How is Continuing Care at Home Different From Long-Term Care Insurance?
Both Continuing Care at Home and long-term care insurance offer you the ability to preserve your future by planning in advance for the costs associated with personal, custodial and/or skilled care. While Continuing Care at Home (CCaH) provides a daily benefit payment component that functions similar to long-term care insurance, it offers more, including care coordination and residential support services. In this article, we detail the differences between these two options of self-funding long-term care, as well as explain how Continuing Care at Home may be the right fit for community members seeking to age in place.
What is Continuing Care at Home?
A Continuing Care at Home program is a life care membership program for consumers who choose to live at home. Participants are covered by a comprehensive package of long-term care services designed to enable them to remain independent and live at home as their care needs increase.
An initial financial, insurance and medical screening of applicants is required. Continuing Care at Home members join when they are functionally well and ready to plan for their future needs for a lifetime. Programs can often accept members with chronic diseases that are well-managed (i.e., high blood pressure), but cannot accept members who already have advanced illnesses (i.e., dementia).
Services are typically designed to address the social, spiritual, recreational and health needs of members, and are comprehensive in nature, often including the following:
- Care coordination and individualized care plans by a nurse or social worker
- Home inspections
- Annual physical
- Access to amenities and services
- Social and educational opportunities
- Emergency response system
- Homemaker and personal care services, including “live-in” services
- Home nursing/skilled care
- Meals/grocery delivery
- Transportation
- Adult day programs
- Referrals for home maintenance, housekeeping, lawn care, etc.
- Assisted living and nursing home facilities (for members who choose a facility setting)
When members become chronically ill and are in need of long-term care services, a daily benefit payment— in an amount based on the member’s contract—is paid and services are individualized and coordinated. Content adapted from the White Paper on CCaH From CliftonLarsonAllen.
What is Long-Term Care Insurance?
Long-term care insurance policies cover the services that are often limited or excluded by health insurance. They typically provide a daily benefit amount to fund personal and custodial care, whether that be in your own home or in a facility, either assisted living or nursing home. Those who take out long-term care insurance are paid or reimbursed at a predetermined amount that may or may not rise with the cost of living. Many policies have a benefit wait period and/or term limits; a typical waiting period is 90 days.
Stand-alone policies are generally purchased around the mid-fifty age range and can have somewhat strict medical underwriting. The purchase of long-term care insurance can be seen as a calculated risk between eligibility and extra years of premium payments. Some newer policies have been structured where the insured can transfer their benefit to a spouse, called “shared coverage,” or have a long-term care benefit paid out from a life insurance death benefit, called a “hybrid policy.” Older plans may be strictly “use it or lose it.”
What are the Benefits of a CCaH with The Wesley Inc.’s Program, The Wesley at Home?
The Wesley Inc. is a non-profit, non-stock organization operating in the State of Maryland that has been serving seniors since 1867. The Wesley at Home is the only proposed Continuing Care at Home provider that the Maryland Department of Aging has permitted to pre-enroll community members 60+ who reside in Baltimore City and Baltimore County. Unlike traditional long-term care insurance, The Wesley at Home will offer individualized initial support services using vetted vendors in the community to keep you well at home before you need long-term care benefits or services.
If enrolled, members will meet with an experienced care coordinator, receive an individualized care plan, get a home safety inspection initially and once every other year, and receive an emergency pendant, plus five free annual telehealth calls to a registered nurse. All members will be enrolled in Maryland Community for Life (SM) which provides home maintenance support (1 hour a month of handyman services), limited transportation support (1-2 trips per month) and community service navigation that includes a referral service for vetted home contractors. Learn more about our services here: Services – The Wesley at Home.
Daily benefit payments for long-term care will begin when a member requires substantial assistance with two (2) Activities of Daily Living (ADLs) and/or has a severe cognitive impairment (consistent with Internal Revenue Code 7702B). There is no wait or “elimination” period for long-term care benefit payments. There is no requirement that services be received in an institutional setting. The Wesley at Home’s daily benefit payments last for your lifetime (there is no lifetime maximum payment limit). We also include provisions that allow family members to act as paid caregivers. The Wesley at Home is a flexible, aging-in-place option for those who forgot to buy long-term care insurance, but want to plan for their long-term care costs and make plans to age in their own homes.
If you already have long-term care insurance, our membership options vary and can complement a long-term care insurance policy. Whether membership will be purchased as a stand-alone alternative to long-term care insurance or as an extra layer of stability on top of an existing policy, you’ll receive the same level of personalized care coordination and long-term care service navigation. Our staff will review your current long-term care insurance policy to estimate any monthly fee discount that you will receive.
We feel that the future of aging well can be achieved in people’s own homes and communities. Call 410-324-2400 or visit our website at www.TheWesleyAtHome.org to see if The Wesley at Home is the right solution to help you plan for your aging journey.
Continuing Care at Home Programs are regulated by the Maryland Department of Aging. Please note that a Preliminary Certificate of Registration or Certificate of Registration is not an endorsement or guarantee of this Provider by the State of Maryland. The Maryland Department of Aging urges you to consult with an attorney and a suitable financial advisor before signing any documents.