Long Term Care Insurance for People With Lung Cancer – Verywell Health
When you are diagnosed with lung cancer, you may want to explore options for covering expenses that might arise as you need assistance in your daily life. This might be a home health aide, assisted living, or nursing home care. These are all forms of long-term care (LTC).
More than two-thirds of people over 65 will need long-term care as they get older. As many as 20% of them will need that care for more than five years. Unfortunately, the cost of long-term care continues to rise and most health plans do not cover it, at least not all of it.
Many people turn to long-term care insurance to cover these added expenses. This type of insurance policy is not meant to replace your health insurance. You still need that to care for the bulk of your medical expenses. Instead, these policies are a supplement to your health plan and are intended to pay for daily care that is not otherwise covered by your health plan.
This article will address how long-term care insurance works, how much it costs, and reasons you may want to consider a policy. It will also discuss why it may not be possible to get long-term care insurance if you don’t have it in place before a lung cancer diagnosis, and what other options you may have.
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The Cost of Long-Term Care
Long-term care includes care you receive when you are unable to perform common everyday activities of living. This includes things like bathing, dressing, feeding yourself, personal hygiene, toileting, and transferring yourself from one position to another.
It can also be difficult for some people to do housework, manage their finances, prepare meals, shop, or take their medications. Help with these functions is not considered medical care.
Unfortunately, long-term care can come with a hefty price tag. According to the Genworth 2021 Cost of Care Survey, homemaker services average $4,957 per month, a home health aide $5,148 per month, and adult day health care services $1,690 per month.
For people who move out of their homes, those costs get even higher. The average cost to live in an assisted living facility is $4,500 per month. The numbers rise to $7,908 for people who share a room in a nursing home and up to $9,034 per month for those in a private room.
Long-Term Care Coverage
Medicare does not provide many options for long-term care. Although Medicare Part A covers stays in a skilled nursing facility after an inpatient hospital stay, that coverage is limited. The first 20 days are covered in full, but you would be expected to pay a daily charge of $194.50 (in 2022) for days 21 to 100. After that, you would pay all costs on your own.
Some people may choose to sign up for a Medicare Advantage plan instead of Original Medicare (Part A and Part B). These plans can offer supplemental benefits like adult day care, nutritional services, transportation, and even some in-home services.
However, these benefits may not be available in all plans. Also, long-term stays in a residential facility, such as a nursing home or assisted living facility, are not covered.
Medicaid is another option. In fact, more than 60% of nursing home stays are paid for by Medicaid. However, in order to be eligible for long-term care benefits, many people will have to spend down their assets. This could be an issue for beneficiaries who want to leave an inheritance for family members or who worry about the financial impact on their spouse.
Long-term care insurance is one way you can get those costs paid without needing to wipe out your savings. These plans are purchased before you actually need long-term services.
You purchase long-term insurance once and you pay for it every year. You will need to decide what level of benefits you want. Specifically, you will want to know the maximum amount your plan will pay each day, how many days it will pay, and the maximum amount it will pay over your lifetime.
Another consideration is the elimination period. This is the amount of time you will have to wait from the time you first need benefits to the time coverage actually kicks in. It can be a 30-, 60-, or 90-day wait.
Companies That Offer Long-Term Care Insurance
There are a number of companies that offer LTC policies. Here are 10 of the most popular in alphabetical order:
What Are the Benefits of Long-Term Care Insurance?
There are several benefits to purchasing long-term care insurance, including:
It covers services your health plan may not: Most health plans offer limited to no long-term care coverage. Getting an LTC plan addresses those gaps in care, improving your overall health and well-being if you ever need those services.
It protects your savings: Long-term care can be expensive and could quickly exhaust your savings if you do not have a backup plan. LTC plans require an upfront cost, but if you can afford them, they may allow you to make your nest egg last longer when the time comes.
You may be able to take advantage of tax benefits: You may be able to deduct your LTC premiums on your annual tax returns. If you spend more than 7.5% of your adjusted gross income on medical care, you could itemize your LTC premiums on your tax forms. The amount you can deduct is based on your age.
You can use a health savings account (HSA) to pay your premiums: You may be able to take advantage of another tax benefit. Money taken out of an HSA for qualifying medical expenses will not be taxed. You could use those funds to pay your annual premiums. Keep in mind that you cannot use an HSA if you are on Medicare.
Is Long-Term Care Insurance Expensive?
How much you pay for long-term care insurance will depend on when you sign up and how much coverage you want. Generally speaking, the older you are when you sign up, the higher your premiums. Also, women tend to pay higher premiums than men because they, on average, have a longer life expectancy.
According to the American Association for Long-Term Care Insurance, a 55-year-old man who signed up for a plan for the first time would pay an average of $950 for a policy in 2022. A woman of the same age would pay $1,500 per year, and a couple, both aged 55, would pay $2,080.
Those numbers would increase to $1,700, $2,700, and $3,750, respectively, at age 65 when first signing up.
Your medical conditions also are considered. Through a process known as medical underwriting, companies that offer LTC policies can increase their rates based on medical conditions you have. They could even deny you coverage altogether.
It is important to realize that premium rates can increase over time, as well. If you are unable to keep up with those payments, you can try to negotiate with your insurer to decrease your benefits so you can keep your old rate.
Otherwise, you will need to pay the increased rate to keep your plan at the same level of benefits. If you stop paying your premiums for any reason, you lose your coverage.
Signing Up for Long-Term Insurance
You will need to shop around for an affordable LTC policy that will meet your needs. Because companies rely on medical underwriting, you will want to reach out to several companies for a quote based on your age and medical history before making a decision. You can reach out to the insurance company directly or to a local insurance agent to get a quote.
Are Lung Cancer Patients Eligible for Long-Term Care Insurance?
Cancer patients can sometimes find it hard to get long-term care insurance. It depends when they were diagnosed relative to their signing up for a plan.
Because these plans use medical underwriting, insurance companies can deny you coverage based on any medical conditions you have at the time you sign up. This is especially true if you have a condition that is more likely to require long-term care in the future.
Cancer, unfortunately, is one of the diagnoses that draws their attention. Depending on the type of cancer you have and the treatments you get (for example, some chemotherapy and radiation treatments could have long-term side effects), you could have chronic care issues that increase your need for long-term care.
That said, some people have cancer that has been successfully treated. If you have been in remission for several years and have no current symptoms, an insurance company may consider you for a plan. You will have to reach out to each plan separately to find out if this is an option for you.
Other Cancer Insurance Options
Cancer insurance is another type of supplemental insurance. Like long-term care insurance, it is purchased before you have any medical issues, specifically before you have been diagnosed with cancer. Due to underwriting policies, you cannot purchase it after the fact.
This type of insurance can cover some of your long-term care needs but also can cover medical expenses your health plan does not cover. This can include deductibles, co-pays, hospital stays, or care you receive out of network that is related to your cancer.
You will need to check with your plan for details but be mindful that this type of insurance can only be used toward cancer-related expenses.
Generally speaking, if you are on Medicare, it may be more affordable for you to sign up for a Medigap plan. This is a supplemental insurance plan that can be used by people on Original Medicare.
Depending on the plan you choose, it covers out-of-pocket costs that Medicare leaves on the table, costs like deductibles (an amount you pay before insurance starts paying), co-pays (a set amount you pay per service), coinsurance (a percentage of the bill you pay), and emergency care in a foreign country. This coverage can be applied to any medical conditions, not just cancer.
Better yet, the insurance company cannot use medical underwriting if you sign up for a Medigap plan during the open enrollment period.
Summary
Most adults will need long-term care at some point in their lives. With the cost of long-term care increasing, many people may not be able to afford it. Long-term care insurance may be an option to keep those costs down and has the added benefit of being tax deductible. It’s essential to purchase coverage before you need it.
Alternatively, if you are on Medicare, a Medigap plan may be a good idea to cover out-of-pocket costs. Many people, however, may need to turn to Medicaid. That could mean having to spend down your assets to become eligible for nursing home coverage.
A Word From Verywell
There are pros and cons to long-term care insurance. These plans can keep your long-term care costs down and may even offer tax benefits. Unfortunately, not everyone is eligible for one of these plans and they can be expensive for some people.
Frequently Asked Questions
Can you get long-term care insurance after diagnosis?
Companies that sell long-term care insurance use a process known as underwriting to decide whether you qualify for one of their plans and how much they can charge you for one. This means they will use preexisting conditions to make their decision.
You are unlikely to qualify for a plan if you are actively being treated for cancer. Depending on the company, you may or may not be able to sign up for a plan if you are a cancer survivor.
Does long-term care insurance cover lung cancer?
Long-term care insurance provides coverage for nonmedical services that help you with your day-to-day living. This can include adult day care, home health services, homemaker services, or living arrangements in an assisted living facility or nursing home. It does not cover medical visits, medications, or other treatments you may need.
Is long-term care insurance the same as cancer insurance?
Long-term care insurance and cancer insurance are both types of supplemental insurance, but they are not the same. LTC policies help cover the cost of nonmedical care you need regardless of your medical conditions. Cancer insurance, on the other hand, provides both medical and nonmedical coverage aimed to address your cancer diagnosis.
