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What Is Covered in an LTC Policy?

Are you looking into long-term care for yourself or a loved one? Long-term care is an increasingly common model for senior adults who could use a helping hand: Worldwide, seven out of every 10 people will need long-term care.

Long-term care is often covered by insurance. However, the type of care needed and the facilities used can vary widely — making it confusing to understand what exactly is covered in a long-term care policy.

Learn more about how long-term care works and the kind of services that an LTC policy can help pay for.

What is long-term care?

If you or a loved one can no longer perform basic activities of daily living on your own, a medical professional may recommend long-term care. Long-term care assists with activities such as:

  • Eating
  • Bathing
  • Getting dressed
  • Taking medications
  • Using the toilet
  • Moving around the house

Often, these needs come up gradually as part of the normal aging process. Sometimes, however, you might need long-term care because of an injury or an illness — such as a stroke or Alzheimer’s disease.

Long-term care allows you to live as independently as possible while staying safe. Some long-term care is provided to the patient by a family member, spouse, or close friend. Nursing homes, home healthcare agencies, and adult daycare centers also can provide long-term care.

When is long-term care right for you? 

It can be hard to admit that you or a loved one needs long-term care. However, this type of care is increasingly common. 13 million people used paid long-term care services in 2000. By 2050, that number is expected to reach 27 million people. Someone turning 65 today has an almost 70% chance of needing some type of long-term care services during the remainder of their life.

These are some telltale signs that yourself or someone you know might need long-term care:

  • You’re concerned about safety at home
  • The house is not clean and household affairs are not taken care of
  • It’s hard to maintain personal hygiene
  • Eating and sleeping habits have changed
  • Existing medical conditions and/or your mobility have gotten worse
  • You feel isolated or depressed
  • Your cognitive ability has declined
  • At-home care isn’t possible or isn’t enough

This is typically the point where it’s time to introduce paid long-term care.

How to determine how much care you need 

There are several different types of long-term care. Each setting is intended to provide a separate level of care, with some environments offering minimal care while others cover everything you could need:

  • Transportation services. When senior adults are no longer able to drive, a transportation service can help them get around.
  • Adult daycare center. An adult daycare facility provides care during the daytime for adults, usually in a public group setting.
  • Assisted living facility. This residential setting might offer health services and more personalized care.
  • Nursing home. Nursing homes are also residential. They provide 24/7 supervision, nursing care, and personal services.
  • At-home care. Often delivered by a home health agency, at-home care is provided by professionals but received at home.
  • Hospice care aims to manage the symptoms associated with terminal illness.

There are multiple “tiers” of home-based care, making it easy to select the option that currently works best for you.

How long does long-term care last?

Long-term care is completely tailored to your (or the patient’s) needs. Sometimes, this care may only be needed for a few months while you recover from a procedure or until a terminal patient passes away.

In other cases, long-term care might be necessary for several years. Keep in mind that most long-term care is not medical-related. Instead, it gives recipients help with personal tasks they are no longer able to do on their own — like taking a shower or cooking a meal. If someone is not able to care for themselves but otherwise physically healthy, they might require long-term care for many years.

The average amount of time a person needs long-term care is 2-3 years.

What is long-term care insurance? 

Long-term care insurance is a type of insurance that covers at least part of the cost for long-term care. This insurance applies to both home care and care provided in a facility such as a nursing home.

It’s important to note that Medicare, Medicaid, and most health insurance plans do not cover long-term costs. You’ll need to get a separate policy to help lift the burden of paying for long-term care.

A short-term care insurance policy is the best choice if you anticipate only needing care for a maximum of 12 months.

What does long-term care insurance cover?

Typically, LTC insurance policies cover non-medical services such as:

  • In-home assistance with personal care (such as bathing and getting dressed)
  • In-home nursing care
  • Assisted living care, nursing home care, adult daycare, or hospice care
  • Occupational, speech, physical, and rehabilitation therapy
  • Specialized care for Alzheimer’s

How much does long-term care insurance cost?

The amount you’ll pay for an LTC policy will vary. Factors such as your age when you purchase the policy; your policy’s total coverage period; and your state of residence will affect how much you will ultimately pay for the policy.

Find the right LTC policy for you

Working with a Bankers Life representative can help you choose the right LTC policy. A Bankers Life representative can be by your side every step of the way helping you navigate the process of paying for long-term care. Learn more about our services here.