In-Home Care Dominate Long-Term Care Insurance Claims

Read Time: 3:40
Published: Nov 13th, 2020
In-Home Care Dominate LTC Insurance Claims
Article Updated:January 9th, 2021

An analysis of Long-Term Care Insurance claims processed in 2019 show families electing in-home care instead of facilities. The research analyzed by the American Association for Long-Term Care Insurance (AALTCI) shows 70% of LTC Insurance claims paid for in-home services. 

"This represents an increase from 52 percent (from the 2014 analysis)," said Jesse Slome, executive director of the AALTCI." The majority of claims began and also ended with the policyholder receiving care in their own home."

Slome says that many people associate Long-Term Care Insurance with nursing homes. While policies do pay for all types of facilities, including adult day care centers, assisted living facilities, memory care facilities, and nursing homes, the facts show in-home care as the popular choice for American families.  

Jesse Slome

"When care is needed, people prefer to remain in the familiar surroundings and comfort of their own home. Long-Term Care Insurance can cover costs associated with care services provided at home," Slome explained.

Billions in Benefits Being Paid by LTC Insurance

In 2019 the major insurance companies paid over $11 billion in benefit from Long-Term Care Insurance policies. These benefits helped American families access their choice of quality care without placing huge burdens on family members. 

The AALTCI analysis shows that less than 1 in 10 claims started in nursing homes. Eighteen percent of LTC Insurance claims started in assisted living facilities. Most Long-Term Care Insurance policies offer comprehensive benefits giving the policyholder, and their family, the choice of how care will be delivered. 

Experts say Long-Term Care Insurance offers choices. Some policies provide cash benefits, which can make the benefits even more flexible. 

Some LTC Policies Offer Cash Benefits

"Cash benefits that can pay for non-certified caregivers, including a family member, are one of the options currently offered," according to George Mellendorf, President of LTC Solutions, a national distributor of individual and multi-life Long-Term Care Insurance products.  

George Mellendorf

"Policies that can pay immediate benefits for home care without having to meet the standard 90-day elimination or deductible period are increasingly popular," Mellendorf explained.

LTC Insurance is Affordable

The criticism from some people about Long-Term Care Insurance is that policies are expensive; however, today's LTC Insurance remains affordable and rate stable. Many states have rate stability rules in place that make it difficult to raise premiums the future. Plus, policies are custom designed with a variety of options.

"For less than $100 a month, a 57-year-old male can currently purchase a policy that pays $5,100 monthly for home care services when he reaches age 85," Slome said. "If home care is needed for two years, the policy would pay out over $122,000 in total benefits."

There are several tax incentives available, making premiums more affordable, and proceeds are tax-free. Plus, 45 states offer Partnership Long-Term Care Insurance plans with dollar-for-dollar asset protection.

Mellendorf explains there are several consumer-friendly features with today's LTC Insurance plans. These features include various inflation benefits and additional benefits to paying for items like home modifications or ramps to help the policyholder stay home. 

Longevity Brings Higher Risk of Dependency

People require long-term care services due to changes in their health, body, or mind. When an individual needs help with routine daily living activities or supervision due to a cognitive decline, they will have access to care. The benefits safeguard income and assets while, at the same time, reduce the stress and anxiety otherwise placed on family members.

Health insurance, including Medicareand supplements, pays a minimal amount of skilled services for long-term care, leaving the responsibility on your family and finances.  

The problem of long-term care is both a cash flow issue and a family issue. Today's LTC Insurance addresses both issues so the policyholder can maintain independence and control and limit dependency.

Experts suggest planning before retirement, ideally in your 40s and 50s, when you still enjoy good health. LTC Insurance is medically underwritten, and every company has their own guidelines. 

LTC Specialists Help Navigate Options

Be sure to seek the assistance of an experienced Long-Term Care Insurance specialist to help you navigate the many available options. Premiums can vary over 100% between insurance companies for the same coverage. 

You can find a trusted and experienced specialist by clicking here

The LTC NEWS Cost of Care Calculator can show you both the current and future cost of extended care services where you live. Use this tool by clicking here.

About the Author

An LTC News author focusing on long-term care and aging.

Editor's Note

LTC NEWS offers man tools and resources to help you research the financial costs and burdens of aging so you can find an affordable solution. 

Find all the resources on LTC NEWS by clicking here.

Items to Discuss with a Long-Term Care Specialist

Be sure to speak with a qualified and trusted Long-Term Care Insurance specialist when you research long-term care. Be sure to ask tehse questions:

  • Partnership: Most states offer special policies that provide dollar-for-dollar asset protection. The Long-Term Care Insurance Partnership Program might be one of the best-kept secrets in retirement planning. Make sure the specialist explains this program and how it might help you.
  • Tax incentives: There are federal tax incentives available for some people. If you own your own business, be sure to ask.
  • Health Savings Accounts: If you have an HSA you can use the pre-tax money in your account to pay for the premium.
  • Asset-Based or Hybrid policies: These are life insurance or annuities with a rider for long-term care. Careful, only a handful are actually a long-term care benefit. However, one of these policies can provide you with the flexibility of both a long-term care benefit or a death benefit. They are expensive but can be paid with a single premium.
  • Health and Family History: Make sure the specialist asks you detailed questions about your health, family history, and retirement plans. Underwritingcriteria vary with each insurance company. If they are not asking you detailed questions, then find another specialist.


Available Research Tools

One of the best tools is the LTC NEWS Cost of Care Calculator. You can find the current and future cost of long-term health care where you live. This information will help you design an appropriate LTC Insurance policy.

The Ultimate Long-Term Care Guide and Long-Term Care Tax Benefits Guide are two must-read guides so you can better educate yourself on these products and options. 

Get Published on LTC NEWS

LTC NEWS offers many resources to help families address the consequences of long-term care, aging, health, caregiving, and other retirement issues. You can be part of the effort to help educate consumers throughout the U.S. and around the world.

Write a story for publication on LTC NEWS and let America hear what you have to say. Be sure your article fits the LTC NEWS target audience of adults 40-70.

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LTC News Contributor James Kelly
James Kelly

Contributor Since
August 21st, 2017

LTC News author focusing on long-term care and aging.

About the Author

LTC News author focusing on long-term care and aging.

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