Research shows that more than 70 percent of Americans 65 and older will eventually require some form of long term care. While many believe Medicare will help pay for these costs, in reality, Medicare only pays for long term care under specific circumstances, such as after a hospitalization, and only for a limited time. In response to this, supplemental long term care insurance plans have grown in popularity. But, these plans aren’t perfect, and include limitations like waiting periods and policy maximums.
Sun Health At Home provides an innovative retirement option for those interested in aging in place, at a fraction of the cost of “pay as you go” options. A Sun Health At Home membership can also help bridge the gap in an existing long term care insurance policy, as a more comprehensive plan for the future. Here’s an in-depth look at how Sun Health At Home compares to long term care insurance.
Required number of Activities of Daily Living (ADLS)
Activities of Daily Living, or ADLS, are the things we do in day to day life. Long term care insurance providers use basic ADLS to evaluate whether or not an individual could benefit from every day assistance at home. These include:
- Bathing
- Dressing
- Eating
- Mobility
- Toileting
- Continence
Long term care insurance
Depending on your long term care insurance plan, you may be unable to receive certain benefits like at home assistance until you have a certain number of ADL deficiencies. For example, many plans require you to have a minimum of two deficiencies that are deemed permanent before they will pay for services.
Sun Health At Home
Sun Health At Home requires one ADL deficit before at home services can begin. This requirement allows Sun Health At Home to be more proactive and assist with minor or short-term needs. Your Wellness Coordinator can help you identify any ADL deficiencies during a home safety check.
Physician certification required for services
This refers to requiring doctor to sign off and certify that a service is medically necessary before provider will pay for services. If you needed a wheelchair, for example, a doctor would need to confirm that a mobility device was necessary based on your health.
Long term care insurance
While not all long term care insurance companies require a physician’s certification, some do. If the policy is tax-qualified, the insurance company is not allowed to require a physician’s certification before paying benefits.
Sun Health At Home
Sun Health At Home does not require a physician certification before services can begin. Instead, you and your Wellness Coordinator can make decisions based on your needs, in order to help you stay safe and healthy at home.
Waiting Period
A waiting period is a period of time before coverage begins. Different policies may have different waiting periods, and generally, plans with longer waiting periods have lower premiums.
Long term care insurance
Most long term care insurance policies have a waiting period between 0-90 days. During this time, you cannot yet use your benefits, and you’ll have to cover all expenses incurred during this period.
Sun Health At Home
Unlike Long term care insurance, Sun Health At Home has no waiting period. From the moment you sign up, you can access your membership benefits and begin receiving support from your Wellness Coordinator.
Length of Benefits
This refers to how long you’ll have access to your benefits, and to how long the insurance company will pay out said benefits. But, this is measured not in years, but in dollar amounts. If your plan includes a 3 year benefit period with a $200 a day benefit, but you only spend roughly half of the benefit ($100 a day) on your long term care costs, your 3 year policy can actually last 6 years.
Long term care insurance
The most common benefit periods you’ll find for long term care insurance policies range between 2-5 years. If a plan has the choice for lifetime or “unlimited” coverage, this will likely come at a considerable expense.
Sun Health At Home
Sun Health At Home includes lifetime benefits for all membership plans, at no additional expense. In the event that your health needs change, Sun Health At Home’s Life Care benefit ensures that you’ll always be able to access all levels of care, including residential assisted living, memory support and skilled nursing services.
Daily coverage limit
The daily coverage limit is the maximum amount that an insurance company will pay on any given day of your policy. Some policies set a daily limit, while others pay out according to a monthly limit. Plans with lower daily limits tend to have lower premiums.
Long term care insurance
Some long term care insurance companies will only pay the full amount of a given daily coverage limit in certain circumstances, like skilled nursing care. Under other circumstances, like at-home care, the company will only pay a portion of the daily limit.
Sun Health At Home
For Sun Health At Home members, the daily coverage limit depends on the plan selected, minus any applicable copays. With several membership plans to choose from, Sun Health At Home makes it easy to find the one with a daily coverage limit that fits your circumstances.
Copays/coinsurance, inflationary protection, and premium increases
Copays refer to the set rate for pay for types of care included in your plan, while coinsurance is the percentage you’ll pay after you meet your deductible. Inflationary protection can help protect your assets over time through various means, such as compounding or simple inflation.
Long term care insurance
For many long term care insurance plans, inflationary protection is an additional feature that adds on to the premium payment. Lower inflationary protection rates come with lower premiums. Premium increases may occur, but regulations may prevent some policies may be prevented from increasing premiums with age.
Sun Health At Home
Sun Health At Home provides financial peace of mind with compounding inflationary protection, to ensure that our member’s plans maintain their value as the years go on. That way, members are protected from rising health care costs. Copays and coinsurance requirements depend on the plan option. When premium increases do occur, they are limited.
Care coordination included and provided locally
A care coordinator is usually a registered nurse, social worker, or someone with a strong background in a related field. If care coordination is included in a policy, you’ll have access to a care coordinator to manage your case and help with things like understanding benefits and filing claims if needed.
Long term care insurance
Some long term care insurance policies include a Care Coordination Benefit, which will pay some of the fees associated with having a professional assess your unique circumstances and make recommendations about your care. They may be employed by the insurance company, or work as an independent contractor. Depending on where they’re employed, they may not be local or available to you outside of regular business hours.
Sun Health At Home
Sun Health At Home serves both the East and West Phoenix Valley, with support from a Wellness Coordinator available 24 hours a day, seven days a week, 365 days a year. From benefits coordination to helping you navigate the healthcare system, your Wellness Coordinator serves as your personal advocate and ally in the world of aging in place. And, if you move outside Arizona, your Sun Health At Home membership moves with you throughout the United States, so you can receive the same level of support and service wherever you call home.
Services covered
Today, most long term care options bill themselves as comprehensive, with a wide range of services covered. But, each plan is different, and some may exclude the services you need.
Long term care insurance
The exact services covered will differ by plan, but generally will help you pay for services in an assisted living or skilled nursing community, or an adult day center. Some comprehensive plans will include coverage for services within the home that include help with personal care/homemaking.
Sun Health At Home
Sun Health At Home is a truly comprehensive option, with a wide variety of services covered that include:
- Health and Wellbeing Services
- Annual Safety Assessment
- Personal Emergency
- Response System
- Transportation Coordination
- Medication Management
- Supportive Home Technology
- Nutritional Support/Meals
- Homemaker/Companion
- Personal Care Aide/Caregiver
- Home Health Aide/Certified
- Nursing Assistant
- Adult Day Health Program
- Assisted Living
- Memory Support
- Skilled Care
Along with the services above, Sun Health At Home also provides the 24/7 support of a Wellness Coordinator to help each member customize their services to fit their lifestyle. Plus, members also have access to a full calendar of social activities and privileges at Sun Health Community locations.
A true comprehensive retirement option: Sun Health At Home
Compared to traditional long term care insurance, Sun Health At Home provides a true comprehensive retirement option, free from frustrations like waiting periods, lifetime maximums and more. If you have a current long term care insurance policy, or are interested in comparing the benefits of Sun Health At Home, contact our friendly Membership Counselors for a complimentary policy review.
