Navigating Long-Term Care Insurance

Long-term care insurance is a specialized type of insurance that provides coverage for patients recovering post-surgery as well as individuals with chronic illnesses, disabilities, or other long-term conditions. The insurance is designed to cover daily patient needs over an extended time period. Daily patient needs may include medical services, personal, and social services.

While Medicare covers limited home care or short nursing home stays, it does not cover long-term care expenses. Similarly, most employer health insurance does not cover daily or long-term care expenses. Without long-term care insurance, aging adults may find themselves without coverage for the care and assistance they need.

According to the U.S. Department of Health and Human Services, at least 70% of individuals turning age 65 will need long-term care. Current health, gender, other disabilities, age, and family network are key factors to help determine whether an individual will require long-term care or not.

If you or your aging loved ones do not have long-term care insurance, take time now to evaluate the health care insurance options that may be most beneficial.

  • Tip: Policies cost less if the policyholder is younger and in good health.

As you consider long-term insurance options, keep in mind not only the age and health of the potential policyholder, but also that individual’s support system, income levels, and savings and investments.

  • Tip: Benefits that are paid out through long-term insurance plans are not taxed as income. In addition, most insurance long-term care policies are “tax-qualified”, meaning that the value of the premiums can be used as deductions for federal income taxes, assuming medical expenses are a certain percentage of gross income. For more information, consult with your accountant.

Some insurance companies require the use of certified home care agencies or licensed professionals, while others are less restrictive.

  • Tip: It may be difficult to find a company willing to cover pre-existing conditions.

Many plans offer varied amounts of coverage for the following:

Long-term care insurance can be purchased as an individual policy from an agent or as a group policy through an association or through an employer. The federal government and many state governments also offer long-term care policies to employees, retired employees, and their respective families. Additionally, some life insurance policies may offer long-term care benefits.

As you review policies, you should carefully compare:

  • Policy coverage amounts and limits
  • “Benefit Triggers” that may include diagnoses or specific conditions to allow benefits to be paid
  • Potential premium rate increases or policy changes and cancellations
  • Policy exclusions
  • Waiting/elimination period before the insurance policy begins benefits

Also, be sure to:

  • Seek out established, reputable companies with a strong history of providing quality long-term care insurance.
  • Ask about potential future premium increases as well as potential benefit changes.

For more information on long-term care insurance in Florida, visit the Florida Office of Insurance Regulation at or click here for long-term care insurance.

Do you have questions about long-term care insurance? Expicare can help. Contact us at 561-736-1422, toll-free: 855-730-9895, or visit

Expicare Nursing, Inc.

Owned and managed by highly qualified Registered Nurses, Expicare is a recognized leader of home health care in South Florida. For over three decades, Expicare has provided unparalleled home health care to thousands of patients throughout Palm Beach County. From post-surgery assistance to compassionate care for patients and families struggling with Alzheimer’s, Expicare provides highly skilled nurses and nursing assistants to care for your parents or loved ones. For more information, contact 561-736-1422, toll-free: 855-730-9895, or visit