Rogers, AR asked in Elder Law for Wisconsin

Q: Will my long term care insurance be negated if I move into an assisted living residence? Which is a better option?

I've had this policy for about the past 12 years. There is a short term policy which is in effect currently. I'm asking for my brother who is currently in a nursing come and may not be able to return to his apartment where he lives by himself more than 500 mile from me. He is 67 and has social security and medicare but doesn't qualify for medicaid.

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1 Lawyer Answer
Thomas B. Burton
Thomas B. Burton
  • Elder Law Lawyer
  • Eau Claire, WI
  • Licensed in Wisconsin

A: It is likely that the long term care insurance policy covers an assisted living facility, because assisted living facilities generally cost less than nursing homes. However, you should check the details of your policy to be sure. Each long term care insurance policy can be different and will be governed by the terms of the agreement that you signed. If your brother's long term care policy is currently paying for his nursing home care, then it seems likely they would pay for an assisted living facility if it is less costly for them. You mentioned that this is a short term policy. If he bought a policy that only covers a certain number of months, then it will likely run out at the end of that time period regardless of what facility he is in. Can you find the name of the Company and call and ask them these questions? An Agent for the Company should be able to explain exactly what it covers and how long the policy lasts. If your brother has significant assets he should also consider consulting with a qualified estate planning and elder law attorney who could help him review his assets and determine if there is any medicaid planning and estate planning that can be done to help him.

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