Frequently Asked Questions 


Q: What is long-term care?

A: Long-term care encompasses a variety of services and includes medical services, sometimes referred to as skilled care or long-term health care, and non-medical care, commonly called non-skilled or custodial care. Long-term care provides assistance to people who have a chronic illness, disability or cognitive impairment. Long-term care helps meet health or personal needs. Most long-term care is to assist people with support services such as Activities of Daily Living, ADLs, like bathing and dressing.


Q: Where do people receive long-term care?

A: Long-term care can be provided in many different settings. Most types of care are provided at the home of the person receiving care or in a community setting such as an adult day care center. When an individual is no longer able to live independently, he/she might move to an assisted living home, an Alzheimer’s facility or a skilled nursing home.

Q: Who needs long-term care?

A: If you are under 65, there is a chance you will need long-term care. Forty percent of the 12 million Americans receiving long-term care are between the ages of 18 and 64. The primary reason for their care is motor vehicle accidents.  For those over 65, the likelihood that you will need some type of custodial care rises to 65%. It is estimated that people over 65 face a 40% lifetime risk of eventually needing skilled nursing home care of some duration.

Sources: "Long-Term Care Over an Uncertain Future: What Can Current Retirees Expect?", Inquiry, Vol.42, No. 4, Winter 2005/2006 and  National Clearinghouse for Long Term Care.


Q: How much does long-term care cost?

A: The average cost for long-term care varies depending on the type of care and the geographical area. Today, the average cost of non-skilled home care is $19 per hour. Skilled home care runs $46 per hour. The national average for a private room in a nursing home is $74,095 annually. 

Source: The Genworth Financial 2009 Cost of Care Survey -- April 2009


Q: Who pays for long-term care services?

A: You do. Health insurance, Medicare and Medicare supplements do not pay for long-term care services. They are designed to pay for short-term skilled rehabilitation services only. Many people think their disability insurance pays but disability insurance provides income replacement only. It will not actually cover any cost of care.


Q: Will Medicare cover my long-term care?

A: Medicare and Medicare Supplemental plans cover long-term care to a limited extent. They only pay for skilled medical rehabilitation in a nursing home over a limited period of time, typically three weeks to a month, after a hospital stay. They do not cover custodial or intermediate care in nursing facilities.


Q: Will Medicaid cover long-term care?

A: Medicaid is a state/federal welfare program that provides benefits covering nursing home care and limited home care only after you have spent down (depleted) the specified amount of your personal assets. To qualify for Medicaid, you must have:

• Depleted most of your assets
• Directed most of your income toward your care and
• Require nursing home level services

Q: Who should buy long-term care insurance?

A: All adults should consider purchasing long-term care insurance. The need for long-term care services can happen anytime due to an illness or accident. As we age, the risk becomes higher that we will need this type of care. The younger you are, the less expensive it will be, and the better chance of qualifying you will have.


Q: What exactly does long-term care insurance cover?

A: It all depends on the type of plan you choose to purchase, but long-term care insurance covers skilled and custodial services in a variety of settings, including in-home skilled and custodial care, adult day care, assisted living facilities, nursing home care and Alzheimer’s centers.


Q: How do I qualify for long-term care insurance?

A: Long-term care insurance is underwritten according to your medical history and current health status. When you apply, you must also be able to perform all of your activities of daily living which are defined as bathing, dressing, eating, toileting and transferring.


Q: If I move, will my policy move with me?

A: Yes, most policies have what is called “portability,” which means they can be used anywhere within the U.S. Some carriers have policies that will even cover benefits outside of the U.S.

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Copyright © 2009 Gurley LTCI