Does Long-Term Care Insurance Cover Assisted Living?

Medicare doesn’t cover assisted living and they are pretty upfront about that. If you have a long-term care policy, though, will that cover it?

Luckily, the answer is ‘yes.’ But, no two long-term care policies are the same. One policy might cover it while another might not. It’s important to know your coverage before you buy it; after all, you are buying it to protect yourself.

What to Look for in Assisted Living Coverage

Assisted living isn’t always seen as a ‘necessity’ by insurance companies. If they do offer coverage, they often make you prove your inability to do certain things before they’ll cover your claims. Some companies rely on the doctor’s prescription. Others want proof that the insured cannot perform a certain number of daily activities on their own before they’ll cover it.

It’s also important to look at where the insurance company will cover assisted living. Today there are various types including assisted living facilities and home care. Many policies won’t cover home care, but they’ll cover the costs of moving into an assisted living facility.

Questions to Ask

Before you decide to move into an assisted living facility, you should ask your insurance company the following questions:

• How long will the coverage last? Some policies only cover a limited time at an assisted living facility.
• Is there a period where you have to pay first and then the insurance will begin covering it?
• Are there any diseases or conditions that are excluded from the policy?

Know the Costs

The cost of assisted living can vary from $1,500 a month to $10,000 per month. What amenities do you need? How much help will you need? Where is the home located? These are just a few of the factors that will affect the cost of the assisted living facility.

Next, you need to know the amount your insurance will cover. The benefits can be all over the board. Some policies cover the entire amount while others only cover a portion, leaving the rest for you or a supplement insurance policy.

The short answer is that ‘yes,’ some assisted living may be covered under your long-term care policy. But it depends on the policy, its age, and what type of coverage you chose. If you have an old policy, you may not have assisted living benefits because that really wasn’t a big deal several years ago. Today it’s common for seniors to transfer to an assisted living facility rather than waiting until they are bad enough to go to a nursing home. Check your policy, talk to your agent, and see what coverage you may have or what coverage you may want if you are first thinking of buying a policy for yourself.