Medicare and other traditional health insurance policies offer a wonderful benefit to help cover the cost of acute medical care, including doctor’s office visits, hospitalization, and short term rehabilitation services. Medicare and other traditional health insurances do not cover the cost of long term daily personal care services, however. Some people opt to take out a Long Term Care insurance policy to help with the cost of these services.
Long Term Care insurance policies differ greatly and can be rather confusing. If you choose to take out any form of Long Term Care insurance it will be very important to thoroughly read the policy and understand the benefits it offers.
A few basic things to consider when comparing Long Term Care insurance policies include the following:
How much does the policy cost? Long Term Care insurance policies can be rather expensive. The premiums vary significantly from policy to policy and are based on a number of factors. In order to get a more accurate idea of cost, this author applied for a Long Term Care insurance policy from three separate, reputable companies. The rate quoted in May of 2016 for a healthy 50 year old woman with no medical history ranged from $1600.00 to $1800.00 for a basic plan.
What triggers LTC Insurance benefits to start?
- Activities of Daily Living. The inability to independently take care of oneself, or perform Activities of Daily Living (ADL’s) is the most common way insurance companies determine a client is eligible to begin receiving benefits. This includes needing help with bathing, dressing, toileting, mobility, and other factors.
- Cognitive Impairment. Most LTC insurance policies also pay benefits for clients who are cognitively impaired (i.e. Alzheimer’s Disease). Insurance companies usually use certain tests of cognitive function to determine a client’s eligibility for benefits under this trigger.
When do benefits start? Most LTC insurance policies don’t begin paying for services the day the client enters a nursing home or begins receiving services in the home. Most policies include an Elimination Period. This is a type of deductible. Clients are expected to pay for services out of their own pocket during this Elimination Period. Typical Elimination Periods are 30, 60, or 90 days long.
How much care is covered? Long Term Care insurance policies vary in the amount of care actually covered per day. A Maximum Coverage Limit per Day is reflected as a specific dollar amount defined in each policy. Some common daily maximum limits are $50.00, $100.00, $150.00 or $200.00.
How are benefits paid? Some Long Term Care insurance policies are set up so that the home care agency providing the services is able to bill the insurance carrier directly for services. Other policies are set up in such a way that the client is required to pay for all services in full out of their own pocket, then turn in receipts to the insurance company for reimbursement.
Does the agency need to be Certified or Accredited? Some LTC insurance policies will only pay for home care services when they are provided by a certified or accredited agency. Other policies will allow these services to be provided by private duty home care agencies, offering the client much greater flexibility.
CNA or HHA? Some LTC insurance policies will only pay for home care services when they are provided by a CNA, while other policies will allow these services to be provided by a Home Health Aide, offering the client much greater flexibility.
Can Benefits Run Out? Long Term Care insurance policies typically specify a Maximum Benefit Period. Some common maximum benefit periods are one year, two years, three years, or five years. Some policies offer a lifetime option is, but this is very expensive.
Long Term Care Insurance is becoming increasingly common among Americans, and therefore increasingly common among clients served by Compassionate Care Home Health Services, Inc. We work with many Long Term Care insurance companies, and we have trained staff available throughout much of Michigan. To learn more, or to inquire about our services for in home health Traverse City, MI families trust, email or call us toll-free at 877-308-1212. Visit our Locations page to see all of the Michigan communities we serve.