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Long Term Care Insurance Explained

Reviewed by: MySeniorCare Staff
Last Updated: 4/14/2010 9:10:14 AM

Although many seniors live long and happy lives with the ability to care for themselves, many seniors suffer from maladies that preclude them from living on their own without assistance. The purpose of long term care insurance is to help mitigate the costs of long-term care programs, such as hospice, palliative care and skilled nursing facilities, as well as in-home care.

The average cost of long term care for an American today is nearly $75,000 per year, which is prohibitive for most and impossible for many. If you have long term care insurance, however, those costs drop considerably and the financial strain created by illness can be somewhat alleviated.

Activities of Daily Living (ADLs)

In order to qualify for long term care insurance, according to, patients must be able to prove that they are unable to complete a certain number of "activities of daily living." These include dressing, eating, moving from one place to another and using the restroom. Inability to complete these tasks demonstrates a clear need for assistance.

There are a few exceptions to this rule. Mental impairment, such as that caused by Alzheimer's, may allow a patient to meet the criteria for long term care insurance even if he or she is physically able to complete the activities named above. However, the patient must be able to prove--usually through a physician--that care is required.

Applicable Coverage

The specifics of your long term care insurance policy will be different depending on where you live and which insurance company you choose. Generally speaking, however, these policies cover both at-home care as well as assisted living and nursing care.

The problem, according to Consumer Reports, is that many seniors purchase long term care insurance with the hope of remaining in the home even after falling ill. Although such care might be available through the policy, the benefits might be less than what is offered for a nursing facility. It is important to realize that inflation and other factors can alter how much these benefits really help.

Public versus Private

There are both public and private long term care insurance options. Federal employees (e.g. postal workers, uniformed officers, etc.) may qualify for the Federal Long Term Care Insurance Program (FLTCIP). This program provides benefits for care in a number of facilities, including nursing homes, adult day care programs and assisted living facilities.

Purchasing a Policy

Long term care insurance is often a preventative measure taken by young Americans. The older the patient, the more expensive the insurance premium, so purchasing a policy at the age of 40 is far less expensive than buying at the age of 65. Furthermore, if a patient waits too long to obtain coverage, he or she might not qualify when diagnosed with an illness.

There are many different situations in which an individual might need long term care insurance. Alzheimer's, cerebral palsy, senility, heart disease and many other illnesses afflict seniors, and insurance might be the best way to ensure your quality of life in the future. Caregivers can help their loved ones choose the best policy and make decisions regarding their long-term care.

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