What is long-term care insurance?

Long-term care is the assistance people need when they can no longer perform basic activities of daily living including eating, bathing, dressing, continence, toileting and transferring. A Long-term care insurance policy is designed to help you pay for assistance with these types of activities. Long-term care needs typically arise as part of the normal aging process but can also be due to injury or illness, such as stroke or cognitive impairment like Alzheimer's disease.

Who needs long-term care insurance?

If you prefer to live in your home for as long as possible, and you want to help protect your retirement savings, you may benefit from a long-term care insurance policy. Typically, Medicare doesn’t fully cover assisted care expenses, including custodial care, which is provided in nursing homes, assisted living facilities or at home. Coverage for these types of health expenses helps you maintain control of where you will receive care and helps protect your life’s savings.

70% of Americans over 65

expect to use some form of long-term care services

The national average cost for a private room in a nursing home is

$7,698 per month

Product features and benefits

Offers independence and financial security
Offers flexibility in making choices and the option to live at home
Provides coverage for unexpected health expenses
Days of care do not have to be consecutive within the claim period

Types of long-term care policies

Comprehensive long-term care insurance

Offers freedom of choice
Covers expenses for nursing home, assisted living facilities†, adult day care centers or home care services

Facility-only long-term care insurance

Covers expenses associated with nursing homes, assisted living facilities† and Alzheimer's facilities

How does long-term care insurance work?

Long-term care insurance policies reimburse policyholders a monetary daily amount (up to a pre-selected limit) for assisted care services such as eating, bathing or dressing. You can select a range of care options and benefits that allow you to get the services you need, where you need them.

How do I know if I'm eligible for long-term care insurance?

Step one in obtaining long-term care insurance is meeting with an experienced, licensed insurance agent/producer to determine the right plan for you. Most individual long-term care insurance policies require medical underwriting and may require a medical exam. Our underwriters will review your medical history to determine if your application is acceptable and to identify your risk classification.

How is the cost of long-term care insurance determined?

Your premium amount will be determined by your length of coverage, your age/gender, your current health, the elimination period (the amount of time before your policy begins to pay benefits) and the maximum dollar amount you can be reimbursed for covered expenses. Qualifying for coverage can become more difficult as you age—the best time to apply is while you're still in good health.

Why Us?

Simplified application process

Our knowledgeable insurance agents/producers sit down with you in your home to understand your preferences and goals. They’ll provide you with simple, clear choices that meet your individual financial needs.

Personalized approach

We take a personalized approach to help protect the individuals and families we serve. We focus on helping you improve upon your financial security, particularly as you enter and navigate retirement.

Service you can trust

Our agents/producers live in the communities they serve and travel to your home or business. Our goal is to provide excellent service to every policyholder and make your life easier when it comes to your claims.

FAQs?

Where is long-term care provided?

Long-term care does not necessarily mean a nursing home. You can receive long-term care in a variety of settings, including:

Adult day care center, where care is provided during the day for adults usually in a public group setting.
Assisted living facility, a residential arrangement that may provide personalized care and health services. Residents may need help with activities of daily living like bathing and dressing. This type also may be called custodial care, domiciliary care, intermediate care, personal care, residential health care, sheltered care or supported care facilities.
Hospice care, provided to relieve pain and manage the symptoms associated with a terminal illness and any related conditions. Hospice care may be provided by an agency that specializes in relieving pain, managing symptoms and supporting dying persons and their families.
Nursing home, a licensed facility providing around-the-clock room and board, nursing care and personal services. Nursing homes also may offer medical care, therapy and other health-related services.
Your home, where you can receive services and supplies without having to leave. Common options are home health care, adult day care, hospice care and respite care.

Other types of long-term care include:

Custodial care (also called personal care), which helps you perform the activities of daily living with help from someone who doesn't have professional medical training.
Skilled nursing care, daily nursing and rehabilitative care performed only by or under the supervision of skilled medical personnel.

What does “chronically ill” mean?

"Chronically ill" means you have been certified by a licensed health care practitioner within the preceding 12-month period as:

Being unable to perform two of six basic activities of daily living, which can include eating, bathing, continence, dressing, toileting, and transferring.
Having a severe cognitive impairment.

If Medicare paid for my expenses, should I still file a claim?

Yes. If your policy has an elimination period, your Medicare-covered expenses could satisfy that requirement. Remember, your policy's benefit-eligibility requirements still must be met before expenses will be paid.

Can I hire a family member to provide home health care for me?

Your policy may have an exclusion that prevents benefits from being paid for care by an immediate family member. Be sure to review your policy to see if it has this exclusion.

If it does not have this exclusion, benefits may be paid from home health care provider by an immediate family member. That individual will simply need to meet the provider-eligibility requirements described in your policy. Contact the insurance company's customer service department before care begins to verify that the family member meets your policy requirements.

I have a home health care agency I want to use. How can I find out if it's an eligible provider with my policy?

Contact the insurance company's customer service department before care begins. We can then verify whether the agency meets all policy requirements. If necessary, we can provide names and contact information for eligible agencies in your area.

Does my policy pay benefits for someone to clean my house?

Many policies pay benefits to cover "homemaker services." You must meet your policy requirements for benefits to be paid. Check your policy for specific information. If you're still unsure, contact our customer service department for support.

What are the requirements for an independent caregiver?

An independent caregiver must meet the policy requirements to be considered an eligible provider. Home health care services provided by independent caregiver—that is, a caregiver who is not employed by a home health care agency—may qualify for benefits if that individual currently meets one of the following:

A licensed Registered Nurse.
A licensed Practical Nurse.
A Certified Nurse Aide.
Included in a government-sponsored Nurse Aide Registry.

Note: These criteria don't apply to independent caregivers in California.

Is there a waiting period before my policy pays benefits?

Most policies have an elimination period or deductible. An elimination period is similar to a waiting period. Benefits aren't paid for an approved claim until after a certain number of days pass. The exact language and number of days will vary by policy. If you have questions, please contact us.

Is there a deadline for submitting claims?

Our insurance policies defines the timeframe during which we must receive the claim. Your state’s insurance regulations may very from this standard and will always override your policy's provisions.

How long does it take to process my claim?

Each state defines the timeframe companies have to pay eligible benefits. Refer to the Prompt Pay law guidelines in your state for your policy type.

To process your claim quickly and accurately, we must gather specific information from your care provider. When you can help us gather the required documents and supply any missing information, you can prevent or decrease delays.

Our claim department will review your documents to verify that we’ve received all required information. The claim will then be reviewed for eligibility. We will communicate with the claimant and/or guardian throughout the process.

Should I file a claim before or after I begin receiving care?

Most insurance policies are "expense incurred" policies. In other words, care must begin with the provider before a claim can be filed and processed.

Can I submit a claim on behalf of insured?

If the insured won't be handling the claim personally, the insurance company requires certain documentation before benefits can be paid. For an authorized representative to manage a claim on the policyholder’s behalf, we must receive one of the following:

A signed third-party authorization form. This document simply authorizes the insurance company to disclose information to a designated individual over the phone or in writing. This form does not give the authorized party the same legal authority as a power of attorney or legal guardian. Visit our service and support page to download the authorization form.
A copy of a health care or durable power of attorney (POA) document. This document may authorize the specific individual to make health care or financial decisions, provide information or handle business affairs for your policy. The POA documentation defines the authority granted to that individual. Visit our service and support page to download the authorization document.

Can I file a claim for my medical alert system?

Many insurance policies pay a benefit for emergency medical response systems, such as Life Alert®. The system must meet your policy's benefit-eligibility requirements to qualify. Please review your policy for details. If you're still unsure, contact us or the insurance company's customer service department.

California residents—Specific individual long-term care insurance policy forms offered in California are available to a prospective applicant upon request. Please contact us on our Contact Us section or Request an Appointment page.

†In California, an “assisted living facility” is licensed as a residential care facility for the elderly or a residential care facility as defined in the Health and Safety Code.

Long-Term Care Insurance

How to help cover the cost of taking care of yourself when you no longer can.