Today is the first day of spring. The sun is shining, the birds are chirping, and the flowers are blooming. It’s a beautiful time of year… to think about long-term care (LTC) planning! Some of you may be wondering, “Does my health insurance pay for my LTC needs?” Or, “Does my long-term care insurance (LTCI) pay for my medical needs?” The short answer is, unfortunately, not necessarily. Both insurances are important, but they cover very different things.
Health insurance – What does it cover?
The majority of Americans get their health insurance through work, while others have Medicare, Medicaid or other state and federal programs. Under the Affordable Care Act all health insurance plans must cover:
- Ambulatory patient services
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
“Perhaps now is the time to spring clean your finances.”
Long-Term Care Insurance – What does it cover?
LTCI is offered by some employers and association (ask your Human Resources Department), but mostly purchased individually. In 2014 there were about 7.25 million individuals with LTCI coverage. Under most plans, policyholders can start receiving benefits when they need help with 2 out of 6 activities of daily living: bathing, eating, dressing, toileting, continence, and transferring, or if they have a cognitive impairment such as Dementia, Alzheimer’s, or memory loss. Services covered by LTCI include:
- Home Health Care
- Respite Care
- Hospice Care
- Personal Care in Your Home
- Assisted Living Facilities
- Adult Day Care Centers
- Other Community Facilities
- Nursing Homes
- Memory Care Facilities
What about Medicare or Medicaid?
Although Medicare and Medicaid might cover some costs, these programs are not without restrictions and limitations. Click the links to learn more about each program.
Now that you know the differences between health insurance and LTCI, perhaps now is the time to spring clean your finances. Talk to a long-term care specialist today about planning for your future. Our team of experts is here to walk you through every option and guide you to the best policy for your needs.
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