Long Term Care Insurance

Many people buy a long-term care insurance policy because they want to stay independent of government aid or help from family. They wants to stay independent of the support from others and have the flexibility of choosing senior home care in their home setting. Long-term care insurance helps our clients to protect assets, help maintain financial freedom, and give them the options necessary to receive quality long term care home care services.  

Eligibility:

Long-term care insurance considers these triggers for the start of benefits. If the client is chronically ill and/or suffers from cognitive impairment and is unable to do at least two activities of daily living (ADLs) without assistance from another person for at least 90 days.

Another way the client may be considered to be chronically ill is if the client requires substantial supervision to protect his/her health and safety due to cognitive impairment. All long-term care insurance policies issued to the client before January 1st, 1997, do not have to define chronically ill as mentioned above.

Activities of Daily Living

Client’s inability to do activities of daily living (ADLs), is the most common way insurance companies decide whether a client is eligible for benefits. ADLs most commonly used are bathing, dressing, eating, toileting and transferring. Typically, a long-term care policy pays benefits based on the clients ability to do a certain number of the ADLs, such as two out of six or three out of six. The six activities of daily living (ADLs) have been developed through years of research. This research also has shown that bathing is usually the first ADL that a person becomes unable to do without assistance. While most long-term care home care policies use all six ADLs as benefit triggers, qualifying for benefits from a policy that uses five ADLs may be more difficult if bathing isn’t one of the five.

Chronic Illness

An illness with one or more of the following characteristics: permanency, residual disability, the requirement of rehabilitation training or a long period of home care supervision, home care observation and in-home care.

Chronically Ill

A term which describes a person who needs long-term home care either because of an inability to do everyday activities of daily living (ADLs) without help or because of a severe cognitive impairment.

Some long-term care insurance policies will pay benefits if the client’s doctor orders or certifies that home care is medically necessary.

Long-term care insurance policies sold in the past required a hospital stay of at least three days before paying home care benefits. Most insurance companies no longer sell long-term care insurance policies that require a hospital stay.

Elimination Period/Waiting Period-a type of deductible; the length of time the long-term home care policy holder must pay for covered home care services before the insurance company will begin to make payment. The longer the elimination period the lower the premium, check with your long-term care insurance carrier regarding elimination period.

Types of Benefit Triggers:

Terms used by insurance companies to describe the criteria and methods they use to determine when client is eligible to receive home care benefits.

Long-term care insurance considers triggers for start of benefits if the client is chronically ill and unable to do at least two activities of daily living (ADLs) without assistance from another person for at least 90 days. Another way a client may be considered to be chronically ill is if the client requires substantial supervision to protect the client’s health and safety due to cognitive impairment. All long-term care insurance policies issued to the client before January 1st, 1997 do not have to define chronically ill as mentioned above.

Activities of Daily Living-client’s inability to do activities of daily living (ADLs), is the most common way insurance companies decide whether a client is eligible for benefits. ADLs most commonly used are bathing, dressing, eating, toileting and transferring. Typically, a long-term care policy pays benefits when a client cannot do a certain number of the ADLs, such as two out of six or three out of six. The six activities of daily living (ADLs) have been developed through years of research. This research also has shown that bathing is usually the first ADL that a person becomes unable to do without assistance. While most long-term care home care policies use all six ADLs as benefit triggers, qualifying for benefits form a policy that uses five ADLs may be more difficult if bathing isn’t one of the five.

Cognitive impairment - A term to describe deficiency in a person’s short or long-term memory, orientation as to person, place and time, deductive or abstract reasoning, or judgment as it relates to safety awareness. Cognitive Impairment-most long-term care insurance policies also pay benefits for “cognitive impairment.” The policy usually pays benefits if a client cannot pass certain tests of cognitive function. Coverage of cognitive impairment is especially important if you develop Alzheimer’s Disease or Dementia. Client must require substantial supervision because the home care client has a severe cognitive impairment, which generally means a home care client has a significant deterioration in or loss of intellectual capacity.

Some long-term care insurance policies will pay benefits if the client’s doctor orders or certifies that the home care is medically necessary.

Long-term care insurance policies sold in the past required a hospital stay of at least three days before paying home care benefits. Most insurance companies no longer sell long-term care insurance policies that require a hospital stay.

Elimination Period/Waiting Period - a type of deductible; the length of time the long-term home care policy holder must pay for covered home care services before the insurance company will begin to make payment. The longer the elimination period the lower the premium, check with your long-term care insurance carrier regarding elimination period.

Services:

Long -Term Care Insurance Policies may cover the following services which are available at Abcor Home Health, Inc. Caregiver (Come & Go), Live-In, Certified Nursing Assistant (CNA), Skilled Nursing (RN/LPN), Physical Therapy (PT), Occupational Therapy (OT) and Medical Social Worker (MSW).

Long-Term Care Insurance Policies may cover the following services which are available at Abcor Home Health, Inc:

Personal Care - (sometimes called custodial care) helps one with activities of daily living (ADLs). These activities include bathing, eating, dressing, toileting, continence and transferring. Personal care is less involved than skilled care, and may be given in-home care setting. Care to help individuals meet personal needs such as bathing, dressing, and eating.

Respite care

If client’s primary caregiver needs to take a temporary break, Abcor Home Health, Inc. can provide an adequate relief for your permanent caregiver by placing a temporary substitute caregiver to provide home care required according to Plan of Care.
Home Health Aides (HHA)/Certified Nursing Assistants (CNA)

Help with personal hygiene, simple healthcare tasks, activities of daily living(ADLs) and instrumental activities of daily living (IADLs) and medication reminders.

Home Health Care

Services at home such as nursing care, therapy, social worker, home health aide (HHA)/Certified Nursing Assistant (CNA), and homemaker home care services. Skilled services in the client’s home such as nursing care and physical, occupational and social work therapy from Illinois licensed professionals.

Hospice Care

Home care provided to relive client’s physical and emotional discomforts in the client’s home if the client becomes terminally ill. Continues home care provided at home for a terminally ill person. A terminally ill person has a life expectancy of six months or less.