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Long Term Care

"Long Term Care (LTC)" is the general term for ongoing care for a chronic illness or disability. Long term care can be provided in a variety of settings ranging from a person's own home, to an assisted living facility, to a skilled nursing facility. A "Skilled Nursing Facility (SNF)" is a licensed institution that provides regular medical care and treatment to sick and injured persons under the care of a licensed physician. Many nursing homes are designated as SNFs.
Unfortunately, many people in the U.S. do not realize that Medicare and most other general health insurance do not pay for long term care. Medicare only pays for a limited number of days of long term care following hospitalization. Nursing home care can cost tens of thousand dollars per year. Many people who go into a nursing home without coverage for long term care spend their life savings before they become eligible for long term care under Medicaid. This is called "Spend Down." By the time someone has gone through the "spend down" to become eligible for Medicaid, they have little money left for anything else.

To protect you against the risk of spend down for long term care, you may want to consider long term care insurance. "Long Term Care Insurance" should cover medical care, nursing care, home health aides, physical therapy, speech therapy, and other assistance needed due to chronic illness or disability. Long term care insurance is generally tax deductible like general health insurance. It often pays a fixed dollar amount for each day of long term care in a nursing home or a smaller amount for long term care in a person's own home. LTC insurance whose payment per day increases with inflation costs more, but provides more financial protection.

Two booklets on this subject are as follows. (1) "The Consumer's Guide to Long-Term Care Insurance," available at Health Insurance Association of America, 555 13th St., N.W., Suite 600 East, Washington, D.C. 20004. (2) "A Shopper's Guide to Long-Term Care Insurance," National Association of Insurance Commissioners, 120 W. 12th Street, Suite 1100, Kansas City, MO 64105.