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Long-Term Care Insurance – What is it and Why Do You Need It?

Long-term care insurance is designed to assist with a range of services and supports you may need to meet your personal care needs. You might need long-term care to help navigate the family, social, and legal dynamics as you age. Or perhaps you need long-term care to help you stay in your home longer, with in-home care. 

First, and very important to understand, is that most long-term care insurance policies do not include medical services. 

However, most long-term care is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called activities of daily living, such as:

  • Eating
  • Getting dressed/undressed
  • Toileting
  • Bathing
  • Transfers to or from bed or chair
  • Reminders for daily activities

Long-term care insurance may help you pay for a variety of health-related services, especially as you age, and most people buy long-term care insurance so they can receive (or continue to receive) care in their own home. Sometimes, however, the services they counted on their policy providing are not part of the coverage. 

What Long-Term Care Insurance Doesn’t Do

Typically, long-term care insurance is not available for someone with a pre-existing condition. Often there’s an ‘exclusion period’ during which you will not be eligible to use your long-term care insurance. And, while care in the home may be covered under many long-term care insurance policies, not all of them will cover care in the home provided by a member of the family. 

You may be concerned that long-term care insurance won’t cover the care needs you or your loved one has or is anticipating. In some situations, this is true. It’s important to know what’s covered and what you will need to depend on Medicare to cover.

What Long-Term Care Insurance Does:

At this point, you may be wondering just exactly what long-term care does cover.

What may be covered, depending on individual policies, is the cost of a stay in a nursing home or assisted living facility; a visit to adult day care, or in-home care in some situations. 

Depending on the policy, nursing care, physical therapy, occupational therapy, and speech therapy may be offered as covered services, and most policies offer coverage to assist with activities of daily living.

At-home services, like those provided by First Care Home Services, also usually are included within a long-term care insurance policy. Tasks like professional nursing care, OT, PT, and daily living tasks all are non-medical services a homecare agency like First Care can provide for you. Some of these additional  tasks, referred to as the instrumental activities of daily living, include:

  • Cleaning and housework
  • Caring for pets
  • Responding to emergency alerts such as fire alarms
  • Managing money
  • Housekeeping/laundry
  • Shopping and preparing meals

Long-term care insurance also may cover some level of hospice care (usually short-term) for a loved one who is terminally ill. In this situation, beneficiaries are entitled to seek end-of- life care in the home, through a nursing home, or through a hospice facility. While hospice is often not considered eligible under long-term care policies, policyholders may receive the coverage they need through a partnership with Medicare.

Finally, long-term care insurance may help cover the costs of temporary or respite care – even for the family caregiver. This coverage provides time off for the family member who is caring for a loved one on a regular basis. The limit on days of respite care available will vary from policy to policy, but the average compensation for caregivers is 14 to 21 days a year, and the care may be provided in the home, at a nursing facility, or at an adult day care facility.

How Do You Get Started?

According to LongTermCare.org “Most Americans will need some kind of long-term care, and long-term care insurance is the best way to pay for it. In fact, 65-year-olds today have a 70% chance of needing long-term care, and an estimated 20% of Americans will need it for longer than five years.”

Given that prediction, and the fact that pricing for policies increases as you age or become unwell, it  would seem starting as early as you can would be beneficial. 

You may purchase long-term care insurance through a private insurance agent, a financial planner, or a broker, and residents of some states may be able to find long-term care coverage through a State Partnership Program that links special policies provided by private insurance companies with Medicaid.

If it seems overwhelming, talk to your financial advisor or call one of our trained Care Managers who will help you learn more and get started with the services you need. We can help you find the care you need so you can get started right away. To book a free senior care consultation, call us in Miami/Dade 305-945-9025 (Medicare & Medicaid Certified) or in Broward at 954-942-4393 or complete our inquiry form to have someone contact you.

*ACHC License #
Miami Dade County: 29992562 (Medicare & Medicaid Certified)
Broward County: 299994743

Looking for a Caregiver?

First Care Home Services provides skilled nursing, home healthcare, and 24/7 nursing services throughout Miami and Broward Counties. Reach out today! We strive to return calls within 30 minutes so you can get started with the services you need.

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