Differing markedly from traditional health insurance, long-term insurance aims to support an individual of any age for an extended period. Long-term insurance does not cover medical expenses. Rather, long-term care supports seniors in nursing home facilities, in adult day care, and those who receive home health care. People who require continual supervision due to chronic illnesses or disabilities also benefit from long-term insurance coverage. Reimbursements through long-term insurance cover the cost of care.
People in their 50s, for instance, who plan ahead are more likely to be eligible for long-term insurance than those who are in their 70s. Individuals who wait until they require continuous care or who have reached a certain age are less likely to qualify for long-term insurance. Medical underwriting (when qualifiers meet certain medical requirements) is often imposed. Qualifying for benefits means individuals must be unable to independently perform two of the six activities of daily living, which include bathing, dressing, eating and toileting. Insurers require a physician or medical professional to expect the disability to extend for a duration of 90 days or more.
Long-term care drains a family’s financial savings. The expensive cost of in-home care, a nursing home or adult day care is offset by long-term insurance. Benefits from long-term insurance rarely cover the full cost of long-term care; however, long-term insurance covers a portion of care expenses.
Not all long-term insurance policies are identical. Comprehensive coverage is an option, as is partial coverage. Electing partial coverage significantly reduces the monthly premiums, while full coverage skyrockets the insured’s premiums. Policies may also be customized with optional riders that increase the amount or type of coverage.
The long-term insurance policy an individual chooses affects what services are covered. Seniors who prefer to age in the comfort of home may utilize long-term care benefits to pay for the in-home services provided by professionals, such as a home health aide or nurse. Some insurers will also reimburse the costs associated with hiring an informal in-home caregiver.
Long-term insurance benefits are designed to give a senior with a disability or chronic condition the option to receive care at home instead of a nursing home or adult day care. Common in-home services covered by long-term insurance fall into three primary categories:
Personal Care
Help with getting dressed, bathing and grooming are all a part of the activities of daily living (ADL). Toileting and incontinence are also an integral aspect of ADLs. An elderly individual who requires help with personal care may elect to hire an in-home caregiver to provide regular assistance. Personal care may also include the caregiver shifting the senior as he or she rests to increase comfort or lifting the elderly individual in and out of bed. In-home personal care is covered by long-term insurance.
Homemaker Services
Seniors who are reluctant to drive benefit from assistance with transportation. Weekly trips to the grocery store, post office, doctor’s appointments and scheduled physical therapy visits are made possible by professional in-home caregivers. Social visits to friends and family, recreational activities or classes are also included in a caregiver’s list of duties intended to increase the well-being of the care recipient.
Elderly people who are unable to stand for prolonged periods of time may utilize the meal preparation assistance offered by caregivers. Seniors may also receive help with eating meals. In the same vein, aging individuals who are no longer able to physically perform regular household chores benefit from caregivers who, as a part of their regular routine, engage in light housekeeping and cleaning tasks. Homemaker services are covered by long-term insurance.
Professional Services
In-home caregivers may range from nurses to home health aides to therapists. When older individuals recover from a surgery at home, for example, they require the skilled medical assistance of a registered nurse. Changing wound bandages, checking vital signs and administering medication are services only a licensed medical professional can provide. Health services delivered by an in-home caregiver are covered by long-term insurance.
Exclusions
While a variety of in-home care services are covered under long-term insurance, exclusions exist. In general, most policies exclude coverage when drug or alcohol abuse are present, mental disorders are evident, suicide is attempted and self-inflicted injuries are committed.
Long-term insurance policies may also refuse reimbursements for care in the event of common illnesses, such as diabetes, heart disease, certain cancers and Alzheimer’s disease.
Additionally, long-term insurance may refuse benefits for participation in a felony, riot or insurrection.
Ideally, those in their 40s and 50s should start looking into long-term insurance. Starting early gives an individual a better chance of qualifying for long-term insurance. The cost of long-term insurance depends on the age of the individual when purchasing a policy, optional benefits (like increased benefits that parallel with inflation) and the maximum time (in days or years) the policy will cover.
When hiring in-home care makes sense for your family, turn to the most reliable name in senior home care, Assisting Hands Home Care. Our carefully screened team of professional caregivers are licensed, bonded and insured to provide the fullest peace of mind to clients. Care recipients and their families trust in our delivery of expert, reliable care.
Common elder care services offered by the Assisting Hands Home Care caregivers include respite care, Alzheimer’s and dementia care, hospice care etc. Care is flexible and may be requested for a few hours a day; or, live in 24 hour care is also an option.
The Assisting Hands Home Care team discusses the needs of the family and care recipient in order to develop a customized yet flexible care plan. As the care recipient’s condition progresses, updates are made to the plan to ensure current needs are met. Alternatively, a team member may be dispatched to your home to evaluate the specific requirements of the senior.
