Long term care options – then and now

While nursing homes have been around for many years, the concepts of “at home” care and “adult
day” care were foreign to most people. However, as longevity rates increased due to new medical
technologies and drugs, more and more people were living longer than expected. Those that needed
some type of long term care were fairly limited in their options.

During the 1980’s, additional options for long term care started to emerge. Assisted living
communities became more popular and many found themselves on long waiting lists because there
simply weren’t enough facilities to meet the demand. Eventually, more were created and the
concept changed a bit. Facilities started offering graduated care – something that made
real sense. A person could live in a facility and receive varied degrees of care. If, and when,
that person needed more care, he could simply “add on” additional services for an additional fee.
Nursing homes saw the value in that concept and many simply converted a wing of their facility to
accommodate those people who only needed occasional services and offered them the option to “move
down the hall” when they needed more care.

Unfortunately, traditional health insurance generally didn’t cover these types of expenses and
long term care insurance was still in its infancy. The result was that many people had to sell
their homes in order to pay for full time care before state aid would kick in. At the same time,
home care and adult day care eventually started to became more popular and more and more insurers
saw the need for long term care insurance. By the late 1980’s and early 1990’s, long term care
insurance was a hot commodity. Everyone had to have it and insurers made a pretty penny on the
deal.

Good policies gone bad

Problems began to arise a few years ago as policyholders, who had been making premium payments
for years, started seeking their policy benefits. What insurance underwriters didn’t know at the
time was how much health care costs would rise over the next 20 years and how much longer
Americans would live. Suddenly, insurers realized that they had underestimated their exposure.
While some stepped up the plate and made good on claims, more did not. Horror stories of elderly
people not being able to get the care they needed started to make the headlines. Insurers were,
and still are, being accused of simply ignoring policyholders and hoping they would die before any
proceeds would have to be disbursed.

The issue has now become both litigious and political. Policyholders have begun suing their
carriers for failing to pay for legitimate claims. The lawsuits have made national headlines and
have gotten the attention of politicians, so much so that Congress and the General Accounting
Office are investigating certain insurers over their marketing and claims practices.

Long term insurance is still a viable option for many, although the number of insurers selling
it has declined. Many insurers have sold off their long term care books of business in favor of
other products as the market has become saturated. Before purchasing a policy, consumers should
make sure that they understand exactly what’s covered and what isn’t. Avoid purchasing policies
from insurers who do not have a solid financial background and check into how many complaints have
been filed against them for non-payment. All insurance companies are rated by agencies such as
A.M Best, Standard & Poor and Moody’s.