Does long-term care insurance cover in-home care?
Long-term care insurance is an essential component of financial planning for many individuals as they age. This type of policy provides peace of mind by covering the costs associated with care services when individuals can no longer perform daily tasks independently due to aging, illness or disability.
While most people associate long-term care with the services provided by nursing homes or assisted living facilities, there are typically other options to choose from, like in-home care. When you receive in-home care services, you essentially receive the same types of daily assistance that you would in a care facility — but in the comfort of your own home.
But while this type of care can be more comfortable than a nursing home or assisted living facility, it can also be costly. In turn, it can be helpful to know whether a long-term care insurance policy will help cover the costs so you can keep your finances on track.
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Does long-term care insurance cover in-home care?
Many long-term care insurance policies include coverage for in-home care services, which allows policyholders to receive care in the comfort of their own homes. And, this type of care can span a wide range of services.
"Home care services cover a wide range of needs, from homemaking and companionship to meal preparation and medication reminders," the American Association for Long Term Care Insurance (AALTC) states. "They may also include personal care services, or those that help with the activities of daily living, including home care services like bathing, dressing, and grooming. To promote a safe and functional lifestyle, a caregiver can help you brush your teeth, secure the buttons on your shirt, or stand-by while you bathe to make sure you do not fall."
In fact, there are significantly more people who receive in-home care than there are in nursing homes, according to the LTCi Sourcebook, published by AALTCI. The association's data shows that there are about 7.6 million individuals who currently receive care at home due to issues from acute illnesses, permanent disability, long-term health conditions or terminal illness. Conversely, there are about 1.8 million individuals who currently receive care in nursing homes.
But while in-home care is often covered by a long-term care insurance policy — and while it's a more popular option than care in nursing home facilities, there are a few key points to consider regarding in-home care coverage, including:
Types of covered in-home care
Most types of long-term care policies will cover a range of in-home care services, such as personal care (assistance with bathing, dressing, and grooming), homemaker services (meal preparation, light housekeeping), skilled nursing care and therapy services. However, the specific coverage can vary depending on the policy and its terms, so it's important to look for a policy that explicitly covers in-home care if that's what you would prefer.
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Coverage eligibility
Eligibility also factors into whether long-term care will be covered by your long-term care insurance policy. To qualify for in-home care coverage, the policyholder typically needs to demonstrate a certain level of functional impairment or cognitive decline, as assessed by a healthcare professional. The policy will outline the specific criteria for eligibility.
Benefit amount
Long-term care insurance policies often provide a daily or monthly benefit amount for in-home care. However, you have the opportunity to choose a benefit amount based on your needs and budget when purchasing the policy, so that may need to be factored in when you purchase your policy.
Waiting period
Some policies have a waiting period, also known as an elimination period, before coverage for in-home care kicks in. During this time, the policyholder is responsible for covering the costs of care. The length of the waiting period varies among policies, but if you need in-home care during the waiting period, you'll likely have to cover the costs.
Caregiver qualifications
Policies may require that the caregiver providing in-home care is a licensed healthcare professional or a qualified caregiver from an approved agency. Be sure to check the policy's requirements regarding caregiver qualifications so you know whether certain caregivers are covered.
Coordination of benefits
Long-term care insurance can be used in conjunction with other sources of funding for in-home care, such as Medicare or Medicaid. However, it's essential to understand how these benefits interact and coordinate to avoid potential coverage gaps — and whether another type of insurance will need to cover the costs of this type of care.
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The bottom line
Long-term care insurance is a valuable tool for protecting your financial well-being and ensuring that you receive the care you need as you age. And, in-home care coverage is an essential component of many long-term care insurance policies, allowing individuals to maintain their independence and receive care in familiar surroundings.
Before purchasing a long-term care insurance policy, though, carefully review the terms and conditions to understand the specifics of the coverage for in-home care. With proper planning and the right insurance coverage, you can have peace of mind knowing that you'll receive the care you need without depleting your savings.