policy. 

Getting the Right Timing for Long-Term Care Insurance

As with term or whole life insurance policies, the younger you are when purchasing long-term care insurance, the lower the cost will be. For this reason, the best time to buy a long-term care insurance policy or add a long-term care rider to an insurance policy is earlier in life. 

By purchasing a long-term care policy when you are young, not only will the costs be lower, you will have less difficulty getting an application approved. Health tends to decline as people age and insurance companies consider this in who they approve for long-term care policies and how much they charge. 

Factors to Consider When Purchasing Long-Term Care Insurance

When deciding to purchase long-term care insurance, consider the following factors:

  • Finances
  • Financial goals
  • Available options for long-term care insurance
  • Age and relative health
  • Funding sources

Group long-term care insurance policies are sometimes offered through employers, and they are highly affordable. 

Couples may also purchase a shared care policy that allows them to draw from their partner’s policy if they exhaust their own benefits. 

In certain states, Medicaid programs allow seniors to keep more of their assets such as their homes and cars.

If you or a loved one has long-term care insurance and needs assistance at home, call one of our specialists at Astir Home Health Care to set up an appointment to learn how we can help. Call 201-685-4441 today! 

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