Long-Term Care Overview
Long-term care provides services that help people with chronic conditions overcome limitations that keep them from being independent. It helps individuals maintain their level of functioning, rather than improving or correcting medical conditions. If individuals have physical illnesses or disabilities, they often need help with activities of daily living (ADLs). These ADLs include bathing, continence, dressing, eating, toileting and transferring. Individuals with cognitive impairments usually need supervision, protection, or verbal reminders to do everyday activities. Skilled care and custodial care are the terms most often used to describe long-term care and the type or level of care needed.
The eligibility for benefits shall not be more restrictive than the inability to perform at least three of the following ADLs: 1.) bathing, 2.) continence, 3.) dressing, 4.) eating, 5.) toileting, 6.) transferring (ability to move into or out of a bed, chair, or wheelchair). Insurers may use ADLs to trigger benefits in addition to these listed, provided they are listed in the policy. However, an issuer of a qualified long-term care contract (discussed in LTCPP below) is limited to considering only the activities of daily living listed in this paragraph.
Long-term care insurance is designed to help pay for an individual’s long-term care expenses. Depending on the plan you choose, it may pay part or all of your care.
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