Long Term Care Facilities: In-Home or Community-Based?
When considering long term care insurance, ask yourself where you want to receive your care: at home, in the community, or in a facility?
Planning for your long term care needs is an important consideration when thinking about your future. To complicate matters more, the types of coverage can vary greatly even between policies with the same carrier.
What is the best for you? In general, we recommend GoldenCare.
Like many reputable companies, GoldenCare is a national agency that can use its size and reputation to find the best rates and coverage for your needs.
What Is Long Term Care?
Long term care is a service provided on a long term basis to assist you with your activities of daily living (ADLs) that you otherwise would perform on your own without assistance. These services are not typically covered by your private health insurance policy, Medicaid, or Medicare.
To qualify for long term care insurance coverage, regardless of your age, you must have experienced an event that resulted in a severe physical injury, or you have a physical disability, or cognitive impairment, which requires assistance with at least two ADLs.
Long term care can be provided in a variety of settings, including your home or a facility such as a nursing home or an assisted living residence. Your physician, a registered nurse, or a care coordinator will determine a plan of care that can include any or all of these settings.
When shopping for long term care policies, keep in mind that quality of care will vary from one setting or caregiver to another. Home care most likely will be done by a family member or friend whereas in a facility, registered nurses will administer care.
Why Consider Long Term Care?
According to the National Association of Insurance Commissioners (NAIC),
We recommend that you answer the following questions before choosing your policy:
Types of Long Term Care
When shopping for long term care, make sure you check to see what services are eligible as well as what types of facility are covered under each policy. You do not want to end up in a non-qualifying facility where your insurance company can refuse to cover what would otherwise be eligible services.
Some policies may qualify a facility only if it has a certain number of registered patients or only qualifies a subset of services per each type of facility. If you move to a new state, make sure to check what types of facilities are covered in that state under your current policy. Additionally, check to see if your policy requires the facility to have any other licenses or certifications from a government agency.
Exclusions and Limitations
Types of Long Term Care
In-home care means just that. You receive your long term care services in your home from a family member or a friend or from a professional caretaker.
These are long term care services that can include adult daycare, senior center activities, transportation, meals, and more. These services can complement in-home care and can provide the caretakers with a much-needed break. Daycare or senior centers provide services in protected settings and are especially beneficial for someone with dementia or Alzheimer’s disease.
Assisted Living Services
The level of care provided in an assisted living facility is normally not as high as a nursing homes. Assisted living residences are often an alternative when you don’t need 24/7 supervision, but you may need more care than what can be provided at home.
These facilities offer much more extensive care than in-home or assisted living care can provide. Nursing homes have meals, activities, help with daily living, and 24/7 supervision. Some also provide skilled nursing care and rehabilitation services.
Continuing Care Retirement Communities (CCRCs)
These type of facilities may be covered for long term care services.
Some policies may cover long term care at a CCRC but make sure to check each policy. CCRCs tend to be very expensive with a large upfront down payment required.
What Kind of Services Do I Need?
Long term care covers a large list of care services, including help with ADLs as well as health care needs.
I know it may be hard to think about what type of service you or a loved one may need in the future, but doing this exercise can help in receiving coverage for the activities or health care needs you desire.
Help with daily activities can include:
- Home Maintenance
- Medication Reminders
Health care needs can include:
- Physical Therapy
- Speech Therapy
- Occupational Therapy
- Alzheimer’s Disease Care
- Health Monitoring
- Skilled Nursing Care
Depending on the setting, different services are available. Again, you will want to check each policy while shopping for long term care insurance.
The Cost of Services
Long term care can be expensive. It depends on the amount and type of care you need and in what setting you receive care. Additionally, costs will vary depending upon a multitude of variables including where you reside (state, urban, rural), age, gender, and health history to name a few.
According to the Genworth 2017 Cost of Care Survey, the following are median annual rates for long term care in the United States:
How Will I Pay for Coverage?
This is the biggest challenge for most people when it comes to considering long term care insurance. Where will the money come from for this type of care? As you can see, in-home care is the least expensive type of care; however, it is not as robust as the care in a facility.
You will want to talk to your insurance agent to find out more about Medicare or Medicaid coverage specifically for you in your area.
We hope this blog post has helped!