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Long Term Care Insurance Overview


Long Term Care (LTC) insurance offers financial protection to individuals that are unable to perform Activities of Daily Living (ADL’s). ADL’s are the things fully-functional individuals do on a daily basis and that require no assistance from others to accomplish them. Those that require assistance of ADL’s receive these services in nursing homes, assisted living facilities, adult day care centers and at home. Major medical insurance does not cover these services as that type of insurance only covers “acute” illnesses or conditions. This is how LTC came into existence.

There are six ADL’s:

  • – Hygiene (e.g. bathing, grooming, shaving & oral care)
  • – Continence (voluntary control over urinary and fecal discharge)
  • – Dressing
  • – Eating
  • – Toileting
  • – Transferring (sitting, standing, moving from a bed to a chair, etc.)

The loss of two ADL’s and/or “significant loss of cognitive function” (as associated with Dementia for example), will trigger LTC benefits for those covered with this form of insurance.

The need for LTC services arises from physical disabilities or chronic health conditions such as:

  • – Alzheimer’s Disease
  • – Stroke
  • – Multiple Sclerosis
  • – Parkinson’s Disease

According to the New York State Partnership for Long Term Care (2008), the average daily cost for nursing home care on Long Island is $369 per day. In NYC, the cost is $338 per day. If an individual requires a lengthy stay in a nursing home, you can see how quickly these costs add up over time. These costs will also increase due to inflation and/or other factors.

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