What Does Long-Term Care Insurance Cover? SC

Most long-term care policies will pay a preset amount of an insured's long-term care costs when the insured is certified by a licensed health care practitioner as a "chronically ill individual." To be certified as a chronically ill individual the insured must either (1) require substantial supervision to protect himself or herself from threats to health and safety due to severe cognitive impairment and/or (2) be unable to perform at least two or more activities of daily living (ADLs). The activities of daily living are: transferring, bathing, toileting, dressing, eating and continence. Once a long-term insurance policy's benefits are triggered, the policy will continue to pay benefits for a preset time period, or until the insured no longer needs long-term care.

Most, but not all, long-term care policies can help cover costs incurred during a nursing home stay, assisted living residency, in-home care, informal care, custodial care, care provided in Alzheimer's facility and hospice care. Some insurance companies will even pay benefits for care provided by family.

Long-term care insurance can help pay for a variety of home and community-based care services, including: physical, speech, and occupational therapists; home health aides and visiting nurses; adult day care, and hospice care. (Note: Generally, skilled care refers to round-the-clock treatment by a registered nurse under a doctor's supervision. Intermediate care refers to occasional nursing and rehabilitative care under the supervision of skilled medical personnel. Custodial care primarily meets personal care needs in activities of daily living such as help in eating or bathing.)

Please note: Long-term care insurance policies vary in coverage and benefits and can vary by state. Be sure that you clearly understand what is covered under any policy you consider.

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