Short-term care insurance provides coverage when you need care from an accident, illness, or disability.
How do you qualify for benefits?
It’s like long-term care insurance in that you qualify for benefits if you need help with at least 2 out of the 6 activities of daily living which are transferring, toileting, bathing, dressing, eating and continence OR if you have a cognitive impairment and need supervision. Although your expected need of care does not need to be at least 90 days like it does with long-term care insurance.
Where can you receive care and how much coverage can you get?
There are plans that will allow you to have facility AND home care coverage. For facility coverage, benefits are available $10 per day up to $300 per day for a benefit period of 90 days up to 360 days. This will pay benefits for all levels of facility care – skilled, intermediate, and custodial care. It will also pay benefits in an assisted living facility. For home care coverage, benefits are available $150 per week up to $1,200 per week for a benefit period of 13 weeks up to 51 weeks. You essentially can get 1 year of facility and 1 year of home care coverage.
Restoration of benefits, issue ages, and elimination period
Some plans also have restoration of benefits which means if you are on claim, then heal up and don’t need benefits for at least 180 days, your benefits will restore to their original amount, making them available in the future for a different period of care. This restoration of benefits can only happen one time.
No prior hospital stay is required, and issue ages are generally from ages 50-89. You can also choose how long your elimination period or waiting period is from 0 days up to 100 days.
These plans are flexible, customizable, and have a short application and underwriting process. The insurance companies run a prescription check and the process is streamlined. Medical exams and medical records are NOT required. It typically takes less than a couple of weeks to get a policy issued.
Payment options and benefits paid
Premiums can be paid monthly, semi-annually, quarterly, or annually. Benefits are paid to the policyholder in cash which means you don’t have to submit receipts to the insurance company for reimbursement.
Who should consider short-term care insurance?
These policies are ideal for people who don’t health qualify for long-term care insurance OR for those who can’t afford it. It’s also a great deductible filler for people who have long-term care insurance and want to fill the elimination period with coverage. If someone has low assets and income and is likely to go on Medicaid for care, it can even help fill the gap before Medicaid benefits begin with a shorter benefit period, e.g., 90 days.
The Bottom Line
Short-term care insurance provides facility and home care coverage for up to 360 days if you need help with 2/6 ADLs or have a cognitive impairment. It can alleviate financial, physical, and emotional burdens on you and your family and help you to stay in control of your care options.