By Sylvana Rinehart

In my first article about Long-term Care Insurance (LTCI), I mentioned that my husband and I purchased it at a younger age. I briefly covered the when, why and affordability of getting long-term care insurance.

Now I would like to address what to look for in LTCI. As previously mentioned, the best source of advice is a reputable insurance broker specializing in long-term care insurance to help you navigate through the intricacies of health insurance plans.

As we age, 80% of us will need care either at home or in a care facility. This is a list of the most important factors to have in your plan:
1) Nursing home is a facility with private and semi-private beds with Registered Nurses around the clock and where they can administer higher levels of care, including intravenous drips. Most nursing homes are now primarily Rehabilitation Centers. Physical therapy is usually available seven days a week. These homes also have a long-term care component like the traditional nursing centers.
2) Assisted Living is a community with apartment-style units and activities with caregivers who bring care to you in your unit. In some cases, once a person needs help from two care professionals, he or she might have to move either to a smaller and more personalized care home or to a nursing home. They generally have a nurse on staff which satisfies the requirements for most LTCI policies
3) Adult Family Home are homes with a maximum of six residents and care staff 24/7. These homes can provide more “hands and eyes on” than assisted living communities. Some are owned by nurses, and all are overseen by a licensed nurse.
4) Home Care is care received in your home by a licensed care provider. They can help with bathing, grooming, and light chores and housework.
5) Care Coordination are services provided by trained and licensed professionals to assist you with locating services and arranging for care and in some cases monitoring of the care providers.
6) Future service options is an important coverage because it covers you when there are new types of long-term care options that didn’t exist when you purchased your policy.

Policy coverage amounts and limits are also an important factor to consider. Some policies can pay an amount per day and limit the number of years or total dollar amount for the beneficiary. The best advice our long-term care insurance broker gave us was to get the Compound Inflation Protection. This automatically increases the maximum daily and lifetime benefits each year by a pre-set percentage on a compounded basis. This benefit is especially important if you decide to get LTCI before reaching 70.

Qualifying benefits: There are certain conditions that have to be met before you can start receiving your benefits. Most plans look for the inability to perform two or three “activities of daily living”. These can be assistance with bathing, eating, dressing, using the toilet, walking and remaining continent. It is also very important to have a policy that covers cognitive impairment such as Alzheimer’s or other related memory disorders. These individuals often need help to perform many of the above tasks and care costs are accordingly higher.

The last tricky aspect when purchasing coverage of long-term care insurance policies is the waiting and elimination periods. Once a person qualifies with their needs to perform their activities of daily living, the insurance company offers 30, 60 or 90 days of waiting period. The lower the period, the higher the price of the policy. Make sure you get one that requires you to satisfy this elimination period once in the lifetime of the policy. Note that when going into a care home, assisted living, nursing home or even if getting help at home, you will pay the provider at the beginning of the month whereas the insurance company will pay you at the end of the month. This might mean several months before you actually see money coming back to you after you start needing care.

With the ever increasing cost of health care and knowing that we are living longer, having long-term care insurance can be very beneficial in later years, providing it fits within our means and we get professional advice. So far it has worked for my husband and me as we feel more secure knowing that we have planned ahead.

Image courtesy of David Castillo Dominici at