Here in Frequently Asked Questions, we've compiled a list of the most common questions we hear about long-term care and long-term care insurance. If your question isn't listed, feel free to Contact Us using the link on the left of this page. Sources for statistics are located at the bottom of the page.
Long Term Care
Your Employer's Plan
The Cost of Long-Term Care Services
Funding Long Term Care Costs
What is long-term care?
Long-term care is really a variety of personal and household services for people who are unable to care for themselves. These services range from basic help with daily activities at home like bathing or dressing to care in a nursing home or assisted living facility. People need care because of injury or accident, or due to chronic illness like Multiple Sclerosis or Alzheimer's Disease. Long-term care services are available in a variety of settings, including at home or in our own community.
What is the likelihood that I or someone I love will need long-term care services?
It’s higher than you may think. In fact, 21 million people had a condition that caused them to need help with their health and personal care.1 Many of these people will need long-term care. In addition to accidents, people who have strokes, heart conditions, Alzheimer's disease, Parkinson's disease and other illnesses often need some type of long-term care.
The need for long-term care knows no age and no gender. Approximately 70% of people over age 65 will require at least some type of long-term care services during their lifetime2, and younger individuals are not immune. More than one third of CNA insureds receiving long-term care benefits are age 65 or younger3.
What long-term care facilities and services are available?
There are two basic settings for receiving long-term care: in a facility or at home. When independent living is no longer an option, facility care may be necessary. Facilities vary by the level of care they offer and the services they provide. They include nursing homes, assisted living facilities, and hospice facilities, among others.
Home or community-based care includes care in your residence provided by a home health agency that sends a qualified home healthcare provider to provide nursing care, personal care, nutritional services, meal preparation, housekeeping or physical therapy. Depending on your policy, care might also be provided by an independent provider, a qualified professional caregiver not affiliated with a licensed home healthcare agency.
Adult day care is another option. Adult Day Care centers offer a protective setting for those who are unable to stay alone. They are not residential facilities but offer services generally for up to 12 hours a day.
Why do nursing homes offer different levels of care?
Some people need round-the-clock monitoring while others only need limited help with personal care or other activities. Nursing homes that are skilled care facilities offer the highest level of care, with skilled professionals available 24 hours a day. Custodial nursing home care, the lowest level of nursing home care, is for those who do not need the continuous attention of trained medical professionals. Intermediate care facilities offer less than skilled care but more than custodial care.
What is inflation protection and why do I need it?
We hope it will be a long time before you ever use your long-term care plan's benefits. The fact is, if you need long-term care services 20 years from the time you apply, costs will probably have increased significantly. That's why your plan includes a feature that gives you periodic opportunities to purchase additional coverage to help protect yourself against rising costs. Your plan may also offer additional, optional inflation protection features, at an additional cost, that automatically increase your coverage at regular intervals and amounts.
Why did my employer choose a CNA group long-term care plan for our long-term care benefit?
Before making a decision, your employer carefully reviewed the group long-term care plans available and decided the plan offered by CNA was best suited for the needs of the company's employees and their families. The CNA plan offers flexible coverage at an affordable price.
What happens if I leave employment or my employer ends the group policy?
Your coverage is completely portable. That means you can continue it with no change in rates or benefits if you, or the person through whom you obtained coverage, terminates employment for any reason. In most cases, CNA will bill you directly if you had been paying by payroll deduction. Similarly, if your employer ever ends the group plan, the continuation of coverage feature allows you keep your coverage with no changes.
To find out more about your employer's plan, please log in at the top left of this page using your employer's password. When you are logged in, you can find out who is eligible for coverage and what features are in your employer's plan. You can also calculate your premium and apply online.
What is the average cost of a nursing home stay?
Nationwide, the average cost of a nursing home in 2007 was $181 per day ($66,000 per year) for a semi-private room. This does not include items such as therapies and medications, which could make costs much higher.4
What about home healthcare? What does that cost?
Home healthcare can range from a few hours of housekeeping assistance a week to intensive, skilled services from a nurse or other caregiver. Of course, cost depends on the type of long-term care services needed. In 2007, the national average cost of part-time basic home care (home health aide three times a week) was $16,000 per year. Skilled care provided by a nurse is more expensive than care provided by a home health aide, and costs will also vary based on the number days per week the caregiver visits. 4
I have healthcare and long-term disability coverage. Won't that cover long-term care services if I need them?
Medical plans usually provide limited or no coverage for long-term care services. Disability income coverage is really meant to replace lost wages when you can no longer work. Most people need disability income benefits to cover normal living expenses like food and housing; typically, not much remains to pay for someone to care for you. Also, many long-term disability plans end at age 65 or when you retire.
Doesn't Medicare cover long-term care?
Medicare is a federal government program designed to cover health care for people age 65 and older and people under age 65 with certain disabilities or conditions. It only covers medically necessary care and focuses on acute care (doctor visits and hospital stays) or short-term services for conditions expected to improve.
Generally, Medicare does not pay for most long-term care. Medicare does not pay for personal or custodial care (help with activities of daily living), which is the greatest part of long-term care services. Medicare will help pay for a limited skilled nursing facility stay, hospice care or home health care, but only if you meet certain conditions, which are described below.
Medicare will pay for care in a skilled nursing home when:
- you have had a recent prior hospital stay of at least three days,
- you are admitted to a Medicare-certified nursing facility within 30 days of your prior hospital stay, and
- you need skilled care such as skilled nursing services and/or physical or other types of therapy.
- If all these conditions are met, Medicare pays all approved amounts for the first 20 days, and all but the Medicare deductible for days 20-100 per benefit period.5
What about Medicaid?
Medicaid does provide benefits for long-term care, but it is available only to certain low-income individuals and families who fit specific eligibility groups. Qualifying for Medicaid typically means "spending down" most of your hard-earned assets. Also, under Medicaid, care choices may be limited because not all long-term care providers accept Medicaid payments.
Couldn't I just invest a certain amount each month to accumulate the money I might need to cover extended long-term care expenses?
That could be difficult. Depending on the plan option you choose, your lifetime maximum benefit could be as high as $365,000 or more. Though many people have a retirement or other savings plan, those funds are usually earmarked for some future need like the children's education or retirement. Even if you started saving $20 a month for possible long-term care costs, it would take years to come up with the amount of protection your plan provides from day one. What if you had an accident or became ill before you accumulated this amount? For most people, funding long-term care services with savings just isn't very realistic.
1U.S. Department of Health and Human Services. National Clearinghouse for Long-Term Care Information. www.longtermcare.gov/LTC/Main_Site/Understanding/Definition/Know.aspx.
2U.S. Department of Health and Human Services. National Clearinghouse for Long-Term Care Information. www.longtermcare.gov/LTC/Main_Site/Understanding/Definition/Know.aspx.
3Based on 3,024 long-term care claims paid by CNA between 1993 and 2008.
4"A Shopper’s Guide to Long-Term Care Insurance, 2008." National Association of Insurance Commissioners.
5U.S. Department of Health and Human Services. National Clearinghouse for Long-Term Care Information. www.longtermcare.gov/LTC/Main_Site/Understanding/Definition/Know.aspx.