What to Know About Long-Term Care Insurance in the Richmond, VA Area

If you're trying to find the right long-term care solution for your senior loved one, you're not alone. In fact, a study from the U.S. Department of Health and Human Services suggests that at least 70 percent of adults over age 65 will need some type of long-term care during their lifetime.

If your loved one is in a situation where they need long-term care, it's important to figure out how your family will pay for it. According to Genworth, the cost of long-term care in the Richmond, VA area can range anywhere from over $5,000 per month for home care to over $9,000 for a private room in a nursing home. And most seniors will need this care for five years or more, so the expenses can add up over time. Since most long-term care providers primarily offer assistance with personal care and Activities of Daily Living, their services are usually not covered by health insurance, Medicare or Medicaid.

However, a long-term care insurance policy can help make your loved one's care more affordable in the long run. Here's what families in Richmond, Mechanicsville, Glen Allen, Short Pump and throughout Henrico and Hanover Counties should know about long-term care insurance.

What Richmond-Area Families Need to Know About Long-Term Care Insurance

What is Long-Term Care?

Long-term care is a type of service that focuses on meeting the health and personal needs of people over the age of 65 or live with a chronic illness or disability. In most cases, long-term care covers non-medical care needs and primarily provides support for Activities of Daily Living (ADLs), including preparing meals, bathing, dressing, housework, running errands, grocery shopping, pet care and other tasks.

What is Long-Term Care Insurance?

Long-term care insurance is a type of insurance policy that can cover part or the entire cost of long-term care for policy holders. This type of policy can be beneficial for Richmond-area seniors because it helps ease the financial burden of paying for care and can help protect their assets.

A long-term care insurance policy will typically cover the costs of personal care needs, such as dressing, bathing, eating and mobility assistance. Depending on the provider and type of policy purchased, your loved one's policy may also cover light housekeeping, laundry, medication reminders and running errands.

How Does a Long-Term Care Insurance Policy Cover the Costs of Care?

When your loved one starts to need long-term care, they'll need to file a claim with their long-term care insurance provider. The insurer must approve your plan of care before their policy can start reimbursing the cost of care. Your loved one may need to submit medical documents from their doctor to their provider and agree to an evaluation from a nurse when filing a claim.

Once approved, your loved one's policy will start reimbursing care costs after they have received the care they need during that period. Depending on the policy, there may be an "elimination period" where your loved one will need to pay for care out of pocket before their policy starts covering expenses. The elimination period can be anywhere from 30, 60 or 90 days.

Depending on what policy your loved one has, their care expenses can be covered in the following ways:

Expense-incurred (also known as reimbursement): their policy will either pay them or the care provider for the cost of care or the daily benefit (whichever is cheaper);

Indemnity: their policy will pay them the full daily benefit, regardless of how much their care costs, but they are responsible for any additional costs that exceed the daily limit

Is a Long-Term Care Insurance Policy Right for My Loved One?

According to the National Association of Insurance Commissioners, individuals should consider buying this type of insurance if they:

Have many assets and/or a good income

Don’t want to use most or all of their assets and income to pay for care

Feel they can afford to pay the insurance premiums, including possible premium increases

Don’t want family and friends to bear the financial burden

When is the Right Time to Look Into Options for Long-Term Care Insurance?

Most people look into their options for insurance in their 50s and 60s. It's definitely a good idea to invest in a long-term care insurance policy ahead of time. Not only will it make your policy less expensive, but it reduces the risk of being denied coverage due to preexisting conditions or already needing help with ADLs.

How Much Will Long-Term Care Insurance Cost?

The cost of a long-term care insurance policy will depend on the provider as well as your loved one's situation when they initially purchase their policy. For example, according to the American Association for Long-Term Care Insurance, a single 55-year-old man in good health might pay an average of $1,700 annually for a policy with a lifetime benefit of $164,000, while a single woman at the same age and health could expect to pay $2,675 for the same policy.

Here are some of the factors that will go into the cost of a policy:

Your loved one's age and health - As previously stated, long-term care insurance is usually cheaper if you invest in a policy in your 50s and 60s. In fact, many insurance companies won't approve applicants older than 75. In addition, individuals who are generally healthy tend to pay less.

The insurance company - It's important to shop around when looking for a long-term care insurance policy. Different carriers will offer different rates.

Amount of coverage - Your loved one will pay more if they purchase a policy with more advantages, such as a higher limit on daily or lifetime benefits, shorter elimination periods, cost-of-living protection and more.

Gender - Since women tend to live longer than men and are more likely to make insurance claims, they tend to pay more for long-term care insurance.

You should also keep in mind that the cost of a long-term care insurance policy can go up over time. However, benefits can also increase over time. For example, if your loved one's policy compounds at 3 percent every year, a policy with a lifetime benefit of $164,000 can grow to $386,500 in 30 years.

What Should be Considered When Looking Into Long-Term Care Insurance Policies in Virginia?

Different states will have different requirements for insurance providers in order to protect the needs of policy holders. The following are required of long-term care insurance policies in the commonwealth of Virginia:

Must provide benefits for at least 12 months;

No requirement for a prior hospital or skilled nursing home stay as a trigger for benefits;

Cannot require an RN or LPN to provide home health care;

Must have a 30-day “free-look” provision (policy holders can review their purchase and receive a full refund of any premium paid if returned within 30 days);

Preexisting conditions must be covered after six months, cannot use waivers or riders to exclude coverage for preexisting conditions and no new waiting period for preexisting conditions can be required when replacing policies;

Cannot exclude or limit benefits based on Alzheimer’s disease, senility, dementia, organic brain disorder or other similar diagnoses;

All policies must be guaranteed renewable (only the policy holder can cancel coverage) or noncancelable;

Group insurance coverage must be fully portable (policies can't be canceled because the policy holder no longer meets eligibility requirements);

Inflation protection is required;

No attained age rating is allowed after age 65;

Provide an option for the insurer to notify a policy holder before a policy lapses or terminates

Can Long-Term Care be Provided at Home?

Yes; in fact, about 65 percent of long-term care recipients receive at-home care. Home care can be highly beneficial because it helps families avoid the stress of having to pack up a loved one's belongings and relocate to a new setting. In addition, home care is usually more affordable than residential care and seniors who receive care at home generally get the care they need for longer than seniors who move to an assisted living facility. Home care is also a better option for seniors who may have trouble adjusting to new surroundings due to health conditions that impact their memory and cognition and seniors who have modified their home for safety and accessibility reasons.

Why Choose Home Care from Visiting Angels Richmond?

If you're looking for a reliable home care agency for your loved one's long-term care needs, choose Visiting Angels Richmond. Since 2007, we've helped elderly and disabled adults in Richmond, Mechanicsville, Glen Allen, Short Pump and surrounding communities get the care and support they need in the comfort and familiarity of their own home.

Although Visiting Angels Richmond does not accept Medicare or health insurance, we do ensure that our services are affordable for the families we work with. What sets us apart from other local agencies in Henrico and Hanover Counties is our commitment to providing personalized in-home care for every client. That means our team will work with you to create a plan of care that includes the services your loved one truly needs with a schedule that works best with their everyday routine. This not only helps your loved one retain their independence, but also makes long-term care more cost-effective since you'll only need to pay for care your loved one actually requires.

Our home care services include:

You can count on caregivers from Visiting Angels Richmond to help your loved one age in place safely and comfortably.

Contact our Richmond, VA office today to schedule a free in-home consultation!