What is long-term care?
Long-term care is the medical and/or social services term for helping people who develop disabilities or chronic care needs. For example, there may come a time when you or a loved one needs help walking, getting dressed, eating, or bathing. It also includes the kind of care you would need if you had a severe cognitive impairment such as Alzheimer's disease. Long-term care services may be brief with full recovery, or they can continue for years. Services may be provided in a person’s home, in a residential facility such as a nursing home or assisted living facility.
What services are covered?
A long term care insurance policy helps you pay benefits for services you receive at home, in an assisted living facility and in a nursing home in the event you need such care. Benefits are payable according to the terms of your long term care insurance policy.A long-term care insurance policy will pay benefits for services you receive at home (such as cooking, cleaning, laundry, grooming and assistance with other activities of daily living), or in an assisted living facility and in a nursing home if a situation requires more intensive attention on a daily basis.
When is an insured eligible for the payment of benefits?
To be eligible for any benefits provided under your policy, you must be chronically ill. This means that you have been certified within the last twelve (12) months by a licensed health care practitioner as:
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being unable to perform, without substantial assistance from another person, at least two activities of daily living for a period that is expected to last at least ninety (90) consecutive days due to a loss of functional capacity; or
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requiring substantial supervision to protect you from threats to health and safety due to a severe cognitive impairment.
Once certified as benefits eligible, the 90 calendar day benefit waiting period will begin. For more details regarding payment of benefits, please request a sample policy from your LTC Specialist.
What is the “right” age to buy Long-Term Care Insurance (LTC)?
Because premiums are based on age and health, the younger an individual is, the lower the premiums will be. Premiums typically increase 8-10% each year a person waits to buy coverage.
What does reduced health screening mean and how does it work?
SESC employees and working spouses/domestic partners who are actively at work for at least 20 hours per week, and between the ages of 18-65, are eligible to apply with reduced health screening. This is a one-time opportunity to apply for long-term care insurance with fewer medical underwriting questions and no medical exam to prove good health during the special enrollment period.
What benefits do I receive? What does the policy cover?
When you purchase long-term care insurance, you are buying a pool of dollars from which you can pay for long-term care services.