10 Things You Should Know About Buying Long-Term Care Insurance

According to the United States Department of Health and Human Services, 70% of Americans over the age of 65 will require some kind of long-term care services at some point in their lives.

The Delaware Department of Insurance (DOI) and the National Association of Insurance Commissioners (NAIC) offer these tips to help you with your decisions concerning long-term care insurance:
 

1. Long-Term Care is Different From Traditional Medical Care

   Someone with a prolonged physical illness, a disability or a cognitive impairment such as Alzheimer’s disease often needs long-term care. Long-term care services may include help with daily activities, home health care, respite care, hospice care, adult day care, care in a nursing home or care in an assisted living facility.

2. Long-Term Care Can be Expensive

   The cost depends on the amount and type of care you need and where you get it. Recent data shows that in Delaware, nursing home care can be about $11,133 monthly, assisted living facilities about $7,425 monthly, and home health aide about $5,625 monthly. These costs may be higher depending upon the level of skilled care needed.

3. You Have Options When Paying for Long-Term Care

   People pay for long-term care in a variety of ways. These include using personal resources, long-term care insurance and Medicaid for those who qualify. Medicare, Medicare supplement insurance and health insurance you may have at work usually will not pay for long-term care. Long-term care insurance will pay for some or all of your long-term care.

4. Decide Whether Long-Term Care Insurance is for You

   Whether you should buy a long-term care insurance policy will depend on your age, health status overall retirement goals, income and assets. For instance, if your only source of income is a Social Security benefit or Supplemental Security Income (SSI), you probably should not buy long-term care insurance since you may not be able to afford the premium. On the other hand, if you have a large amount of assets but do not want to use them to pay for long-term care, you may want to buy a long-term care insurance policy. Many people buy a policy because they want to stay independent of government aid or the help of family. They don’t want to burden anyone with having to care for them. However, you should not buy a policy if you can’t afford the premium or are not sure you can pay the premium for the rest of your life.

5. Pre-Existing Condition Limitations

   A long-term care insurance policy usually defines a pre-existing condition as one for which you received medical advice or treatment or had symptoms within a certain period before you applied for the policy. Some companies look further back in time than others. Many companies will sell a policy to someone with a pre-existing condition. However, the company may not pay benefits for long-term care related to that condition for a period after the policy goes into effect, usually six months. Some companies have longer pre-existing condition periods or none at all.

6. Know Where to Look for Long-Term Care Insurance

   Long-term care insurance may be available to you in several different forms. You can buy an individual policy from a private insurance company or through an agent, or you may have an option to buy coverage under a group policy through an employer or association membership. You may also have an option to add long-term care benefits through a life insurance policy.

7. Check With Several Companies and Agents

   Contact several companies and agents before you buy a long-term care policy. Be sure to compare benefits, the types of facilities covered, limits on your coverage, what is not covered and the premium. Policies from different insurance companies often have the same coverage and benefits but may not cost the same. Be sure to ask companies about their rate increase history and whether they have increased the rates on the long-term care insurance policies.

8. Don’t be Misled by Advertising

   Most celebrity endorsers are professional actors paid to advertise, not insurance experts. It is also important to note that Medicare does not endorse or sell long-term care insurance policies, so be wary of advertising that suggests Medicare is involved. Do not trust cards you get in the mail that look like official government documents until you check with the government agency identified on the card.

9. Make Sure the Insurance Company is Reputable

   To help you find out if an insurance company is reliable, you can take the following actions: Stop before you sign anything, call the DOI and confirm that the insurance company is licensed to do business Delaware. After you make sure they are licensed, check the financial stability of the company by checking their ratings. You can get ratings from some insurer rating services for free online or at most public libraries.

10. Review Your Contract Carefully

    When you purchase long-term care insurance, your company should send you a policy. You should read the policy and make certain you understand its contents. If you have questions about your insurance policy, contact your insurance agent for clarification. You can find additional information about Long-Term Care Insurance. If you still have questions, call the DOI at (302) 674-7300 or email consumer@delaware.gov.