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What Long-term Care Insurance Has To Offer

July 1, 1997
Related Topics: Benefit Design and Communication, Health and Wellness, Featured Article
According to a survey released in May by Washington, D.C.-based Health Insurance Association of America (HIAA)—a trade association representing approximately 250 of the nation's leading commercial health-insurance carriers—insurers continue to offer long-term care insurance policies that provide a wide range of benefits options at a moderate price. HIAA survey findings include the following:

  • In 1995, the average annual cost of a private long-term care insurance policy offering four years of $100-a-day nursing home coverage/$50-a-day home health-care coverage and a 20-day elimination period (a deductible, during which benefits aren't paid) at age 50 was $378. The same policy at age 65 was $1,010 annually and $4,148 annually at age 79. The same policy with 5 percent compounded inflation protection costs an average of $798 a year at age 50; $1,881 at age 65; and $5,889 at age 79.
  • All of the top-11 sellers of private long-term care insurance plans offer nursing home and home health care, adult day care, respite care and alternate care services. Ten of the top-11 sellers offer hospice care, and nine of the top-11 sellers cover living in an assisted-living facility.
  • All 11 plans are guaranteed renewable, have a "30-day free look" period, cover Alzheimer's disease and offer unlimited nursing home maximum benefit periods and choices for elimination periods (usually between zero to 100 days).
  • Other common benefits offered include: care coordination or case-management services, homemaker or chore services, medical-equipment coverage and spousal discounts.
  • Benefits eligibility criteria known as "activities of daily living"-such as eating, bathing and toileting-are used to help determine functional disability, as well as cognitive impairment. None of the top sellers of private long-term care insurance uses "medical necessity" as the sole trigger to determine benefits eligibility.
  • As of the end of 1995, more than half of the sales of individual long-term care insurance policies took place in nine states: California, Florida, Illinois, Michigan, Missouri, Ohio, Pennsylvania, Texas and Washington.

Information contained in the HIAA survey is derived from written surveys, follow-up telephone calls and detailed analyses of long-term care insurance policies from 11 sellers representing approximately 80 percent of all individual and group association policies sold in 1995.

Workforce, July 1997, Vol. 76, No. 7, p. 87.

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