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What does long-term care insurance cover?

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No one plans to need long-term care. But the best time to purchase protection is before that day ever comes. And with the high price of long-term care, planning for that expense is a necessity if you want to help protect your retirement savings. In a 2022 report, it's estimated that 56% of Americans turning 65 today will develop a disability and need long-term care services.1 For many families, paying for these services out of pocket or taking on the caregiving role can present a challenge.

Adding long-term care insurance to your financial plan can help protect your finances and give your family choices about how and where care is provided—including at your own home.

Which services does long-term care insurance cover?

Due to a chronic illness, including conditions like Alzheimer's or dementia, disability or simply aging, you may end up needing help with the standard activities of daily living (ADLs). These include getting dressed, bathing, eating, using the bathroom, getting into or out of a chair or bed and walking. Long-term care insurance often kicks in when you need help with at least two ADLs. While some long-term care insurance contracts only cover nursing home stays, most reimburse for a wide range of services.

Medicare typically only covers preventive and curative medical expenses and only pays for long-term care in specific circumstances. Medicaid may cover many of these needs, but it has certain restrictions that are based on your income and assets. If your income is above a certain threshold, you would need to shed some assets to qualify.

What does long-term care insurance cover specifically? Here's a look at the services that are typically reimbursed.

Home care

Long-term care facilities aren't always the first choice for those who need extra support. It's common for people to prefer to stay in their home while receiving care.

Long-term care insurance contracts typically cover the cost of a professional home health aide, whether you need assistance with basic living activities or require nursing services. Some contracts even cover care coordination services, caregiver training for your loved ones and respite time for caregivers who need a break.

Most long-term care insurance also reimburses for necessary modifications to your home, including the installation of ramps and specialized bathroom fixtures, which easily can add up to thousands of dollars. Medicare and Medicaid cover only specific kinds of in-home services,2 and they rarely cover remodeling needs.

Assisted living facilities

When you need assistance with daily tasks and in-home care isn't a viable option, you may consider an assisted living facility. Because these facilities provide a care-based environment with trained staff, the monthly cost can be steep. Get a sense of what the cost of care is for your state by using our cost of care tool.

Long-term care insurance does cover assisted living—it may reimburse for all or part of your stay depending on your policy and medical needs. That's important, because Medicare typically doesn't pay for care in these facilities, and Medicaid is only available to adults who meet its requirements for income and financial assets.

Nursing homes & memory care facilities

Nursing homes, which are intended for adults with more significant medical needs, are even more expensive than assisted living facilities. By covering many of those costs, long-term care insurance can relieve the added financial stress that often accompanies those stays. Some contracts will include a reservation benefit to hold a bed for you if you need to temporarily leave your home.

Should you develop Alzheimer's disease or another condition that causes dementia, most contracts also will cover stays in a specialized memory care facility. Medicare generally only pays for temporary stays in a nursing home or physical rehabilitation facility in particular cases.

Adult day care

At a national average of $68 a day,3 adult day care centers tend to be more affordable than most other care options. These facilities represent an opportunity for adults with physical or cognitive impairments to enjoy recreation and socialize with peers. Because they're only open during designated hours, however, many families still will need to hire a home health aide as well.

Medicare alone does not typically cover adult day care, though some expanded plans may offset some costs.

Hospice care

Hospice programs provide palliative care to patients with a life expectancy of less than six months. While Medicare generally covers the cost of nursing services, supplies and equipment, patients usually must pay for caregivers out of pocket. Long-term care contracts that include hospice coverage can help offset those costs.

How much does
long-term care cost?
Pricing and availability of long-term care services can vary
widely depending on where you live.

Start by exploring extended care expenses near you,
so you can more accurately estimate the cost of coverage.

See costs

Limits to long-term care coverage

When you receive qualifying care under your long-term care contract, the insurer does not typically provide payment for expenses until you first reach the elimination period outlined in your policy. If you have a contract with a 60-day elimination period, for example, you would have to pay for eligible costs out of pocket for that length of time before your policy starts to reimburse you.

Your policy also may have daily, monthly or lifetime caps on the total costs for which it provides reimbursement. These coverage limits may vary based on the type of expenses you incur.

Most long-term care contracts won't reimburse for medical costs such as doctor bills or prescription drugs. And, in most cases, they won't provide payments for services that are eligible for reimbursement through Medicare.

Creating a long-term care plan that works for you

With the array of coverage long-term care insurance affords, you'll gain choice around where you'd receive care. With that flexibility comes more options. You can consider additional riders to tailor your policy or shop around for certain features that best fit your needs.

A Thrivent financial advisor can answer your questions about long-term care insurance and help you decide whether it makes sense for you. If you do end up needing long-term care, preparing for your future needs now can help you and your loved ones focus solely on quality time together in the future.

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THRIVENT IS THE MARKETING NAME FOR THRIVENT FINANCIAL FOR LUTHERANS.

1ASPE,  https://aspe.hhs.gov/sites/default/files/private/pdf/265126/LTSSOlAmRB.pdf, 1/21.

2NCOA, https://www.ncoa.org/article/seven-things-you-should-know-about-medicares-home-health-care-benefit, 3/3/21.

3ACL, https://acl.gov/ltc/costs-and-who-pays/costs-of-care, 2/18/20.

If requested, a licensed insurance agent/producer may contact you and financial solutions, including insurance, may be solicited.

All applications are subject to the underwriting requirements of Thrivent. A medical exam may be required. Premiums are not guaranteed to remain unchanged, except during the first five contract years. Any changes to premium rates will apply to all similar contracts issued in your state to contract owners in the same class on the same contract form. This means you cannot be singled out for an increase because of advancing age, changes in your health, claim status or any other reason solely related to you.

Long-term care insurance may not cover all of the costs associated with long-term care. Long-term care contracts have exclusions, limitations, and terms under which the benefits may be reduced, or the contract may be discontinued. For costs and complete details of coverage, contact your licensed insurance agent/producer.

Long-term care insurance is not for everyone as determined by NAIC income and asset test criteria.

Thrivent is not connected with or endorsed by the U.S. government or the federal Medicare program. Not available in all states.

Thrivent provides advice and guidance through its Financial Planning Framework that generally includes a review and analysis of a client’s financial situation. A client may choose to further their planning engagement with Thrivent through its Dedicated Planning Services (an investment advisory service) that results in written recommendations for a fee.

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