What Is Long-Term Care?

Long-term care is non-medical care for people with chronic illnesses and disabilities. It is often referred to as long-term services and supports or custodial care as well. Long-term care services include assisting with day-to-day activities, such as getting dressed, taking a shower, using the bathroom, and shopping for groceries. While these services are considered non-medical, they’re crucial for people who are unable to do all of these things for themselves. Most nursing home care is regarded as long-term care also.

Where Is Long-Term Care Provided?

Long-term care can be provided in a hospital, a nursing home, an assisted living facility, or somewhere else in the community.

Is Long-Term Care Covered By Original Medicare or Medicare Supplement Plans?

Generally speaking, no. Original Medicare does not cover long-term care, and neither do Medicare Supplements or Medicare Advantage plans. While Medicare doesn’t cover long-term care in an assisted living facility or a nursing home, it does cover Part A and Part B medical needs while you are there, as well as prescription medications if you are covered by Medicare Part D.

Long-term care is generally available as a standalone medical policy supplied by a private insurance company. As most people know, long-term care can get quite expensive, so it’s essential to look into purchasing a standalone policy when you are as young and healthy as possible. Without a standalone policy, you will be responsible for 100 percent of long-term care costs, including nursing homes, which is just not affordable for many people.

How Can I Get Help Paying For Long-Term Care?

If you want to make sure you have long-term care coverage, you have a couple of options.

1.     Nursing Facility Medicaid

If you need long-term care that Original Medicare doesn’t cover, it’s a good idea to see if you qualify for Nursing Facility Medicaid. In order to qualify for this particular coverage, your income must be below a certain level, and you must meet the criteria for nursing home functional eligibility.

2.     Standalone Long-Term Care Policy

Another good option is a standalone long-term care insurance policy. The cost of long-term care can add up incredibly quickly, so if you don’t qualify for Nursing Facility Medicaid, this is definitely something you want to look into. It’s unlikely that you would be permitted to purchase a long-term care insurance policy once you already require this type of care, so it’s crucial to buy an insurance plan long before you actually need it. This way, you know that you will have the care you need when you need it at an affordable rate.

What Does A Standalone Long-Term Care Policy Cover?

Most long-term care policies help pay for skilled and non-skilled care. Skilled care includes services that a doctor orders, such as physical therapy, occupational therapy, and speech therapy. It is usually acute short-term care, often needed after a medical procedure or a stay in the hospital. Non-skilled care services include assisting with day-to-day activities, such as getting dressed, taking a shower, using the bathroom, and shopping for groceries.

All standalone long-term policies will be priced differently, and they won’t offer the exact same coverage because they are provided by private insurance companies whose benefits can differ.  It’s important to research these policies because there can be significant differences between each one.

How Much Does A Long-Term Care Policy Cost?

Long-term care policies differ in price depending on which company you purchase it from. The most important thing you can do is buy this type of insurance when you are young and healthy because the older you get, the more expensive these policies cost. The price often increases to something entirely unaffordable for many people as they get older.


  • According to 2021 averages, A 55-year-old single male who purchases a $165,000 policy will have to pay $950 per year. This comes out to a little more than $79 per month. For a 65-year-old male, the price increases to $1,500 per year, which is $125 per month.
  • For a 55-year-old female, the average price for this type of policy is $1,500 per year, or $125 per month. Once that female turns 65 years old, the price increases significantly to $2,7000 per year, or $225 per month.

Keep in mind that these prices are just an average, so some policies will be less expensive. Still, many will be much more costly, especially as you start to get past the age of 55.

Purchase A Policy Before It’s Too Late

You definitely want to purchase a long-term care policy before you need that type of coverage. If you wait too long, you’re likely to be declined. You can see above how expensive the long-term care policies become as you age. Additionally, the out-of-pocket expenses can be astronomical if you fail to purchase any type of standalone policy.

In 2020, the annual long-term care costs were between $93,000 and $106,000 for care in a nursing home, around $53,800 for homemaker services, approximately $55,000 for a home health aide, $52,000 for an assisted living facility, and a little more than $19,000 for adult day health care. These costs are just per year, so if you need long-term care for multiple years, the out-of-pocket prices quickly become completely unrealistic and basically impossible to afford for most people.

Enroll Medicare Can Help

Don’t wait until you need long-term care, or it will probably be too late to purchase an affordable policy or even to purchase a policy at all. If you ever need help figuring out which policy to buy or when to buy it, please contact us. We have experts who can help with all of your questions every step of the way.

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