As people begin feeling the effects of aging, they may have difficulty with bathing, eating, dressing, toileting and ambulation. These basic tasks are commonly called activities of daily living, or ADLs, in long-term care settings.
Individuals who regularly need help with two or more ADLs may require long-term care services. When cognitive impairment is present, the likelihood of needing long-term care increases.
What Is Long-Term Care? Long-term care is not only a permanent nursing home stay. It can also mean personal care at home, in a hospital or in a private facility for people who need help with ADLs for an extended period.
It’s important to know that Medicare and most private health plans generally pay for skilled care—nursing, rehabilitation or medical services—not custodial care. Custodial care covers assistance with ADLs and is usually not covered by those programs. For information about insurance options, see Understanding Long-Term Care Insurance.
Will I Need Long-Term Care? People under age 55 are unlikely to need long-term care, and only a small share of people in their 50s and early 60s will require it. However, many people who reach age 65 will need some long-term care at some point later in life.
Trends show that many people who might previously have entered nursing homes now go to assisted living or similar settings that offer more space and lower cost but generally provide more limited assistance than nursing homes. For information on care provided at home and in assisted-living settings, see Long-Term Home Care Coverage.
There is encouraging news: generations today are staying healthier longer, so many people can delay using long-term care services until later in life.
When Is the Best Time to Buy Coverage? As a general rule, buying long-term care insurance before age 60 is usually best. Younger applicants are less likely to be declined and typically pay lower premiums.
Rejection rates rise with age. For example, applicants in their 50s face a lower rejection rate than those in their 60s and 70s. The younger you are when you begin a policy, the lower the premium will tend to be, and many policies lock the premium at issue.
There are also advantages to buying a policy at an appropriate time. To compare coverage types and potential policy features, you may find it useful to review information about insurer responsibilities and coverage options such as Long Term Care Liability Insurance.
If you want to discuss options or get specific quotes, talk to an agent.
Frequently Asked Questions
How long does long-term care usually last?
Duration varies widely—from a few months after an illness to several years for chronic conditions—so planning should consider personal health, family history and preferences.
Does Medicare cover long-term custodial care?
No. Medicare typically covers skilled medical or rehabilitation services, not ongoing custodial care that helps with ADLs.
Can I get long-term care at home?
Yes. Many people receive personal care and supportive services at home; home care can be an alternative to facility-based care depending on needs and resources.
When should I buy a policy if I’m concerned about cost?
Buying earlier often reduces the premium and lowers the risk of being declined, so many advisors suggest applying before age 60 when possible.