Individual Long-Term Care Insurance
Medicare only covers episodes of care which are designed to bring you back to a functional baseline. Medicare does not cover Long-Term Care. This solution helps pay for care in your own home, in a nursing home, and in an assisted living facility. Your policy will either pay you a certain amount per day or per month for a certain duration of time or pay the facility in which you live. These types of plans are made available by insurance carriers and are held separately from your Medicare plan.
To qualify for benefits, you must require standby assistance when performing two of six activities of daily living as defined below. You can also qualify for benefits if you have a severe cognitive impairment.
Bathing
Washing oneself by sponge bath; or in either a tub or shower, including the task of getting into or out of the tub or shower with or without equipment or adaptive devices.
Dressing
Putting on and taking off all items of clothing and any necessary braces, fasteners, or artificial limbs.
Toileting
Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.
Transferring
Moving into or out of a bed, chair, or wheelchair with or without equipment such as canes, quad canes, walkers, crutches or grab bars or other supportive devices including mechanical or motorized devices.
Continence
The ability to maintain control of bowel or bladder function; or, when unable to maintain control of bowel or bladder functions, the ability to perform associated personal hygiene.
Eating
Feeding oneself by getting food into the body from a receptacle (such as a plate, cup, or table) or by a feeding tube or intravenously.
There are two types of Benefit Payment Methods
Indemnity Policies: These are the most liberal policies. They will pay your entire monthly or daily benefit regardless of the expenses you incur during that day or month. Benefits are paid solely on the existence of a disability. However, you must incur some expense.
Reimbursement Policies: These are more restrictive policies. You must submit your expenses to the insurance company who will reimburse you for the expenses. If you only have $100 worth of expenses for the day and your daily benefit is $200 per day; you will only receive $100 for the day. However, your benefit will last longer; your benefit duration will be increased.
