Long Term Care is one of the most overlooked forms of insurance. People buy insurance to protect their vehicles, homes, health, and loved ones financial interests. However, protection of ones personal assets is often neglected. Most people believe they will never need long term care, however one in two people will need some form of long term care at some point in their lives.
One of the biggest misconceptions of Long Term Care insurance is that it protects the insured in the event of being confined to a nursing home. However, very few people in need of long term care actually need nursing home care. Long term care is primarily done in their residence. With the proper Long Term Care policy, home care would be covered.
Many situations could cause a need for long term care, situations such as a stroke, heart attack, disability, cognitive impairment or most prolonged physical illnesses that would prevent someone from performing activities of daily living (ADL). The ADL’s most insurance companies base their benefit payout on are bathing, dressing, continence, eating, toileting, and transferring.
A policy begins paying benefits when the insured is unable to perform a certain number of ADL’s independently. The minimum number is predetermined by the insurance company, usually two or three. So if an individual is unable to perform the minimum number of ADL’s for a specific period of time, typically 90 days, the Long Term Care policy will help to pay for some or all of services to assist the insured in living as he or she does now.
Most Long Term Care policies can include a Home Health Care rider that will pay for care done in the policy holder’s home. Some will even help pay to have a family member or spouse certified to administer the care, as well as pay them the benefits.
Do not feel safe that Medicare will take care of long term care needs. Medicare will pay for the first twenty days in a skilled nursing facility, but the individual will have to share in the cost for the next 80 days. As of 2007, the patient is responsible for $124.00 a day for days 21 thru 100. After day 100, the individual is responsible for 100% of the costs.
Without a Long Term Care policy, some or all of ones assets could be at risk should the need arise. Although Medicaid will pay for some of the long term care costs, few people qualify for Medicaid’s payments. The individual must exhaust all of their own resources before Medicaid will consider taking over payments. After all the personal funds are gone, the individual will have to “spend down” the rest of their assets. Once the individual has exhausted all of the assets and fall below the poverty level, Medicaid will then pick up their share of the payments.
Although Long Term Care insurance is expensive, not having a policy if needed can be very costly. Long term care costs in Pennsylvania can range from $190.00 per day, up to $285.00 per day, depending on the geographic location. That’s $69,350.00 to $104,025.00 per year. Unfortunately, no one can predict their own need for long term care, but if you have assets or savings you want to protect, or preserve them to pass on to loved ones, the costs of the premiums will be worth it.