What is long-term care?

Insurance is an important tool for protecting yourself against risk. For instance, health insurance pays your doctor and hospital bills if you get sick or injured. But how can you help protect yourself against the significant financial risk posed by the potential need for long-term care services, either in a nursing home or in your own home?

Long-term care goes beyond medical care and nursing care to include all the assistance you could need if you ever have a chronic illness or disability that leaves you unable to care for yourself for an extended period of time. You can receive long-term care in a nursing home, assisted-living facility, or in your own home.

Though older people use the most long-term care services, a young or middle-aged person who has been in an accident or suffered a debilitating illness might also need long-term care.

Beyond nursing homes, there is a range of services available in the community to help meet long-term care needs. Visiting nurses, home health aides, friendly visitor programs, home-delivered meals, chore services, adult daycare centers, and respite services for caregivers who need a break from daily responsibilities can supplement care given by family members.

These services are becoming more widely available. Some or all of them may be found in your community. Your local Area Agency on Aging or Office on Aging can help you locate the services you need. Call the Eldercare Locator at 800-677-1116 to identify your local office.

Are you likely to need long-term care?
You may never need long-term care. But about 19 percent of Americans aged 65 and older experience some degree of chronic physical impairment. Among those aged 85 or older, the proportion of people who are impaired and require long-term care is about 55 percent. In the year 2020, some 12 million older Americans are expected to need long-term care. Most will be cared for at home.

Family members and friends are the sole caregivers for 70 percent of elderly people. A study by the U.S. Department of Health and Human Services indicates that people age 65 face at least a 40 percent lifetime risk of entering a nursing home sometime during their lifetime. About 10 percent will stay there five years or longer.

The American population is growing older, and the group over age 85 is now the fastest-growing segment of the population. The odds of entering a nursing home, and staying for longer periods, increase with age. In fact, statistics show that at any given time, 22 percent of those age 85 and older are in a nursing home. Because women generally outlive men by several years, they face a 50 percent greater likelihood than men of entering a nursing home after age 65.

While certainly older people are more likely to need long-term care, your need for long-term care can come at any age. In fact, the U.S. Government Accountability Office estimates that 40 percent of the 13 million people receiving long-term care services are between the ages of 18 and 64.

Download Guide to Long-Term Care Insurance

PDF format, 158KB.

America’s Health Insurance Plans
www.ahip.org

Contents
What is long-term care?..........................................2
Are you likely to need long-term care?....................2
What does long-term care cost? ..............................3
Who pays the bills? ................................................4
Where can I get long-term care coverage? ..............5
What are the types of long-term care policies? ........5
What do policies cost? ............................................6
Will my premiums increase as I get older? ..............8
What do long-term care insurance policies cover? ..8
What is not covered? ..............................................9
What else should I know before I buy? ................10
What about switching policies? ............................12
What should I look for in a policy? ......................12
Before you buy ....................................................13
Long-term care policy checklist ............................14
HIPAA’s impact on long-term care insurance ......16
Tax treatment ......................................................16
Consumer protection standards ............................17
If you need help ..................................................19

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