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Long Term Care
What should I Know?

Long-term care is not covered by Medicare, but may be covered by Medicaid if eligible.
( Eligible for Medicaid? Click HERE to find out )

What it covers:

  • Care in nursing homes and home care services such as nursing care, physical therapy, and home health aides
  • Assisted living, adult daycare, and alternate care
  • Alzheimer's and other organic cognitive disabilities usually covered

What is NOT covered:

  • Preexisting conditions (insurance companies may exclude coverage of preexisting conditions for six months)
  • Some mental and nervous disorders, alcoholism, and drug abuse

Policies often include "pooled benefits", which means that you are provided with a total dollar amount that may be used for different types of long-term care services. Usually, there is a daily, weekly, or monthly limit to your covered expenses. Daily benefit amounts generally range from $50 to more than $300 per day for nursing home coverage. You will have to pay for any costs exceeding the daily benefit amount that you purchase.

Factors that affect cost of policies:

  • Inflation adjustment- initial benefit amount will increase automatically each year at a specified rate; can add 40 percent to over 100 percent to the premium
  • Age- the older you are, the more expensive the premium; however, premiums remain the same each year so the younger you are when you buy the policy, the lower your annual premium will be
  • Benefits- size of daily benefit and length of time for which benefits will be paid
  • Elimination or deductible periods- number of days in residence at a nursing home or number of home care visits you must receive before policy benefits begin; range from zero to 100 days, the longer the period the lower the premium

The following table shows the differences in costs depending on age and whether the policy has an inflation adjustment:

1999 Long-Term Care Policy $100 per day benefit for 4 years Same Policy with Inflation Feature
50 year-old 65 year-old 79 year-old 50 year-old 65 year-old 79 year-old
Cost per year $409 $1,002 $4,166 $881 $1,802 $5,895

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To return to the Mature Individuals section of our site, click
>MATURE INDIVIDUALS<

To learn about the differences between Medicare and Medicaid, click
>MEDICARE VS. MEDICAID<


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