Long Term Care (LTC) is a relative newcomer to the Canadian Insurance scene. The idea of LTC is that when an individual’s health erodes to the point that he or she cannot perform some of the basic tasks of self care, they become eligible for benefits. The intention is that these benefits help to offset the rapidly rising costs of health care that are not covered by provincial health care plans and reduce the financial strain on the rest of the family.
There are two basic types of LTC coverage available. One is known as an indemnity plan, which pays you or your representative for expenses incurred. You submit receipts and are reimbursed up to the monthly maximum of your policy. The other type is referred to as an income plan. With an income plan, once you qualify for benefits, the insurance company simply sends the monthly benefit to you to use as you wish.
Most LTC plans are built around Activities of Daily Living. These ADLs usually include bathing, feeding oneself, getting dressed, the use of the toilet, transferring oneself to and from bed and maintain continence. Once a person cannot perform any two of these without help and once a waiting period is satisfied, they are eligible to receive benefits. Most plans also contain an alternate definition that simply states that any significant loss of mental capacity that results in an inability to take care of oneself alone (IE Alzheimer’s) will also be sufficient to qualify for benefits. Depending on how a plan is designed, an individual may receive benefits while receiving care at home and a higher amount while in a care facility. Some plans allow for family members to provide the care while others are more restrictive on this point.
In Canada today, the cost of long term care is increasing at a pretty dramatic rate. As well, subsidized extended care is harder to get than even just a few years ago and really, most folks would like to stay in their home as long as they can. Many families are experiencing the physical AND financial strain of helping parents and grandparents who’s ability to care for themselves is not what it once was. Long term care coverage is the best way we know of to make sure proper care is available to people who need it while protecting the assets they have accumulated over a lifetime. Give us a call for further information on Long term care coverage for you and your loved ones.