2024-01-01 · personal, care

Long-Term Care Coverage

Overview

Long-term care insurance helps pay for ongoing assistance with daily activities, such as bathing, dressing, or eating, when a chronic illness or disability limits independence. Coverage can apply to in-home care, assisted living, or nursing facilities depending on the policy.

What long-term care insurance typically covers

• In-home care: home health aides, homemaker services, and adult day care.
• Assisted living facilities: room, board, and personal care services.
• Skilled nursing care: higher-level medical and custodial care.
• Care coordination: assessments and care plan management.

Common exclusions and limitations

• Pre-existing conditions: many policies require a stable health period before coverage applies.
• Short-term recovery care: rehabilitation after surgery may fall under health insurance instead.
• Benefit triggers: coverage often starts only after a doctor certifies inability to perform activities of daily living.
• Elimination period: a waiting period (often 30–90 days) before benefits begin.

Key cost factors

• Age at purchase: younger applicants generally pay lower premiums.
• Daily or monthly benefit amount: higher benefit levels cost more.
• Benefit period: longer coverage durations increase premiums.
• Inflation riders: protect purchasing power but raise costs.

How to compare policies

1. Review benefit triggers: confirm the ADLs and cognitive impairment definitions.
2. Compare elimination periods: shorter waits mean higher premiums.
3. Check care settings covered: ensure in-home care and assisted living are included.
4. Evaluate inflation protection: consider 3–5% compound options.

Tips for choosing coverage

• Buy before health changes make you ineligible or increase rates.
• Estimate local care costs to select realistic benefit levels.
• Consider shared-care or hybrid life/LTC policies if you want flexibility.

Frequently asked questions

Does Medicare pay for long-term care? Medicare only covers limited skilled care after a qualifying hospital stay and does not cover extended custodial care.

Can premiums increase? Yes, insurers can request rate increases for a group of policyholders with state approval.

Is at-home care covered? Most modern policies cover in-home services, but verify limits and provider requirements.