Long-Term Care

Long-term care (LTC) is a variety of services that include medical and non-medical care for people who have chronic illnesses or disabilities. According to Congressional Budget Office (2013), most LTC is not so much medical care as assistance with the basic personal tasks of daily life such as eating, dressing, bathing, transferring, and using the bathroom.

The U.S. Department of Health and Human Services (HHS) predicts that 70 percent of those turning age 65 today will need some type of LTC. Nonetheless, according to the American Association for LTC Insurance, only eight million Americans currently have LTC insurance policies, compared with ninety-three million people of age 55 or older.

Part of the reason is that LTC insurance is not affordable for most retirees and not accessible for those with preexisting conditions. For instance, an annual LTC insurance premium for age 55 couples estimated by American Association for LTC Insurance is currently as much as $3,725 for coverage of $162,000 each with a 3% inflation option. LTC without insurance coverage is expensive, and Medicare and most private health insurance plans do not cover LTC costs. The U.S. Department of HHS estimates monthly national median costs for home health aide, assisted living, and nursing home living (with a semi-private room option) at $4,385, $4,051, and $7,513, respectively, in 2019.

 

Find resources about long-term care services, common long-term care insurance questions, and how to complain about long-term care.

Learn About Long-Term Care (LTC)

Long-term care (LTC) is a variety of services that include medical and non-medical care for people who have chronic illnesses or disabilities. If you are thinking about long-term care needs for yourself or your loved one, these resources can help:

Most health insurance plans and Medicare severely limit or exclude long-term care. If you want coverage, you may need a separate long-term care insurance policy or alternatively Virtual Annuity that provides a saving and financing plan for LTC. Learn more about the long-term care insurance. You should consider pros and cons of Virtual Annuity and long-term care insurance as you plan for retirement.

These questions can help you evaluate long-term care insurance policies.

  • What qualifies you for benefits? Some insurers say you must be unable to perform a specific number of the following activities of daily living: eating, walking, getting from bed to a chair, dressing, bathing, using a toilet, and remaining continent.
  • What type of care is covered? Does the policy cover nursing home care? What about coverage for assisted living facilities that provide less client care than a nursing home? If you want to stay in your home, will it pay for care provided by visiting nurses and therapists? What about help with food preparation and housecleaning?
  • What will the benefits amount be? Most plans are written to provide a specific dollar benefit per day. The benefit for home care is usually about half the nursing-home benefit. But some policies pay the same for both forms of care. Other plans pay only for your actual expenses.
  • What is the benefits period? It is possible to get a policy with lifetime benefits but this can be very expensive. Other options for coverage are from one to six years. The average nursing home stay is about 2.5 years.
  • Is the benefit adjusted for inflation? If you buy a policy prior to age 60, you face the risk that a fixed daily benefit will not be enough by the time you need it.
  • Is there a waiting period before benefits begin? A 20 to 100 day period is not unusual.

To report an emergency where there is immediate danger, call 911 or contact your local authorities.

If you have a complaint about a long-term-care facility, reach out to the National Long-Term Care Resource Center to find a state’s long-term care ombudsman program.

Contact your long-term ombudsman or local elder abuse resources if you have an elder abuse complaint.