Federal Long Term Care Insurance vs. Private – Everything You Need To Know

Federal Long Term Care Insurance vs. Private – Everything You Need To Know

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— Last Updated May 27, 2022

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Reviewed by
Eric Berkman

Guide Federal Long Term Care Insurance vs. Private – Everything You Need To Know

— Last Updated May 27, 2022

Stephanie Wilson

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Reviewed by

Eric Berkman

Federal Long-Term Care Insurance vs. Private Insurance

Getting older should be a time for relaxing and spending the days with family. For many, it also means thinking about long-term care. Long-term care (or LTC) are the services and facilities that help you get through your daily activities once age makes them too difficult. This could include staying in a nursing home or simply getting assistance for dressing, taking medication, and transportation.

Long-term care can be expensive, and that is why so many people think about using federal long-term care insurance vs private. Navigating long-term care insurance is difficult, and choosing between federal or private coverage can be particularly frustrating. That’s why helpful agents, like the ones at Policy Solver can be so helpful. Keep reading to learn more about long-term care insurance, starting with the question: what is federal long-term care insurance?

Federal Long-Term Care Insurance

Let’s begin by defining federal insurance before getting into the debate about federal long-term care insurance vs. private. To begin, let’s clarify that federal long-term care insurance is different from Medicare. Medicare, the health insurance program for those over the age of 65, does not cover long-term care.

Definition

As a simple definition, federal long-term care insurance is an insurance coverage program for federal government employees, Uniformed services members, or their qualified spouses that is meant to assist with the various parts of long-term care. It is essential that you understand that federal long-term care insurance is only available for those who are federal employees or who meet a similar category.

Examples

One of the most popular examples of federal long-term care insurance is the Federal Long-Term Care Insurance Program, also known as FLTCIP. To qualify for the FLTCIP, you must be a federal or U.S Postal service employee or annuitant, a retired or active uniformed service member, or a close relative such as a spouse of someone meeting those categories. If you qualify for Federal Employee Health Benefits (FEHB) you will most likely also qualify for FLTCIP.

The U.S Department of Veteran Affairs also offers some long-term care financial assistance for military veterans or their spouses. These are the two most common examples of federal long-term care insurance.

What It Covers

Long-term care insurance has certain services or facilities involved in order to qualify as long-term care. When it comes to the FLTCIP and other federal long-term care insurance programs, they cover informal caregiving from friends or family, your choice of care in an assisted living facility or nursing home, and modifications to your home or caregiving needs.

Advantages

Some advantages of federal long-term care insurance are that federal employees can start their LTC insurance journey whenever they wish. The fact that it provides eligibility for both active and retired employees and service members widens the scope of coverage, as does allowing spouses to be supported.

Federal long-term care insurance is often guaranteed to be renewed as long as you pay your premiums on time. Premiums are the monthly fees you pay to your insurance company or provider. Federal programs also often waive the need to pay premiums once you begin receiving your long-term care benefits. There are great benefits of insurance that you can get.

Disadvantages

The most obvious disadvantage of federal long-term care insurance is that it is only an insurance program for people in a select category with specific eligibility requirements. If you are not a current or retired service member or federal employee, you can not access federal long-term care insurance.

In addition, federal long-term care insurance does not typically offer a refund or discount if you never end up needing long-term care services. It is also not subsidized by agencies.

For these reasons, whether or not federal long-term care insurance is right for you should be carefully considered. Now let’s review: how does federal long-term care insurance compare to private long-term care insurance?

How Does Federal Long-Term Care Insurance Compare to Private Long-Term Care Insurance?

If you are a federal employee or qualify for federal long-term care insurance, you are probably wondering about federal long-term care insurance versus private. These are big questions, and the biggest areas in which private insurance seems better is in having better availability, lowered cost, and increased coverage. At the same time, federal insurance may be easier to obtain and renew as a long-time service member.

So, which one is better?

Federal Long-Term Care Insurance vs. Private

Let’s go into deeper detail as far as the differences between private and federal long-term care insurance. This will help you to clarify your own needs, although it will be beneficial to find a trustworthy insurance agent to help you navigate these differences once you’re ready to take the next step.

Availability

First up on the list of primary differences is availability. We have already discussed how federal long-term care insurance is available for active or retired service members, federal employees, and occasionally their spouses. This may seem like a wide array of coverage, but what about people who do not meet these qualifications? There are certain reasons for long-term care insurance rejection.

In contrast, anybody can get private long-term care insurance. All you need is an insurance provider, the ability to pay your premiums and other coverage, and a specific long-term care plan. In short, private insurance has better availability in that it is open to both federal and non-federal employees.

Cost

While neither option is cheap, there are some differences in cost that are important to know about. When it comes to both cases, you can expect to pay a variety of costs, from premiums to deductibles to copays. We’ve already covered premiums, which will be the monthly cost you pay until you actually use your benefits. Depending on overall health status, you could be paying premiums for years! It’s important you know how to choose between long-term disability vs long-term care insurance.

A deductible is the amount that you need to pay before insurance kicks in, and a copay is a payment you make for a service after insurance has covered everything else. The copay is usually a fraction of the cost of the overall service. When thinking about federal or private insurance, considering your ability to meet these payments is crucial.

With private insurance, it is estimated that a single 55 year old man who purchases a $165,000 policy will end up paying about $950 a year. Gender, health status, and marriage status can impact these payments, and they are unique for every situation. This is just an example to help provide perspective.

Federal long-term care insurance is harder to calculate, but will also include premiums and annual fees. An example of a premium calculator can help estimate cost and premium based on their standard and most common plans. This is a helpful tool, but makes it difficult to estimate right off the bat, unlike private insurance.

Overall Coverage

Generally speaking, long-term care refers to the personal care and assistance you need with daily activities. In the medical field, these are known as Activities of Daily Living, or ADLs. They consist of:

  • Bathing
  • Dressing yourself
  • Using the bathroom
  • Taking needed medication
  • Eating
  • Drinking
  • The ability to move yourself from place to place

When you are unable to complete your own ADLs, be it due to a chronic illness, cognitive impairment or other medical condition, or accident, it is a clear sign that long-term care is needed. The type of care for people can include the need for:

Both private and federal insurance offer general long-term care insurance coverage for such instances, with some exceptions.

The biggest difference is that private long-term care insurance can be customized to a specific health insurance plan, while federal long-term care insurance cannot. Typically, federal insurance uses “prepackaged” or standard plans as their baseline for coverage. This means that the plans will already have coverage determined that can be tweaked later.

On the other hand, private long-term care insurance is more flexible and coverage can be added or taken away based on your prediction of your needs. That is also why working with an insurance agent is so beneficial. For example, you know about ADLs. But did you know about Instrumental Activities of Daily Living, also known as IADLs? They consist of:

  • Ability to use a telephone
  • Housekeeping
  • Managing your medication
  • Caring for a pet
  • Leaving the house
  • Grocery shopping or errands

These are still basic activities needed for life, but not as important as daily activities. Federal long-term care insurance will be less likely to cover such basic activities and services due to the fact that plans are less flexible and applied to broad groups of people. This is in opposition to private long-term care insurance, which can be tweaked to fit your specific situation. Make sure you remember this information when applying for disability insurance.

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Federal Long-term Care Insurance vs. Private Summary Comparison

Designing a federal long-term care insurance plan of care, for example with the FLTCIP, involves two primary steps: deciding on a daily benefit amount (DBA) and choosing a benefit period. The DBA is the maximum benefit amount that the program will pay each day for the covered long-term care services. You can choose anywhere between $100 to $450 dollars. Next, the benefit period is the length of time you will receive long-term care benefits. You can pick anywhere from two, three, or five years.

In contrast, a private long-term care insurance policy is a bit more flexible. Working with an insurance provider means that you can customize your plan of care, which gives you more freedom. Some people even opt to do “hybrid” plans which combine long-term care with their life insurance policy. This gives you more flexibility to decide on benefits and coverage. However, both plans will involve paying monthly premiums and other costs to retain eligibility for benefits.

So, a federal long-term care insurance plan of care is possible, but doesn’t offer as much flexibility as a private long-term care insurance plan. And, of course, not just anyone can even qualify for a federal long-term care insurance plan, so that might not even be an option.

In conclusion, both forms of long-term care insurance have their own benefits. But when looking at essential categories such as availability, cost clarity, and flexibility, many will find that private long-term care insurance is the clear winner. It depends on your unique situation, but the specific benefits are clear.

Is Private Long-Term Care Insurance Worth It?

After learning all of this, you are probably asking yourself if private long-term care insurance is even worth it. After all, you may not even use it! Why bother? In actuality, there are several reasons it is worth it for many.

  • It is incredibly likely that you will need long-term care at some point in your life. Most adults and elderly people do end up using long-term care at least temporarily.
  • Convenience. You already have health insurance and possibly even a life insurance policy, so long-term care insurance is an obvious next step.
  • Peace of mind for yourself and loved ones. Worrying about the costs of care and the strain on family caregivers or other informal caregivers can be incredibly worrisome for all parties. With long-term care insurance, such worries can be put to rest.

Where Can I Find Out More and Get Advice on Federal Long-Term Care Insurance vs Private?

Today, you can find multiple private insurance companies on the internet. However, choosing the right advisor is another difficult task. Policy solver has knowledgeable, licensed agents, and is here to help you navigate through your insurance journey. We are a team of professional insurance policy brokers and we can save you time and money while finding the right policy and long-term care insurance premiums for your specific needs.

Our experienced advisors will ask you a few questions to understand your unique situation and will come up with a comprehensive analysis of different insurance plans so they will be able to recommend the best long-term care insurance policy at the best price for you.

Contact us or schedule a free consultation, and we will get back to you soon!

Sources:

“Explore What the FLTCIP Has to Offer.” LTCFEDS, https://www.ltcfeds.com/.

Fallas, Diego. “Guide to VA Long-Term Care Benefits.” A Place for Mom, A Place for Mom, 16 Apr. 2021, https://www.aplaceformom.com/veterans-benefits-guide.

“Long-Term Care Insurance Cost: Everything You Need To Know.” ” Long-Term Care Insurance Cost: Everything You Need to Know, https://www.marketwatch.com/picks/guides/insurance/long-term-care-insurance-cost-everything-you-need-to-know/.

“Tools – Premium Calculator, Plan Comparison: FLTCIP.” Tools – Premium Calculator, Plan Comparison | FLTCIP, https://www.ltcfeds.com/tools/premium-calculator.

“Activities of Daily Living Measure the Need for Long-Term Care Assistance.” ElderLawAnswers, 20 Nov. 2015, https://www.elderlawanswers.com/activities-of-daily-living-measure-the-need-for-long-term-care-assistance-15395.

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