Insuring Americans for Long-Term Services and Supports: Challenges and Limitations of Voluntary Insurance
Many older adults pay for long-term care out of their income and personal savings until they are poor enough to qualify for Medicaid. In an effort to avoid exhausting their resources and relying on Medicaid, others depend on unpaid family support or go without needed services. Learn more in this policy brief, developed with Avalere.Date Updated: 03/20/2013
Under our current system, the financing options available to most individuals who need long-term services and supports (LTSS) are limited to Medicaid, personal savings and unpaid family caregivers. Medicare does not pay for long-term services and only between 7 and 9 million Americans have private long-term care insurance. Many older adults pay for LTSS (averaging $81,000 per year in a nursing home) out of their income and personal savings until they are poor enough to qualify for Medicaid, a means-tested welfare program. In an effort to avoid exhausting their resources and relying on Medicaid, others depend on unpaid family support or go without needed services…
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This policy brief provides background on the historical development of benefit eligibility triggers in the private long-term care insurance market. Understanding how these triggers came into being can provide important information to those charged with implementing the CLASS Plan.
This policy brief provides information about how long-term care insurers implement benefit eligibility triggers in the private insurance market. The way in which companies have operationalized benefit eligibility triggers can inform the development of regulations for the CLASS Plan.
This policy brief provides information on the benefit eligibility assessment process in the private long-term care insurance industry. It focuses on how long-term care insurers use the information in the adjudication process, who is involved in the process, and how activities of daily living and cognition are assessed.