Dispelling the Myth: Is LTC Insurance Only for Nursing Homes, or Home Care Too?

Contrary to popular belief, one of the biggest benefits of LTCi, or long-term care insurance, is empowering oneself to be able to receive care at home. According to studies conducted by the American Association for Long-Term Care Insurance, almost 8 million people receive care at home, as opposed to less than 2 million in nursing homes.

LTCi and Home Care Decoded

Everyone would like to live in a safe, comfortable and familiar environment, but sometimes (due to illnesses, injuries or simply old age), living in our own home and handling things ourselves just isn’t feasible. Home-based care makes it possible to receive assistance at home for as long as possible, regardless of age or disability.

This assistance can simply be companionship, cooking, help with ADLs (activities of daily life like brushing, bathing, etc.) or even skilled services like nursing, depending on an individual’s specific needs.

Who Should You Approach for Home Care?

Caregivers can be employed via a home care registry or agency, and here’s how they differ:

• A home care registry is an organization that employs caregivers on an individual contract basis. Though a caregiver employed through a registry may be well-suited for the client and cheaper, the liability for payroll taxes and possible work-related injuries falls on you.
• A home care agency, on the other hand, is an agency that trains, bonds, insures and conducts background checks for caregivers, to ensure quality, safety and a hassle-free experience.

Two essential points to enquire about from long-term care providers of either kind are whether regular background checks are carried out for caregivers (especially with respect to criminal and sexual abuse records), and whether unannounced quality assurance visits are carried out.

10 Must-Ask Questions for Home Care Providers

1. Since when has the agency been in the business of private home-based care, and what kind of references can they provide?
2. Does the agency develop a customized care plan (in writing) in consultation with you and your family members, and update the plan when any changes occur?
3. How does the company deal with emergencies that take place after normal business hours?
4. Does the agency conduct non-scheduled supervisory home visits and maintain a daily journal of activities in order to ensure that the quality of care is properly supervised?
5. Are qualified professionals (like nurses and social workers) hired by the agency to make regular home visits and conduct quality assurance checks?
6. Are clients provided with a written document stating their rights and responsibilities as well as an explanation of the agency’s code of ethics and privacy policy?
7. Are employees carefully and thoroughly triple-screened, i.e. investigation of references, driving records and criminal backgrounds?
8. Are the agency’s employees given regular and on-going training, to ensure that their skills are up-to-date and at par with industry care standards?
9. Are employee and payroll-related matters handled by the agency? Do its employment practices adhere to state and federal guidelines for appropriate taxes and benefits like workers’ compensation?
10. Are independent contractors used by the agency? If yes, who employs them, pays relevant taxes and handles withholdings, and what kind of background checks are conducted for these employees?

Role of LTCi Coverage in Home Care

Advancement in medical science has prolonged overall life expectancy, and thus increased the need for home care in later decades of life. In case of chronic illnesses like cancer, Diabetic Retinopathy or strokes, trained caregivers or nurses may be needed to check vitals and handle medical equipment installed in the home.

While selecting a policy, one of the points to be considered is the range of services anticipated, whether just caregivers for ADLs or more specific medically trained personnel. Also enquire about the waiting period after which the funds can be accessed. Generally, the longer the waiting period, the longer the benefit period.

Remember, Sooner Is Better

Getting LTCi earlier in life has its benefits. Firstly, the price of the annual premium is significantly lower when insurance is bought earlier, and secondly, there are higher chances of the application being accepted.

Planning ahead helps one get an affordable policy and avail home care in earlier stages of ageing and/or debility caused by illness/injury, to prolong the duration for which one can stay at home. If you keep waiting for the most appropriate time to avail LTCi benefits, home care may not be feasible anymore and nursing homes will become inevitable.

In the next 30 years, the annual cost of long-term home care is expected to increase by 330%, going up to an average of $300,000, much beyond what we can save during our working years. On the other hand, if we anticipate our needs and invest in the appropriate LTCi policy now, our worries are lower when the need for home care arises.