Long Term Care Insurance

What is Long Term Care?

Long  Term Care is the assistance individuals need when they are unable  to care for themselves and need help with Activities of Daily Living  (ADLs) - bathing, dressing, transferring, toileting, continence (control  of bodily functions), and eating - or they have severe cognitive  impairment such as
Alzheimer's disease. The need for long term care  can result from an accident, chronic illness or short-term disability,  or from advance age. Long term care can include a broad range of  services, provided in any setting outside a hospital. It might be help  with simple daily tasks like bathing or dressing. It might include  skilled care in your own home, an assisted living facility, some  other community resources, or a nursing facility. 

Who Needs Long Term Care?

  • 19%  of Americans aged 65 and older experience some degree of chronic  physical impairment. (AHIP, "A Guide to long term Care Insurance", 2004)
  • About  55% of those ages 85 and older are impaired and require Long Term Care.  (AHIP, "A Guide to long term Care Insurance", 2004)
  • By 2020, 12 million older Americans will need long term health care. (AHIP, "A Guide to long term Care Insurance", 2004)
  • Family  and friends are the sole caregivers for 70% of elderly people and most  will cared for at home. (AHIP, "A Guide to long term Care Insurance",  2004) 
  • People age 65 or older face at least a 40% lifetime  risk of entering a nursing home. 10% will stay more than five years.  (AHIP, "A Guide to long term Care Insurance", 2004) 
  • 22% of people over age 85 are in a nursing home. (AHIP, "A Guide to long term Care Insurance", 2004)
  • Women,  because they outlive men, face a 50% greater likelihood of entering a  nursing home after age 65. (AHIP, "A Guide to Long Term Care  Insurance.", 2004)

Some Misconceptions about Medicaid and Medicare


Medicaid  pays for health services for the very poor of any age.  Qualifications for Medicaid vary by state. Being eligible for Medicaid  does not guarantee placement in a nursing home. There may be long  waiting lists for facility care. 


Medicare  pays for health care for people 65 and over and for those who are  disabled. Medicare does not pay for long term medical service such as  assisted living or adult day care. Medicare pays only the first 100 days  of skilled care, such as physical therapy or nursing, which only  accounts for 5% of all long term care costs. You are eligible for the  care only if you have been in the hospital for at least three days. The  personal care must relate to the treatment of an illness or injury.  Medicare pays 100% for the first 20 days then you pay $128/day for the  next 80 days.

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