Will Long Term Care Cover Assisted Living

The world of long-term care planning is confusing. A common question is does LTC pay for assisted living. Short answer-Maybe.

Long Term Care Insurance Explained

The Basics of long-term care Insurance Covers Long-Term Care services when you can no longer perform the ADLs independently. These services can include bathing, dressing, eating and other services you need for your life tasks of daily living.

Types of Long Term Care Insurance Policies

Before you shop for assisted living coverage, know the types of long-term care insurance:

Typical Long-Term Care Insurance
These policies cover long-term care expenses. They generally have a daily or monthly benefit amount and a maximum benefit period.

Hybrid Policies
Such would combine life insurance or even perhaps an annuity with long-term care coverage. They often pay a death benefit if long-term care is not needed.

Short-Term Care Insurance
These policies offer coverage for a limited time (up to a year) and may have fewer health requirements for qualification.

The kind of policy you have or are looking at will help determine whether assisted living is covered.

Assisted Living & LTC Insurance

But several long-term care policies cover assisted living. Still, your policy will have slightly different language. Some factors affecting coverage:

Other Policy Provisions
Some policies even require a certain level of care before benefits kick in.

Benefits Limit
And whether the benefits are daily or monthly, the question is how long will a coverage last depending on your policy benefit limits of LTC insurance.

Eligibility Requirements
Some benefits and services may have eligibility Requirements, including meeting certain criteria to receive assistance with activities of daily living (ADLs).

Understanding Policy Triggers

Long-term care insurance policies frequently have “triggers” that should be satisfied before benefits begin paying out. They often include:

Cognitive Impairment
This includes conditions including Alzheimer’s disease and various other types of dementia which impair mental functioning.

Functional Impairment
This usually means needing assistance with a certain number of Activities of Daily Living (ADLs). Most policies want help with at least two ADLs.

Medical Needs
Some policies require a doctor’s certificate that long-term care is medically necessary.

Know these triggers in your policy – they affect when and whether assisted living expenses are covered.

Other Considerations

Assisted Living Costs
Average price Assisted Living homes vary widely by area So compare the costs with your potential insurance benefits.

Other Options
If you lack LTC insurance, look into Medicaid or veterans’ benefits.

Plan in advance
Younger and healthier people buying long-term care insurance can mean cheaper premiums.

Using Your Long-Term Care Insurance Benefits To the Fullest

In case you carry long-term care insurance that covers assisted living, here are some tips to maximize your policy:

Know Your Waiting Period
Most policies have a waiting or elimination period before benefits start. Plan for this gap in coverage.

Keep Detailed Records
Document all care and expenses. This can ensure you get reimbursed fully by your policy.

Review Your Policy Frequently
Make sure your policy covers long-term care as your needs change. Some policies allow you to add coverage over time.

See Care Coordination Services
Some policies provide care coordination services. These are helpful in navigating long-term care and maximizing benefits.

Understand Tax Implications
Many long term care benefits are tax-free. But always check with a tax professional about your particular situation.

If you understand and use your long-term care insurance properly, you could save big on assisted living costs.

Beehive Homes of Rowlett: Your Partner in Care

We at Beehive Homes of Rowlett know that planning in advance is important. We can not give you financial advice, but reach out in case you want even more information or assistance finding long-term care. We try to provide a nurturing environment for all our residents – no matter their income. For questions about living insurance or assisted care, please contact us. We’ll always be there to enable you to make wise choices regarding your future.