New Federal Long-Term Care Insurance Policy May Soon Be Available

New Federal Long-Term Care Insurance Policy May Soon Be Available

A new federal long-term care insurance policy will become available if the Community Living Assistance Services and Supports Act is passed as part of the current proposed health care legislation. The new program will be a voluntary opt-in insurance plan that would give beneficiaries up to $75 a day to pay for long-term care expenses.  While the premium amounts for this plan have yet to be determined, people who pay into the program and later require benefits will have a wide range of options on how to spend them. For example, they can choose whether to spend their benefits on cooking and transportation help or rent in a long-term care facility.

This is a significant change for many reasons. The main reason is that this is the federal government’s first step in covering long-term care with a national plan (not including Medicaid, which is used for nursing-home care but isn’t a long-term care insurance plan).

Below is a summary of important points to know about the CLASS Act should this legislation be passed. These were summarized by Bonnie Burns, our Training and Policy Specialist, in a recent article in Reuters.

  • That $75 daily benefit could help a moderately impaired person get the help they need to stay in their home and on the job longer. But it’s not even close to what you’d need to cover full-time assisted living in a decent facility, or life in a nursing home. That’s closer to $200 a day, according to MetLife’s latest survey.
  • Medicaid covers nursing-home care for people who no assets and are poor. Nothing (except for personal savings and private long-term care insurance) covers an extended stay in a nice assisted living facility. If you’re living in an assisted living facility and you run out of money, you’re most likely to get kicked out and be sent to a nursing home.
  • Private long-term care policies, which have been developed and promoted as the solution to budget-busting long-term care bills, have had a lot of problems, including sharply rising premiums, lack of stability of the underwriting company, failure to pay expected benefits, and heavy-handed promotions to people who probably shouldn’t be buying those policies. The National Association of Insurance Commissioners has reported logging an ever-increasing number of consumer complaints about long-term care insurance.
  • Increased government regulations, mostly at the state levels, are helping those policies shape up. The argument for buying insurance now is always that if you wait too long, you may develop a condition that disqualifies you from buying it later. That’s true, but long-term care insurance is a product most people buy and don’t expect to use for a couple of decades, or longer. It makes more sense to wait for a solid plan before buying it.
  • Insurance companies like Genworth, a major long-term care player, are already trying to figure out how to integrate the federal program into their policies. Some companies may simply deduct the government’s $75-a-day plan from their own benefits. That should make their policies cheaper. Other companies may let you keep that $75 for extras, like a second policy. Some policies that have already been sold, may have a ‘coordination of benefits’ provision in them that will be affected by the new government plan. Make sure to check your policy.
  • Figure out if you’re a reasonable candidate for long-term care insurance. It’s a policy designed to protect your assets if you need that kind of care. If you don’t have very much money, don’t bother to buy a policy because you’re likely to spend down your own funds quickly and qualify for Medicaid. If you have loads of money, you can pay your own long-term care costs. If you have assets in the middle, say between $75,000 and $2 million, you should consider buying a policy. Even if you have enough money to pay for your own care, you may want to buy a policy to protect your children’s inheritance and budget. (If that’s the case, you could always ask your kids to help with the premiums.)
  • Check out your state’s insurance regulator before buying a policy. Find them through the NAIC (www.naic.org/state_web_map.htm). Some states have stronger long-term care insurance regulations than others. Some also offer partnerships with the policies, so that purchasers only have to buy enough insurance to cover them for 5 years, and then can get state funding for care needs that exceed that period.
  • Don’t buy long-term care insurance without vetting the insurer. The policy has to last decades; you don’t want to pay premiums to a company that will go under in 5 or 10 years. Check the firm’s ratings with key agencies. You can see a list of the strongest and weakest long-term care insurance companies at Weiss ratings.
  • Make sure you buy a policy that includes inflation protection for benefits. And don’t buy a plan unless you are confident that you could continue to keep the policy in force, even if rates rose 20% or more.

See Bonnie Burn’s full summary of the CLASS Act for more information.

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.

Join us for an educational webinar

Preventing Workplace Violence & Active Shooters in a Healthcare Environment

January 23, 2020 » 10 - 11:30a.m. PST

Learn More