Unlike traditional health insurance, Long Term Care (LTC) insurance is designed to cover long-term services and supports, including personal and custodial care, in various settings, such as your home, a community organization, or another facility. LTC insurance policies reimburse policyholders a daily amount (up to a pre-selected limit) for services to assist them with activities of daily living such as bathing, dressing, or eating. You can select a range of care options and benefits that allow you to get the services you need where you need them.

The cost of your long-term care policy is based on:

• How old you are when you buy the policy

• The maximum amount that a policy will pay per day

• The maximum number of days (years) that a policy will pay

• The maximum amount per day times the number of days determines the lifetime maximum amount the policy will pay

• Any optional benefits you choose, such as benefits that increase with inflation

If you are in poor health or already receiving long-term care services, you may not qualify for long-term care insurance, as most individual policies require medical underwriting. In some cases, you may be able to buy a limited amount of coverage or coverage at a higher "non-standard" rate. Some group policies do not require underwriting.

LTC insurance typically covers these services if they’re provided in a setting other than a hospital’s acute care unit: Diagnostic, Preventive, Therapeutic, Rehabilitative, Maintenance, Personal care

LTC insurance typically pays benefits when an insured person can no longer independently do two or more of the following Activities of Daily Living (ADLs):

1. Bathing

2. Go to the bathroom

3. Eating

4. Dressing

5. Transfer (such as getting out of a chair or bed)

6. Control their bladder or bowels (continence)

There are three main types of long-term care insurance:

1. Traditional Long Term Care Insurance

2. Hybrid Long Term Care Insurance

3. Life Insurance with a Long Term Care rider

The length of time an individual stays in long-term care can vary greatly and depends on several factors, including their health condition, age, and personal preferences. On average, the length of stay in an LTC facility is around 2.5 years, although some individuals may need to stay for a shorter or longer period.

What types of care do LTC insurance cover? LTC insurance helps with many medical, personal, and social services for people with prolonged illnesses or disabilities. It can include home health care, adult day care, nursing home care, and group living facility care.

Skilled Nursing Care (Nursing Home)

• Skilled nursing care is a type of long-term care that provides 24-hour medical and nursing care for individuals with complex health needs. It is typically provided in a nursing home or rehabilitation center and is designed for individuals needing more medical support and attention. Skilled nursing care is normally the most expensive type of LTC and may not be covered by health insurance or Medicare.

Home Care

• Home care is the most common level of LTC. It includes a wide range of services, such as assistance with activities of daily living, home health care, and rehabilitation services. Family members, professional caregivers, or volunteers can provide these in the individual's home. This level of care is often preferred by older adults who wish to age in place and maintain their independence for as long as possible.

Adult Day Health Care (ADHC)

• ADHC centers offer a medical model of care through an outpatient day program for older persons and adults with chronic medical, cognitive, or mental health conditions and disabilities who are at risk of needing institutional care.

Group Living Facility Care

• A dwelling, licensed by the State of Washington Department of Social and Health Services, in which a person or persons provide personal care, special care, room and board to more than one but not more than six adults who are not related by blood or marriage to the person or persons providing the services.