What is Long Term Care Insurance?

Tiffany Rubin

Chief of Happiness

Nurse Next Door Delaware

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We get a lot of questions about Long Term Care Insurance (LTC Insurance).  It’s no surprise; understanding insurance of any kind can seem daunting. That’s why we’d like to take the mystery out of LTC Insurance and answer some of the most common questions we receive. Grab a cup of coffee—or whatever beverage you fancy—and read on.

Frequently Asked Questions About LTC Insurance

  1. Why do I need it?
  2. When I have it, when can I use it?
  3. How can I use it?
  4. Can I Stay at Home and Receive LTC Insurance benefits?
  5. How does reimbursement work on LTC Insurance plans?
  6. What is the ideal age to invest in LTC Insurance?

#1 Why Do I Need It?

We have insurance for our cars, our homes, even our pets. People are living longer, so the probability of needing Long Term Care Insurance is very likely. Why wouldn’t we want to prepare for a time in our lives when the benefit of assisted care will be most needed?  “When developing a retirement strategy, it is important to plan for the expected and prepare for the unexpected.” Edward Jones

#2 When I have it, when can I use it?

Although all policies are slightly different, insurance companies use Activities of Daily Living (ADLs) to measure an individual’s level of functioning and, in turn, determine whether benefits should commence. There are six generally recognized ADLs:

  1. Bathing
  2. Dressing
  3. Eating
  4. Transferring – Being able to either walk or move oneself from a bed to a wheelchair and back again.
  5. Toileting – The ability to get on and off the toilet.
  6. Continence – The ability to control one’s bladder and bowel functions.

Needing assistance with two or more ADLs will typically be the trigger to qualify for benefits. Most policies carry an exemption period ranging from 0 to 120 days that is selected when choosing a plan. During the exemption period the insured is responsible for the cost of care out-of-pocket until the exemption period is over

#3 How Can I Use It?

Find a provider, like Nurse Next Door Delaware, that takes LTC Insurance. Here are some resources to help you:

#4 Can I Stay at Home and Receive LTC Insurance Benefits?

Yes! Many of our clients at Nurse Next Door Delaware are able to receive care at home because they have a Long Term Care Insurance policy. According to Cynthia Ramnarace of AARP, “Today most policies are joint policies, meaning they cover both in-home assistance and nursing home care.”

#5 How Does Reimbursement Work on LTC Insurance Plans?

At Nurse Next Door Delaware, we’ve streamlined the process for our clients. A client simply submits the initial claim and afterward, we submit all documentation and invoicing monthly on their behalf. Our client pays us and is reimbursed by their insurance company.

#6 What Is the Ideal Age to Invest in LTC Insurance?

While everyone’s circumstances are different, usually the best time to buy LTC Insurance is in your mid-50s. Consulting with a financial advisor is the best first step you can take in determining what is right for you and your circumstances.

Christopher Smith of Edward Jones in Dover, DE is a local Certified Financial Planner who helps individuals with questions like this. His focus areas include Saving for Retirement and Insurance Needs. You can “virtually” meet Chris here: Christopher Smith, CFP®, AAMS®

Additional Reading:

A Woman’s Perspective on Long-term Care – Edward Jones

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