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What does LTC insurance cover?

Will LTC cover assisted living or is it strictly for nursing homes?
Status: Open    Sep 09, 2014 - 09:57 AM


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Expert Answers

Dec 21, 2014 - 12:09 PM

Coverage from a Long Term Care insurance is dictated by the specific language that is unique to each individual policy. Check with your policy provider for more information on the specific type of senior living covered. A customer support phone number should be listed on each statement and/or at the company website. Before purchasing a policy, be sure to ask for information regarding the specifics of coverage. Some long term care policies cover only nursing home care and some are available for assisted living. Depending on which state the policy originates from, coverage may be limited to assisted living communities licensed to provide a particular level of care or higher. Only the policy provider can answer specifics on an individual long term care insurance policy.


Mar 24, 2015 - 10:48 AM

The question has been answered but here is another perspective.

1. If you already have a LTC plan, look in the summary page to determine what benefits are offered -- comprehensive (home or care center) or is the plan specific to home or specific to care center.

2. Plans offered are mostly comprehensive because care begins usually in the home and
then it maybe transitioning to a care center.

3. If you have a plan, call the carrier or your agent to ask them to familiarize with the benefits of the plan.

4. People believe these plans are complicated to understand or the benefits are difficult to comprehend. If explained properly, there is the qualificiation -- do you have 2 of 6 daily living issues which qualifies you for benefits. If you are diagnosed with dementia, that is the only criteria and once certified you are entitled to benefits.

It is to your advantage to periodically review your plan to understand your benefits and to tell those who will be responsible for your care giving that you have a plan and what to do to apply for benefits and what the benefits offer.

People often buy plans and never look at the plan for years and forget what the plans offer or believe that plans offer more or less then what is provided. That is why it is of value to ask questions and be informed before. Once you need the benefits, it is crisis time and our thinking is overwhelmed with medical and situational issues.

Raymond Lavine


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