Long-term care insurance is typically something aimed at older individuals, but what about disabled adults who need medical care immediately or are likely to at any moment? Can long-term care insurance for disabled adults be a useful tool, or do you still need to wait until you’re older? Maybe you’re not disabled, but a close loved one is, and you’re concerned about their future?
This guide will walk you through the details you need to know regarding what long-term care insurance is, how it can benefit you or a family member dealing with a disability, and the best way to find a policy that will suit your needs if the time ever comes that you need to make a claim.
What is Long-Term Care Insurance?
Long-term care insurance is an insurance type that covers costs relating to stays in long-term care facilities such as nursing homes and assisted living, but it also provides coverage for a number of key treatment options for the disabled or elderly.
Can You Get Long-Term Care Insurance with a Pre-Existing Condition?
This is a common, and completely legitimate, concern for many people with disabilities in need of disability insurance. However, you shouldn’t worry too much.
While insurance companies are known for taking every detail of your medical history into account before providing you with a policy, that doesn’t automatically mean you’ll never get a policy. There are policies available to accommodate people with pre-existing conditions.
These policies can be purchased from standard long-term care insurance providers, and they typically have higher premiums due to the increased risk the insurer takes on, or they can be purchased from companies that focus on helping those with mental or physical disabilities and various other medical conditions that other insurers may be hesitant to take on; without charging unreasonable additional premiums and other things that would be cause for concern ((1)).
In any situation, it is best to make your pre-existing disability or condition, along with all your other medical information, crystal-clear upfront.
How Will My Disability Affect My Long-Term Care Application?
As mentioned previously, one of the ways your pre-existing condition can affect your long-term care application is by increasing your premium rates. This is because of the increased risk an insurer takes on giving insurance to people with a disability in comparison to those who have had a clean bill of health their entire life.
However, there are other ways your pre-existing condition might affect your LTC insurance. Obviously, some companies that don’t specialize in helping disabled clients might deny you, but dishonesty can create an even more problematic situation.
It’s important to ensure you disclose all information about your disability while applying because if you don’t, you might get the insurance policy, but you will likely have any claims you make for long-term care costs denied when the insurance company acquires your full medical records; leaving you uncovered when you need it most.
The Affordable Care Act and Long-Term Care Insurance
If you’ve been keeping up with insurance-based legislation, you’ve probably heard of the Affordable Care Act and how it prevents insurance seekers from being denied or charged more for insurance due to pre-existing conditions. That contradicts the last couple of sections, but there’s a reason for that.
While the Affordable Care Act protects those looking for health insurance and some other health-related insurance policies, long-term care insurance wasn’t included in the bill.
This means that insurance companies are free to increase your premium rates, deny your initial application, or limit what is available to you because of your disability ((2)).
This might make it difficult for you to find a suitable insurance coverage policy on your own, and it’s recommended to seek the help of a professional insurance consultant agency such as Policy Solver.
Can I Buy Long-Term Care Insurance for Someone Else?
Perhaps you aren’t looking at long-term care insurance for yourself? Can you buy a policy for someone else who may need it? Yes, you can, and it’s actually a common practice for several reasons ((3)).
There can be several reasons for you to do this. Normally, people purchase long-term care insurance for their parents to not only ensure that their parents get proper care but to also prevent the exorbitant costs of LTC insurance from being passed down to them if their parents end up requiring nursing home care.
However, if you have a disabled child or another disabled person who relies on you for survival, it may be a smart idea to purchase a policy for them, too. Disabled adults often rely on their parents when they suffer from cognitive issues or other things that prevent them from attaining independence, and while that works for a long time in best-case scenarios, it eventually produces a major problem; what happens when their parents die or end up needing long-term care themselves?
If you have a disabled adult child who relies on you, purchasing a long-term insurance policy for them can ensure that they are well cared for in the event of your passing or entering a nursing home.
This is a great pre-emptive move to make to ensure that the people you love the most are protected when you can no longer provide for them in the special ways they need you to, and it’s one of the biggest reasons to purchase a long-term care policy for a disabled adult.
What Does Long-Term Care Insurance for Disabled Adults do?
Long-term care insurance, as mentioned before, pays for several different levels of care for people such as nursing home or other assisted living facility stays, adult day care, and various other medical services.
Here’s a list of what services are available and how they may help disabled adults.
Nursing Home Stays:
If your disability requires a lot of skilled care and medical attention, less intensive long-term care services may not be enough. Instead, personal care services in an all-inclusive care nursing home might be crucial to ensure you receive all of the health care services you need in one place.
Assisted living is very similar to nursing facility care, but it’s not as uptight and medically focused. Instead, it focuses on the more standard personal care needs and medical assistance of its residents such as ensuring you eat properly, take your medications, maintain good hygiene and get plenty of socialization time. This is preferable to a nursing home, but it is also a residential care facility.
Imagine your parents have taken care of you your entire life, and they have suddenly passed away. Now, your sibling wants to help, but providing you with this non-custodial care means sacrificing their job, personal time, and various other parts of their personal lives, and they may not even know what they’re supposed to do to provide proper care.
Long-term care insurance can resolve all of those issues with caretaker training and respite services. Caretaker training prepares your preferred caretaker to give family care to you in the comfort of your own home, and it makes them eligible for caretaker pay from your state government since they likely won’t be able to maintain a job while dedicating their time to you.
This is a benefit for your at-home caretaker. It can be extremely stressful to take care of a loved one; even when they love to do it. They have to post-pone their personal goals, spend time away from their families, and overall dedicate most of their time to your needs.
Respite care services give assistance to people who are carers, providing them with regular breaks to get away for a period of time and recharge or focus on themselves while a professional takes care of you for a few hours.
Adult Day Care:
Adult day care is an out-patient service. You go to a facility for a couple of hours regularly, and the staff helps ensure you’re taking care of yourself, provides therapy sessions, and various other services in a community setting. This is ideal for patients who have health conditions that require some help but can still remain at home.
If you end up requiring a nursing home or assisted living arrangement, you will be essentially renting a room or half of a room. If you leave for an extended period, such as for extensive medical care, you can lose your spot.
If you have long-term care insurance, it can pay to reserve your spot until you return; allowing you to stay in the same living arrangement despite long absences.
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Long-Term Care Insurance for Disabled Adults
So far, you’ve learned about some disability-specific things to look out for, and you’ve learned about the services covered by long-term care insurance. Long-term care insurance for disabled adults can really come in handy because many disabled adults typically have challenges with activities of daily living, and so having the benefit of long-term care insurance can be a way to help pay for the help that will be needed. But, to be clear, there is no specific long-term care insurance for disabled adults product. Rather, there are just different considerations to keep in mind if you’re disabled, or have a loved one who is, and you’re considering long-term care insurance.
Now, it’s time to learn about the basics: Price, receiving benefits of insurance, and potential issues.
Long-term care insurance is one of the more expensive forms of insurance. For a 55-year-old man, it usually costs around $1700 per year, that’s a monthly premium of around $140. However, if you’re purchasing a policy while you’re younger or for a disabled loved one who’s young, your rates will usually be lower ((4)).
Making a Claim:
The claims process requires you to acquire a claim application from your insurer, fill out the necessary information, and turn it back in. You will likely need to have a doctor fill out paperwork as well, and you’ll need to provide all of your medical and financial records.
Benefits for people are given or denied after a waiting period of 0-90 days ((5)).
Potential Issues with Making a Claim:
The waiting period is designed to give your insurer time to process your claim. During that process, they will comb over every detail of your medical history and financial status to ensure that you’re eligible for benefits. After all, they are business professionals, and they want to avoid paying benefits to people if possible. This causes some issues for policyholders.
First and foremost, they will look for omitted information in your application in comparison to your claim to see if you left out a detail that may be used to deny your claim.
Then, they can try to ask for superfluous or duplicative documents to stretch out the process and buy themselves time or cause you to miss necessary deadlines.
It’s important to understand this. Be as detailed about your health history as possible when applying for health care coverage, provide every bit of information possible when making a claim, and if they do deny you on a baseless claim, consider a long-term care attorney who can appeal the decision more effectively ((6)).
How to Get the Best Long-Term Care Insurance for Disabled Adults
As you can see, there are some obstacles disabled individuals face when trying to purchase long-term care insurance, or even when people without disabilities try to purchase policies for their loved ones as pre-emptive protection for the future.
These obstacles might make it seem impossible to get a proper long-term care insurance policy due to the nature of a disability being a pre-existing condition, but that’s simply not true. You just need a bit of help to work your way through the massive network of insurance providers and their policies to find the right one.
For that, there’s only one solution guaranteed to help: Policy Solver.
Policy Solver is a professional insurance consultant service specializing in helping people from all walks of life to find the insurance policies they need to protect themselves; all without breaking their budget or sacrificing must-have coverage features.
Policy Solver staffs a full team of professional insurance experts who provide one-on-one guidance and assessments to get a clear view of your needs and then lead you towards the right policy. Besides that, we have also built meaningful relationships with the top insurance companies in the country to ensure they can find you the best policies at the best prices without having to dedicate tons of time to manually searching for those policies.
If you’re a disabled adult who needs long-term care insurance to ensure you’ll be taken care of in the future, contact Policy Solver and bypass the obstacles blocking you from getting high-quality insurance.
1: Taken from ALTCP.org, 03/14/2022, https://www.altcp.org/long-term-care-insurance-pre-existing-conditions/
2: Taken from Merlin Law Group, 03/14/2022, https://www.propertyinsurancecoveragelaw.com/2014/01/articles/insurance/longterm-care-insurance-the-preexisting-condition-dilemma/
3: Taken from Insurance QnA, 03/14/2022, http://www.insuranceqna.com/long-term-care-insurance/buy-long-term-care-insurance-to-cover-parents.html
4: Taken from Smart Asset, 03/14/2022, https://smartasset.com/insurance/how-much-does-long-term-care-insurance-cost
5: Taken from Elder Law Answers, 03/14/2022, https://www.elderlawanswers.com/what-a-good-long-term-care-policy-should-include-5592
6: Taken from Stop Insurance Denial Law Firm, 03/14/2022, https://www.stopinsurancedenial.com/services/insurance-claim-denial/long-term-care-insurance-denial