Long-Term Care Insurance


Long-Term Care Insurance

Paying for Assisted Living and Memory Care

For many seniors, selecting assisted living or memory care services is a necessary decision. Fortunately, there are numerous high-quality, nationally recognized assisted living and memory care communities throughout the Northern Virginia area. Assisted Living provides support to seniors who require help with activities of daily living (ADLs), to include feeding, bathing, dressing, grooming, toileting, transferring, and ambulating. Memory Care is an extension of assisted living, providing assistance with ADLs in addition to specialized support to individuals with memory and cognitive impairments. With private pay, assisted living in Northern Virginia is commonly around $4,500 to $9,500+ per month, and memory care is generally about $5,000 to $8,500+ per month. While a large majority of senior care communities in Northern Virginia do not accept Medicaid, the few that do accept it have an extensive waitlist.

Long-Term Care Insurance Policies Can Help Pay for Assisted Living and Memory Care

When private pay is an impossibility, long-term care (LTC) insurance can be an ideal alternative to cover the cost of senior care services. LTC insurance is an insurance product that covers expenses accrued from licensed home care, home health care, hospice care, respite care, adult day care, nursing home, assisted living, and memory care providers. While situations can differ, most assisted living and memory care communities qualify for reimbursement by LTC insurance policies. In fact, many LTC policies will pay for most or even all the costs associated with assisted living and memory care services. Yet, while all LTC policies have daily, annual, and lifetime payout limits, an LTC policy could cover up to 100% of your care expenses, depending on the payout limits defined in your particular policy.

However, like other types of insurance, not all LTC insurance policies pay for all the same services, nor do they all cover the same amount for parallel services, so determining which care services you want or need will allow you to decide which LTC policy is best for you. For assisted living, a "facility-only" policy covers care received by a licensed skilled nursing or assisted living provider. Some LTC insurance policies stipulate paying for assisted living benefits based on your ability to perform two or more ADLs. It is common for LTC insurance providers to request that you receive a health evaluation from one of their preferred physicians to ensure your health status qualifies for coverage. For memory care, your LTC policy terms may vary regarding when benefits will cover the cost of care, the duration of the care, and much more.

Typically, assisted living and memory care communities operate on a ‘pay as you go’ basis, with the residing senior or their family receiving a bill each month for care services rendered during that month period, and it is the responsibility of the recipient to pay the bill. The residing senior or their family will generally pay the monthly bill with personal income or assets. When there is a LTC insurance policy, the recipient sends the bill to the insurance provider for reimbursement.

It is also important to remember that LTC insurance usually does not cover general living expenses, such as residence in a 55+ apartment complex. However, as mentioned previously, care within licensed assisted living and memory care communities is recognized as qualified health supervision and is covered by LTC insurance. Assisted Living Locators of Northern Virginia works with licensed communities, so we can help you prior to placement to confirm whether your LTC insurance policy will reimburse you for care services received by communities in our area.

To verify that a prospective assisted living or memory care community qualifies under your LTC policy, you can also contact your insurance provider to submit a provider inquiry. Many policyholders coordinate with their LTC insurance provider in advance to make sure the assisted living or memory care community being considered meets the requirements of their LTC policy and to identify any possible issues that could hinder the processing of payments. In doing so, if there are any concerns related to coverage, they can be addressed before a financial obligation has been made to a particular community.

With over 100 assisted living and memory care communities in the Northern Virginia area, Assisted Living Locators of Northern Virginia is ready to help you find the right community for you. We aid you in deciding which community is the best fit on various levels, to include how long financial assets will cover the cost of care at a specific community and how to utilize financial assets, such as LTC policies, to pay for the most appropriate senior care.

For more information or no-cost assistance with independent living, assisted living, memory care, or other senior living options in Northern Virginia’s Prince William County, Fairfax County, Loudoun County, Arlington County, or Alexandria, please call our local elder care experts today at (703) 878-7870 or contact us via e-mail.