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A person’s need for long term care services may develop in many different ways. To adequately protect a person from excessive long term care expenses, insurance policies should be flexible and provide protection for all levels of nursing home care and for care in the home without severe restrictions.
The following types of policies provide some coverage for nursing home or in-home services, but may not actually cover most long term care services for individuals with chronic, debilitating problems. Purchasers need to understand the restrictions and limitations of these policies.
Medigap policies that supplement Medicare
This also includes other policies that supplement the Medicare skilled nursing home benefit. Medigap policies can offer valuable protection from hospital and physician bills, but these policies have limited coverage for nursing home stays.
Remember, Medicare nursing home coverage has severe restrictions. Medigap policies, which only supplement the Medicare nursing home benefits, contain these same restrictions for nursing home coverage.
Policies that only cover skilled nursing care
Most people who stay in nursing homes for long periods do not need skilled nursing care for most of their nursing home stay. Nursing home residents receiving a lower level of care, intermediate or custodial care, would not be covered under these policies.
Policies covering nursing care only after long stays
Some policies only cover custodial care after stays of 20 or more days in a skilled or an intermediate nursing facility. Some individuals do not require skilled nursing care when they enter a nursing home, or do not require skilled nursing care for more than a few days.
Coverage would be limited by this type of policy, and it is possible that coverage would be denied since treatment did not begin in the designated facility.
Policies giving benefits only in Medicare approved homes
Many nursing homes are not Medicare certified or approved. If a particular home were the best choice because of its location, cost or other qualification, it might not be eligible for benefits.
Policies with coverage only in a skilled nursing home
These policies may provide coverage for all levels of nursing home care, but only if the care is provided in a skilled nursing home.
You should check to determine if the nursing homes in your area are skilled nursing homes and whether these homes provide different levels of care to residents over longer periods of time.
Policies paying only a small part of the expected costs
You will find that some policies pay only a fraction of the costs of long term care services, such as $10 per day if you are in a skilled nursing home. Regardless of the amount, the policy benefit will tend to diminish with time in its ability to offset expenses.
Covering home health care only after confinement
Many policies cover home health care only after a long nursing home confinement. Statistics show very few people who stay in a nursing home for a long period of time return to the community.
Sources: GE Financial, Long Term Care Division, GE Long Term Care Insurance Nursing Home Survey, March 2002.
Financial Planning Consultants, Inc. |
