What LTC Insurance will Cover
Will long-term care insurance pay for assisted living?
Whether long-term care insurance covers the costs of assisted living will vary from one policy and insurance company to another. Most policies sold today are “comprehensive” and provide coverage for assisted living, but those purchased several decades ago when assisted living was still relatively new may not cover such services.
If you are in the market for a long-term care insurance policy and are interested in assisted living, make sure that the policies you are considering are comprehensive or otherwise include assisted living in their coverage. If there are specific assisted living services that you think you will want to make use of, check to see that those are covered as well. In addition to assisted living, comprehensive policies typically include coverage for in-home care, adult day services, hospice care, nursing homes, and specialized facilities for those with Alzheimer’s. It should also be noted that Medicare will not cover assisted living services.
Keep in mind that even if your policy does cover assisted living, there are often requirements that must be met before it will begin to pay out. Most policies require that the enrollee be unable to perform two to three activities of daily life (ADLs) such as bathing and getting dressed without assistance. An evaluation by a doctor and time spent in a hospital and/or nursing home may also be required. Finally, some policies only provide coverage for care in facilities that meet certain specifications. Review your policy carefully to see what sort of requirements will need to be met in order for you to receive coverage for assisted living services.
Does long-term care insurance cover independent living?
Independent living communities are designed as ideal environments for active, healthy seniors who are able to live on their own but want a smaller, more convenient living space. There is a great deal of flexibility in living arrangements in these types of communities, with housing options ranging from homes to condos and apartments. Independent living communities are typically restricted to residents 55 and older and provide certain amenities such as yard maintenance, community activities, golf courses, dining halls, laundry services, healthcare and fitness centers, transportation, and security. While most people living in such communities are healthy and independent, some may hire private caregivers to provide in-home services.
Most independent living communities will not accept long-term care insurance, Medicare, or Medicaid. Personal income is the most common way of funding independent living, and you may also choose to tap into pension payments, annuities, investment retirement accounts, and so on. If you have a long-term care insurance policy and are interested in remaining as independent as possible, you should look into in-home care or an assisted living facility.
Will long-term care insurance pay for in-home care?
While often marketed as something to help cover nursing home costs, many people who purchase long-term care insurance do so with the intention of putting the funds towards in-home care. In-home care, which includes services such as personal care, homemaking, meal preparation, medication reminders, companionship, and assistance with everyday tasks, allows one to live independently and remain in the comfort of his or her home as long as possible. In-home care can be a great solution for those who need a little extra help but not enough to require a nursing home.
Most long-term care insurance policies sold today are “comprehensive” policies, which cover in-home care as well as care received in nursing homes, assisted living facilities, Alzheimer’s facilities, and more. Such policies typically include skilled nursing services and various forms of therapy under the umbrella of home care in addition to the services noted above. However, while most LTC insurance policies cover at least some forms of in-home care, others are “facility-only”, meaning that they will only cover care received in a licensed assisted living or skilled nursing facility and not in an unlicensed facility such as your home. If you are in the market for long-term care insurance and are interested in in-home care, look for an integrated home care policy that offers 100% protection regardless of the setting in which care is received.
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Services Covered by An LTC Insurance Policy