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Long-Term Care Insurance, also known as LTCI, provides coverage for custodial care services that are not typically covered by Medicare or private health insurance. Allowing more control and comfort, knowing a person can age with dignity to live their life to the fullest.
To go on claim, one must have difficulty performing two of the six activities of daily living (see ADLs below), or, have a diagnosed cognitive impairment.
The Activities of Daily Living (ADLs) include: getting out of bed or a chair, walking, showering/bathing, continence, dressing, and eating. We describe this as the activities you would do within the first few hours of waking up.
If a person cannot safely perform two of these six ADLs and the problem is expected to last at least 90 days, they will receive benefits if they have a long-term care policy. At the same time, a person could have no problems with their ADLS, but have cognitive decline. If that decline translates to moderate to severe dementia or cognitive decline, they will be approved to receive benefits.
No, except for the lifetime benefit of 100 days of skilled nursing only after a person has spent three nights in the hospital. Medicare does not cover the care that a person will need at home after they’ve had a stroke, broken a hip, or their arthritis makes it difficult to do the activities of daily living.
Most long-term care benefits are received tax-free and in certain cases the premiums can be partially or fully deductible. Even if you can afford to pay for years of care, there’s likely a better way to finance your care as opposed to liquidating a taxable asset or having to liquidate when the timing is suboptimal. Please check out this Cost of Care Calculator: https://www.carescout.com/cost-of-care.
Aside from financial reasons, your loved ones will appreciate the support and guidance they get from the Care Coordination for services.
No. Those with a policy can go on and off claim as many times as needed, as long as they meet the criteria to be on claim. Additionally, some states offer short-term care insurance policies. Please reach out to us if this is something you’re considering.
Yes. It is possible to find certain plans to cover services at home or a facility, but most plans cover both.
Probably not. Premiums are more expensive the older we are, but there’s a saying: Money buys long-term care insurance, and health pays for it. Recently, we’ve had 2 unrelated women, age 78, purchase long-term care insurance. Even once a person is 80, they can still qualify for an annuity with LTC benefits, and certain states offer short-term care plans.
It’s best to speak with us directly. You are likely not eligible while a PT treats you, but we can help determine when it’s okay to apply.
Like most insurance, there is no benefit or refund if you don’t use it. However, long-term care insurance has some options. Many plans offer a return of premium option. You pay for this option, but you can be assured that your money will be returned to your estate. Many Hybrid plans have life insurance. For example, if a client dies before $ 100,000 is paid out, their estate will receive up to $ 100,000, and so on.
No, anyone can have a long-term care event at any time. Approximately 40% of all long-term care claims involve individuals under the age of 65.
In most cases, yes. Most plans are federally regulated and tax-qualified. With that in mind, benefits for those plans are received tax-free.
Creating a Plan of Care involves assessing your current needs, estimating future needs, and considering your long-term care goals along with your family’s goals. Find our helpful Plan of Care tool here.
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