Long-term care insurance
Long-term care insurance
Long-term care cover pays towards help with daily living, whether that is care at home or in a facility. It is bought for a stage of life most people would rather not picture, which is part of why it is so often left until the price has risen.
Worth knowing: The trigger, not the monthly amount, is the part to read first.
How a claim is triggered
Benefits usually begin when you cannot perform a set number of activities of daily living without help — typically bathing, dressing, eating, transferring, toileting and continence — or when cognitive impairment is established.
How many activities, and how they are defined, differs between contracts. Two policies paying the same monthly amount can be very different products because of this clause alone.
Reimbursement or income
Some policies reimburse costs actually incurred, against receipts. Others pay a set amount once the trigger is met, however the money is used. The second is simpler to claim and usually costs more.
Where care is provided by family rather than bought in, that difference matters a great deal.
What public funding does and doesn't do
Provincial programmes fund some home care and subsidise some long-term care beds, with eligibility and waiting lists that vary by province and by region within a province. Accommodation costs in a facility are generally charged to the resident.
The gap is not usually all of the cost; it is the part above what is funded, for as long as care is needed. Because the current rules and rates are set provincially and change, the province's own published rates are the place to check rather than any summary.
Questions people ask
When do people usually look at this?
Commonly in their fifties and sixties. Premiums rise with age at application, and health at that point determines whether cover is available at all, so the decision tends to get harder rather than easier with time.
Does it cover care at home?
Many policies do, and for a lot of people that is the point: help at home is what extends independence. Whether home care is covered, and on what terms, differs by contract.
What if I never need care?
Then no benefit is paid, as with any insurance bought against something that may not happen. Some contracts offer return of premium options at additional cost.