Long-Term Care Insurance

Long-term care insurance can help you pay for long-term Services & Supports over extended periods in order to help you manage chronic conditions or cognitive impairment, or to perform Activities of Daily Living (ADLs) like bathing, dressing or eating. Support may be provided in a variety of settings: at home, in an assisted living facility or in a nursing home. In order to receive payment, most long-term care insurance policies require that the insured person:

• Be unable to perform at least two ADLs (such as bathing, dressing or eating) without substantial assistance from another person for an expected period of at least 90 days; or

• Require substantial supervision due to a severe cognitive impairment

A severe cognitive impairment is considered to be a deterioration or loss in intellectual capacity that places a person at risk of harming him or herself or others.

Contrary to popular belief, the Services & Supports covered by long-term care insurance are generally not covered by traditional health insurance or by Medicare. Long-term care services, especially in Connecticut, can be very expensive, whether provided at home or in a nursing home. Although Medicaid will cover the costs of long-term care for those who qualify, many people prefer not to spend all or most of their own assets in order to qualify for Medicaid. Long-term care insurance can help to fill that gap.

Connecticut has a program that works with the private insurance industry to sell long-term care policies that help pay for long-term Services & Supports while also providing Medicaid Asset Protection, should an individual ever require Medicaid assistance.

The younger and healthier you are at the time of purchase, the less expensive the premium and the greater the likelihood you will be accepted for coverage.

Individuals with disabilities and certain health conditions may not qualify for long-term care insurance because they already need or are likely to need long-term Services & Supports. In these circumstances, the individual must either pay with their own resources or qualify for Medicaid or other public programs.

The number of Services & Supports covered by long-term care insurance may vary, but most policies cover:

• Adult day care
• Respite care
• Hospice care
• Home modifications to accommodate disabilities
• Alzheimer’s support

Some long-term care insurance policies only pay for care received in a nursing facility or assisted living facility. Others provide a comprehensive pool of dollars that can be used to pay for care received in the home, the community, or a nursing facility. The more comprehensive the policy, the more choices policyholders will have of the type of services covered.

The applicant for long-term care insurance has several decisions to make when applying for coverage, all of which will affect the premium. He or she must decide how much daily and overall coverage to buy, the amount of the deductible, the waiting period before benefits kick in, and whether the benefit will rise with inflation over time.

• Personal Care Assistance (PCA) Services
• Homemaker-Companion Services
• Nursing Homes
• Home Health Care
• Assisted Living Facilities and Managed Residential Communities