Understanding the difference between long-term care insurance and Sun Health at Home

By Meghann Finn Sepulveda

Research shows that about 70 percent of people turning 65 will need some sort of long-term care. But determining future health care needs can be daunting. There are many options to consider before choosing a plan that works best. Unlike a long-term care insurance policy, Sun Health at Home is a unique and comprehensive continuing care at home program that offers support and coordinated services designed to allow seniors to remain safely in their homes as they age.

A personalized, wellness-based approach

All Sun Health at Home members are partnered with a wellness coordinator/registered nurse case manager, who serves as a personal advocate by managing all aspects of health, wellness and long-term care.

Wellness coordinators work closely with members to create individualized plans that encourage and promote independent living by conducting home safety assessments, identifying reputable provider referrals, explaining benefits, helping to navigate the health care system and arranging transportation, among other highly personalized services.

If a member does eventually require in-home caregiving or care in an assisted living, memory support or skilled care residence, the wellness coordinator will arrange needed services and provide support to ensure the transition is as seamless as possible.

No waiting periods

As opposed to a long-term care insurance policy, the Sun Health at Home program does not require a waiting period before members can begin receiving benefits.

“Long-term care policies typically require a 90-day waiting period or longer,” says Barbara Mason, executive director of Sun Health at Home. “Our members can immediately access the services they need, when they need them.”

In addition, Sun Health at Home does not require a physician to determine coverage eligibility.

“With long-term care policies, a person must be deficient in two or more activities of daily living such as eating, bathing, dressing or toileting, before services can be initiated,” Barbara says. “Members in our program can immediately activate home services when just one deficiency – temporary or permanent – is identified.”

Financial protection

The Sun Health at Home program, which is regulated by the Arizona Department of Insurance, can be a cost-effective alternative or complement a long-term care insurance policy.

“We realize that some people may already have an existing long-term care insurance policy in place,” Barbara says. “Our classic plan is designed to work with and strengthen existing LTC policies, while our other plans provide a robust alternative to long-term care insurance for those who do not yet have a plan in place for their long-term needs.”

Long-term care policies often have a lifetime cap on covered services, which can be challenging because Medicare does not cover these expenses.

“People are now living a lot longer,” Barbara says. “The average cost to stay in a skilled nursing facility is approximately $77,000 per year, which can wipe out hard-earned assets and cause financial hardships.”

Sun Heath at Home does not have a lifetime cap on benefits and instead provides a Life Care benefit, which guarantees that benefits are provided for the duration of a member’s life. Sun Health at Home is designed as a prepaid plan to protect members’ assets by helping them to avoid the threat of rising health care costs. Members pay a one-time membership amount and a monthly fee to belong to the program.

“We have five membership plans available, with varying levels of service and coverage,” Barbara says. “We offer basic and more inclusive plans, tailored to our members’ needs.”

Visit sunhealthathome.org or attend a Discovery Seminar to learn more about this innovative approach to aging in place.

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Events are held at the Sun Health Center for Health & Wellbeing,
14719 W. Grand Ave., in Surprise, unless noted otherwise.

• Wednesday, Aug. 2 at 2 p.m. 
• Thursday, Aug. 10 at 11 a.m.
• Wednesday, Aug. 23 at noon
  Palmbrook Country Club,
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• Thursday, Aug. 24 at 9:30 a.m.