Does long term care insurance cover assisted living expense?


Yes, there are some long term care insurance policies that provide for assisted living expenses. But you should be sure to check the policy provisions as to how the policy defines long term care. Commonly, the long term care insurance will pay for fees to a nursing home, to home health care and to an assisted living facility.

Assisted living facilities or residences help the client out, particularly in performing the ADLs - Activities of Daily Living. The facilities also help safeguard the well-being of the client, making sure he gets the medication he needs, that he is safe from harm. The services provided is usually given by trained staff that have some level of medical care.

Assisted living facilities may provide the client with his own apartment, where the staff are on-site to help with things. This way, the client can still enjoy a semblance of home life and some privacy while ensuring that he gets help in his daily tasks. Unlike a nursing home, though, the facilities would usually not include monitoring equipment.

Most policies usually provide this option to their customers. What is important is that you know from the start what the benefits concerning assisted living expenses provide. How long will the payments last? Is there an elimination period where you have to pay out of pocket at the beginning? How long will the elimination period be? Is there a waiting period for specific diseases? What diseases or medical conditions are covered by the policy? It is important to check these provisions so you know what to expect when you do need to claim.

Having said that, you should also know that you have other sources to help you out in defraying the cost of assisted living:

  • Medicaid. If you are eligible for Medicaid, you can get monetary assistance to help pay for a portion of the cost. Please note that Medicare does not provide for assisted living care.
  • Retirement benefits. You can use your retirement benefits to provide for assisted living. However, you still need additional resources, as the costs are expected to increase over the years.
  • Reverse mortgage or sale of your home. A reverse mortgage allows one to get a loan against his equity of his home. You can also sell your home and use the proceeds to pay for the assisted living facility fees.

Having some provision for the kind of long term care of your choice - in this case, admittance into an assisted living facility, it is best to prepare for it beforehand. That way, you can concentrate more on the quality of care being provided and not on whether you can afford it or not.

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