Navigating the roads of long-term care and ‘terrain’ of long-term care insurance products can be confusing, especially since these products are not standardized like Medicare supplement insurance (known as Medigap). We’ve recently updated our website sections on long term care and our long-term care fact sheet series which provide great resources for: 1) learning about this area of care; 2) how to plan for it financially; 3) long term care options and insurance products; and 4) a whole section on frequently asked questions.
Below is an answer to a question we received regarding a beneficiary’s situation that may be pertinent to many people who bought a long-term care (LTC) policy when still fairly young and didn’t look too closely at the details of what the policy covers. Now, many years later, when this particular beneficiary is interested in coverage for some LTC services, she’s realizing that it doesn’t cover the type of care she wants. Her policy only covers nursing home care and respite care, but not any home care or community-based care services. She contacted our office to see if we know of any companies in California who sell home care only policies. Bonnie Burns, our Training and Policy Specialist who is an expert and national consumer advocate in long-term care, responds to her question below.
There don’t appear to be any companies left selling home care only long term care insurance policies in California. In fact, many of the companies selling long-term care insurance have withdrawn from the market, although some are still some left and selling in California. I suggest you contact an agent in your community who has taken the required training to sell long-term care insurance and work with him or her to find a package of benefits that will wrap around what you already have. I agree with your assessment to keep what you already have and supplement it in some way. It doesn’t seem reasonable to forfeit the premiums you have already invested in this policy if it provides at least some benefits for future care.
It’s important to know that today most long-term care starts at home, and many people never move beyond home care to institutional care. But, institutional care can be an impoverishing event so having benefits for it is still very necessary.
One option, depending on the company that issued your previous coverage, is to ask if that company would be willing to upgrade you to a more current policy and give you some premium credit for what you have already paid. In California, if a company does that and it’s the same company that issued the previous policy they may be required under state law to give you such a credit. You’d have to pass medical underwriting, but you would have to for a home care only policy anyway if it was available.
You can go on the insurance department website and look for companies selling in California. Click on sample rates and fill in the information to get a look at what is being sold. You can also contact your nearest Health Insurance Counseling and Advocacy Program (HICAP) for free, local help. They won’t be able to recommend a company or agent, but they can help with information to help you make a decision.
For more information, resources and FAQs, see our website section on Long-Term Care.