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How can ADLs affect eligibility for long-term care benefits?

On Behalf of | Jun 26, 2024 | Estate Planning, Medicaid Planning |

Obtaining insurance can be an effective way to plan for the future, especially for unavoidable situations that may come with age. Specifically, seniors can benefit from long-term care insurance policies that cover their needs living with impairments and other health conditions. Still, eligibility for these benefits can vary based on different factors, such as their capacity to perform activities of daily living (ADLs).

Understanding What They Are

For insurers, these ADLs could be vital when gauging how limiting an elder’s health issues can be. These activities can involve essential tasks usually done in private, including:

  • Taking a shower or bath
  • Relieving themself on the toilet
  • Transporting or moving the body independently, including getting out of bed or a chair
  • Eating meals
  • Putting on clothes

Depending on the insurance policy terms, a senior can qualify for long-term care based on whether they can perform a specific number of these ADLs.

However, their benefits can still vary according to the insurance coverage they initially acquired. These details and the eligibility requirements can significantly depend on the type of long-term care insurance and the features included in the policy. In addition to ADLs, these terms can indicate the coverage’s specifications, such as receiving care in nursing home facilities or home-based services.

Planning with proper guidance

Preparing for elder needs can be challenging, especially when doing it alone. In most cases, legal counsel could be helpful even before choosing the type of long-term care insurance and the extent of coverage. With experienced guidance, an individual can foresee situations and needs that the policy can cover. Chronic medical issues and impairments can be inevitable with age, but insurance coverage can provide security for seniors and their families.