According to the US Department of Health and Human Services, 70 percent of those age 65 and older will need some form of long-term care, which is not covered by regular health insurance. Long-term care insurance policies pay a daily amount for a certain predetermined period of time, which can be anywhere from two to six years or for the rest of your life.
Eligibility for Long-Term Care Insurance
Many insurance companies have the right to deny your application for long-term care insurance if you answer yes to any of the following:
- Currently using long-term care services
- You already need help with one or more of the six basic activities of daily living (ADLs); eating, bathing, dressing, toileting, transfer, and continence
- Have AIDS or an AIDS-related complex
- Have Alzheimer’s disease, a form of dementia, or other cognitive dysfunction
- Have a progressive neurological disease, such as multiple sclerosis or Parkinson’s disease
- Had a seizure in the last 1-2 years or have a history of seizures.
- You have a form of cancer that has spread beyond its original site
The Cost of Long-Term Care Insurance Long-term
care insurance can be purchased from an insurance company or through an agent, and some employers offer coverage that can be purchased from the company’s insurance provider for a fee of cluster.
The cost of long-term care policies are based on a few key factors:
- Age – Coverage costs less the younger you are when you buy the policy.
- Gender – Women generally pay more because they typically live longer and are more likely to make a long-term care insurance claim.
- Marital Status – Premiums are lower for a couple than for single people.
- Daily Subsidy – The maximum dollar amount a policy will pay per day.
- Policy Term – The maximum number of days or years that a policy will pay.
Keep in mind that premium costs can go up after you buy a policy. Prices are not guaranteed.
Because the benefits of long-term care insurance policies vary, it’s worth comparing policies to find the policy that best meets your needs and budget. You can find out which insurance companies offer long-term care coverage in your state by contacting your state Department of Insurance .
Receiving Long-Term Care Benefits
Having a long-term care insurance policy means being prepared to receive help with personal care needs that can occur with aging, but some services may not be covered. Just as you have to qualify to buy long-term care insurance, you also have to qualify to receive your policy payments.
Eligibility to Receive Long-Term Care Benefits
Eligibility to receive long-term care benefits is a two-phase process:
- Benefit Criteria – An insurance company will evaluate your physical condition and health to determine if you need to receive benefits. With most policies you qualify for benefits if you need help with one or more of the six ADLs, or at the onset of cognitive decline.
- Elimination Period – If the criteria is confirmed and you have received a Plan of Care approved by your insurance company, you will have to wait 30, 60 or 90 days before you start receiving payments for long-term care services. The elimination period is also a factor in determining the cost of your long-term care insurance. A longer period will cost you less than a shorter period.
