What Does Long Term Care Insurance Cover?
You have choices about what type of insurance to buy to protect yourself and your family from the costs of caregiving.
Different types of plans cover long term care in different ways.
As the need for long term care increases because of our aging population, the variety of insurance plans that offer some type of long term care benefits is increasing. Different types of plans offer different options for what is covered but typically you choose how long benefits will be paid and how much they will pay out when applying for the insurance plan.
Generally, benefit payments fall under one of two categories:
- reimbursement of covered long term care expenses (require bills be submitted for approval)
- cash payments to beneficiary (cash can be used as the beneficiary wishes)
When deciding what kind of long term care insurance to purchase, how the benefits are paid out can matter. If your family or friends plan to provide some of your care, a cash payment plan may work best since the cash can be used to pay them.
What Long Term Care Insurance Covers
Plans which provide long term care insurance or long term care insurance riders are regulated by the same IRS tax code (7702b). These types of “qualified” plans are given special consideration by the IRS. Qualified long term care plans are granted certain tax advantages.- Premiums paid for these plans may be tax deductible (usually as a health care expense.)
- Benefits paid to you or on your behalf for long term care are excluded from income tax.
- Benefits paid for your long term care may be excluded from income consideration when applying for Medicaid.
- In-Home Care
- Community Day Care
- Assisted Living Facilities
- Nursing Homes
3 Types of Qualified Long Term Care Insurance
Traditional Long Term Care Insurance
Like health insurance or house insurance, these plans are designed to provide long term care insurance - period. They are very effective at what they are designed to do.Key features:
- Most benefits for your premium dollar. Premiums rise over time.
- Inflation protection available to help benefits keep pace with rising cost of care.
- Couples usually have an option of sharing benefits.
- Reimburses covered long term care expenses. (Some offer a smaller cash alternative.)
- Health qualification can be difficult.
2 Varieties of Asset-linked Long Term Care Insurance
Asset-linked long term care insurance plans combine either life insurance or annuities with a long term care rider. The focus may be to offer fixed premiums and death benefits while maximizing long term care coverage. Or they may focus on a better death benefit, better growth of the cash value, or better guaranteed lifetime income. Choosing the right insurance for your situation means having an overall plan for retirement savings and finding the policy that fits your current goals
Asset-linked plans have the following benefits in common:
- Some plans accept tax-deferred funds like IRAs and 401(k)s.
- Guaranteed payout (for long term care or as a death benefit)
- Beneficiaries receive a tax-free death benefit if not used it for long term care.
- Inflation protection not typically available.
- Couples’ shared benefits not usually available.
Differences between these 2 types of plans:
Life Insurance with a Long Term Care Rider
- Fixed premiums with several options for payment frequency
- Typically, benefits are paid directly to you as a cash payment.
Annuity Insurance with a Long Term Care Rider
- One single premium paid up front.
- Typically benefits are paid as reimbursement.
Alternatives To Long Term Care Insurance
Qualified long term care insurance is only ONE category of insurance that pays for care provided to those who are disabled or chronically ill. Below is a list of alternatives. Each type of plan offers a unique way to pay for the costs of care so you stay independent longer and safer.
Life Insurance and Annuity Insurance with Accelerated Benefits
In the last 5-10 years it’s become common for life insurance and annuities to offer or include “Accelerated Benefits”. Accelerated Benefits plans are not qualified long term care plans.
- They aren’t required to provide the same benefits.
- Coverage is structured more simply
- Typically don’t provide options for benefit growth.
- Some plans require a disability to be permanent.
- Pay benefits for 3 types of care
- Terminal Care – usually defined as a diagnosis of 2 or less years to live.
- Chronic Care – long term care
- Critical Care – short term or “recovery” care
- Taxes on premiums and benefits are evaluated differently. (They are regulated under IRS tax code 7702b but moderated by 101(g).)
Since the benefits are paid from the base policy first (base policy can be life or annuity insurance), insurance companies have less risk. Lower risk to them means easier to qualify for and cheaper for you.
Short Term Care, Cash and Home Care Insurance
Whether or not you are interested in a long term care or accelerated benefits insurance plan, you may want to consider one of the options below as a “hedge”. Alternatives like these can be used alone or in combination with other plans.
For example, a recovery care plan or a short term home health care policy may be just what you need to fill in the 90 day deductible gap on your traditional long term care insurance.
Or what about that period before you’re eligible long term care benefits? You can use a prepaid home health care plan to make life at home more manageable by paying for help with household chores, driving, and yard work.
- Critical Cash Policies
- Pay cash if you end up with a specific health condition. For example, a critical cash policy can be a way around a history of cancer to still cover you for heart attacks.
- Recovery Care Plans
- These plans are designed for people who don’t qualify for long term care coverage but want some protection that includes nursing home care.
- Prepaid Home Health Care
- Use this plan to stay at home. No health questions—the only requirement is that you are not currently disabled or about to be disabled.
- Short Home Health Care Policies
- A simpler and easier to qualify form of the recovery plans but only cover home health care. These plans generally pay you cash.