Long term care insurance fills the biggest gap in most retirement plans: who pays when you need ongoing daily help. Here is how it works and how to choose.
How does long term care insurance work?
You pay premiums to an insurer, and in return the policy pays benefits when you can no longer handle daily activities on your own. Coverage typically starts once you need help with at least two activities of daily living, such as bathing or dressing, or have a cognitive condition like dementia. Benefits pay toward nursing homes, assisted living, adult day care, and in-home aides up to a daily or monthly limit you choose. Because Medicare does not cover this custodial care, long term care insurance prevents you from paying it all out of pocket. A 1-800-MEDIGAP advisor can explain the details for your situation.
Who should consider long term care insurance?
Coverage makes the most sense for people in their 50s and 60s who have assets to protect and want to avoid burdening family. If you have a family history of dementia or chronic illness, or you want to keep care decisions in your own hands, a policy can provide both funding and choice. Those with very low assets may qualify for Medicaid, while the very wealthy may self-fund. Most seniors fall in between, where insurance adds real value. Call 1-800-633-4427 to see where you stand.
What does long term care insurance not cover?
Policies generally do not pay for care needed because of a pre-existing condition during a stated exclusion period, care provided by family members in some plans, or medical costs already covered by Medicare. Most policies also include a waiting period, often 30 to 90 days, before benefits begin. Reading the fine print matters because terms vary by carrier. A licensed 1-800-MEDIGAP advisor reviews exclusions and waiting periods across companies so you are not surprised when you need to file a claim.