Long Term Care

There is a great misconception by the public that Medicare will pay for long term care expenses.  Medicare does pay for rehabilitative services at home or in a rehab type facility.  At most, that coverage lasts for 100 days and there is a required a 3-day inpatient hospitalization prior to that. At home care is provided and paid for only if it medically necessary and a professional (like a nurse or therapist) makes intermittent visits to the home. 


Paying for long term care services can be expensive in both the nursing home and home care setting.  Like all insurance, you need to qualify and pay for LTCi well in advance of needing it.  Basically, there are three different ways of insuring for this chronic care.

  1. Traditional Long-Term Care policies.  You must medically qualify and pay a regular premium either monthly or yearly.  To qualify for expenses to be paid, you must have documented evidence of not being able to perform at least 2 of the six activities of daily living (ADL).  The six ADLS’s are bathing, continence, dressing, eating, toileting and transferring.  The policy will also cover benefits for someone with a cognitive impairment such as Alzheimer’s who may need standby care.  The benefits can be used in a variety of situations and the policy can have a menu of extra options.  I explain, it is like pre-buying a pot of money.  The cost is relative.  It is based on your health at application, your age and location.  The bigger the pot of money you buy, the more it will cost.  Generally, licensed agencies must provide care.  A family member or friend does not qualify.
  2. Life insurance with a Long-Term Care rider. One of the reasons people do not buy LTCi is because you pay even though you might never need or use it.  This is not any different than other types of insurance.  However, there is a product available that guarantees that there is some benefit paid.  If you do not utilize the long-term care benefits or only part of them, the full or reduced face value of the policy is paid to a beneficiary upon death.  Some policies charge extra for the LTCi rider and others are competitive with life insurance policies without living benefits. Then the cost of the rider comes out when and if it is utilized. 
  3. At home care plans are available to help pay for in-home care only. This is not true insurance; it is a membership with benefits.  The good news is that it is relatively easy to get a plan at any age or health condition.  The only criteria are that you do not need assistance at the time of purchase. The cost is based on the amount of benefits pre-purchased.  You can utilize a contracted certified home health care agency or friend, or neighbor can be used for care.  The following link provides more information.

P Q Wallace Insurance represents many different plans and companies.  It is important to understand your choice, both the good value and the restrictions.

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