WA Cares Provides Long Term Care Insurance We Can Afford
The truth is, most of us will need help at home someday. Whether it’s because we’re aging, injured, or dealing with an illness, 70% of us will need help with daily tasks. We’ll need help with things like preparing meals, getting dressed, hygiene, or moving around the house. We might also need special home modifications, like an accessible shower or ramps. Or medical equipment, like a hospital bed or wheelchair. While most people want to stay home as we age, some of us might move into a retirement or assisted living facility.
What Is Long Term Care Insurance For?
All these things – help with daily tasks, home modifications, medical equipment, assisted living, and more – are part of long-term care. And unfortunately, this kind of care is expensive. Without WA Cares, we don’t have many options. Private long-term care insurance is very expensive and often denies people with pre-existing conditions. Medicaid requires spending down our assets to $2000 or less. Medicare does NOT cover long-term care. Thankfully, WA Cares lets us access long-term care insurance at an affordable rate.
Now, with WA Cares, we have a safety net that doesn’t rely on private insurance companies or spending down assets. By making small contributions only while we’re working, we build WA Cares benefits that will be there for us when we need them. WA Cares has none of the long approval processes, high premiums, or pre-existing condition denials that long-term care insurance brings.
The Pitfalls of Private Long-Term Care Insurance
While private insurance is an option for some people, it’s not the solution Washington needs. Private long-term care insurance premiums are high – and they increase with age, making them unaffordable for those of us who may need them the most. Premiums continue to rise while coverage limits fall over time. Private insurance companies also often charge women up to twice as much as men, for the exact same policies.
Private insurance programs also makes it difficult to get the care you need when you need it. Many long-term care insurance policies require extra visits to the doctor and long waiting periods before you can use your benefits. The policies often exclude many pieces of long-term care, like home modifications, medical equipment, and family caregivers.
“I’ve always been employed, but I had no idea how I would be able to pay for Lupus support. I’ve looked into the options for getting long-term care insurance to cover the costs when I need a caregiver to come help me out at home. Even if I could afford the expensive premiums, private long-term care insurance would deny me because of my pre-existing condition.”
-Anthony Jones
Pre-Existing Conditions & Long-Term Care Insurance
Even with policy restrictions, waiting periods, and exclusions, long-term care insurance simply isn’t available to many of us. Even if we can afford the high premiums and are prepared to pay for medical equipment or home modifications ourselves, private insurance companies are likely to deny us if we have a pre-existing condition, like diabetes or sleep apnea.
Pre-existing conditions are much more common than most of us might think. When we think of pre-existing conditions, we often think of significant health issues, like ongoing cancer treatments. But the truth is, long-term care insurance companies also deny people for things that many of us live with every single day – like diabetes, lupus, high blood pressure, arthritis, or asthma.
In 2020, The American Association for Long-Term Care Insurance shared estimates on how many people were denied long-term care insurance policies because of pre-existing conditions: 5 in 10 people over 70 who applied for long-term care insurance policies were declined. Almost one-third of us between 60 and 65 will be denied. More than 1 in 5 people in their fifties – or nearly 200,000 Washingtonians – can expect our long-term care insurance applications to be rejected by private companies.
Even if we start shopping for home care insurance before we reach our fifties, our pre-existing conditions could still stand in the way of us getting coverage. Around 3.1 million Washington adults under the age of 65 have a pre-existing condition that could disqualify us from private long-term care insurance. With WA Cares, everyone is covered, no matter if we have a pre-existing condition or not. WA Cares Fund is a critical resource for those of us who cannot qualify for private long-term care insurance.
Can Medicaid or Medicare Replace Private Long-Term Care Insurance?
Before WA Cares, the only other option we had to pay for daily assistance was Medicaid. Many of us have been told that if we can’t afford long-term care insurance premiums or get declined because of pre-existing conditions, we can use Medicaid or Medicare to pay for the help we need. Unfortunately, it’s not that simple. Just like the issues with private long-term care insurance, Medicaid and Medicare fail to provide the safety net we need.
First, Medicare does not cover long-term care. Whether it’s help with meal prep, home modifications, payment to family caregivers, or care retirement and assisted living facilities, Medicare will not cover it. Only long-term care insurance, Medicaid – and now WA Cares – can cover the daily assistance we need in long-term care.
Second, while Medicaid does provide limited support for long-term care needs, like in-home caregivers and medical equipment, it has some restrictions. In order to qualify for Medicaid, we need to spend down our assets to under $2000. That means we’d have to sell our homes, spend down our retirement funds, and work through our savings before Medicaid will pay for the help we need.
Even if we reach the financial requirements for Medicaid, we still have to go through difficult approval and authorization processes. Medicaid also limits benefits, just like long-term care insurance policies. It does not pay family caregivers, and limits the amount of medical equipment you can access in a year.
With WA Cares, we won’t have to spend down any of our assets, retirement funds, or savings accounts to get help paying for the care we need. Our benefits are earned through paycheck deductions and are ours to claim when we need them (find out more about your benefits here). We can pay family caregivers, and get the medical equipment or home modifications we need, all with our WA Cares benefits.
“I tell my patients — you may think Medicare or other insurance will cover care at home should you need it — it will not. You’ll have to tap into your savings, your home equity, or worse, declare bankruptcy.”
-Dr. Charles Mayer
WA Cares vs. Private Long-Term Care Insurance
WA Cares addresses the gaps left by the current long-term care insurance options by providing coverage for any working Washingtonian, regardless of gender, race, assets, or pre-existing conditions. Most of us want to stay home as we age. With WA Cares, we can.
WA Cares gives us flexibility and options to choose what is best for our daily living when we need help. Whether it’s in-home care, family care, or care in a facility. This is flexibility that long-term care insurance doesn’t offer us. We can hire caregivers so our loved ones can keep working, or pay a loved one to take care of us. We can purchase crucial medical equipment or modify our homes so we don’t have to leave. We can count on the fact that our small contributions – just $0.58 for every $100 – won’t skyrocket as we age.
Private providers offers little flexibility, long waiting periods, and uncertainty for a much higher cost. Medicaid requires near-bankruptcy, and Medicare doesn’t cover long-term care needs. WA Cares is the best option for long-term care for working Washingtonians.
Right now, more than 3 million working Washingtonians are building WA Cares benefits. That’s more than 3 million of us with long-term care options, and peace of mind. With WA Cares, we know that our families won’t have to leave their jobs when we need help at home. We know that if our family members do want to care for us, we can pay them for their time. We know that if we need a mobility aid, CPAP machine, or hospital bed, we don’t need to go through complicated long-term care insurance processes. We know that WA Cares will be here for all of us, regardless of age, race, or gender, filling the gaps for Washingtonians.
More About WA Cares & Long-Term Care Insurance
Do you want to learn more about WA Cares and long-term care insurance? WA Cares is a new program, and we’re getting lots of great questions about WA Cares benefits. If you have questions too, take a look at our FAQ or contact us!