Will long-term care insurance let me be cared for at home?

Jill Overmyer

Long-term care insurance covers costs associated with not being able to care for yourself that aren’t normally covered under health insurance policies or Medicare. Long-term care policies, according to the U.S. Department of Health and Human Services, can cover costs and services like:

• Adult day care centers.
• Assisted-living facilities.
• Hospice care.
• Nursing homes.
• Home equipment like ramps, stair glides or medical alert systems.
• Transportation to medical appointments.

  

Does long-term care cover at-home care?

Some may not like the idea of a nursing home and would prefer to remain at home under the care of a caretaker or nurse. The good news is that long-term care insurance typically covers at-home care, depending on your policy and its limits.

Most policies allow you to choose coverage that fits your needs. For example, Physicians Mutual provides a home health plan designed to cover the costs connected with staying at home. Other policies provide comprehensive coverage, which includes home care and assisted-living facilities. You also can opt for a facility-only policy or a home-care-only policy.

Each policy has different exclusions, but long-term care insurance does not usually cover care from volunteers or family members, or services that are covered under an existing policy.

What are the pros and cons of at-home care?

If you’re considering a home-care-only plan for long-term care insurance, it’s important to weigh the pros and cons. A few benefits include:

• Greater independence. Many elderly policyholders are hesitant to give up the independence of living at home. Home care allows them to remain at home while receiving medical care and assistance.
• Affordable policies. Long-term care policies that are at-home-only are usually more affordable than comprehensive policies, according to a 2006 report by the AARP Public Policy Institute.
• Additional services. Many policies pay for equipment that allows policyholders to live at home with greater independence, as well as transportation from home to medical appointments and training for friends who want to help care for you, according to the U.S. Department of Health and Human Services.

Some of the drawbacks of home-care-only policies include:

• Eligibility requirements. Most policies place strict eligibility requirements for home caretakers, as well as the agencies that can be used. Moreover, caretakers who are family members cannot receive payment under some plans, even if they are putting in many hours, according to the AARP report. Other plans restrict coverage to family members who live with the patient.
• Fewer options. Some choose home-care-only plans thinking they’ll never end up in a nursing home. But in the event that  you’re no longer able to be cared for at home, a home-only policy can be quite limiting.

Most long-term care plans offer the coverage you need to be cared for at home. However, it’s important to consider factors like your budget, your condition and the plan’s exclusions before choosing a home-care-only plan for long-term care insurance.