Understanding Mutual of Omaha Long Term Care Insurance

At some point during their lives, many older adults need help taking care of themselves. In fact, according to the Administration for Community Living, about 60% of individuals will eventually need assistance with daily activities, such as getting dressed or cooking meals. But, whether care is delivered in a residential facility or at home by a home health aide, the cost of these services can be high. Mutual of Omaha long-term care insurance helps seniors prepare for their future needs, covering services and supports that aren’t provided for by Medicare and other health insurance policies.

What Is Long-Term Care Insurance?

Long-term care insurance pays for some or all of the services and supports needed if a policyholder is diagnosed with a disorder, disability or chronic medical condition that affects their ability to live independently. Benefits typically cover non-medical services, such as assistance with the activities of daily living, which include:

• Bathing
• Dressing
• Eating
• Using a toilet
• Continence
• Transferring to and from a bed or chair

Some LTC policies may also cover medication management services, transportation and personal assistance, such as shopping, cooking and housekeeping.

Where Can Long-Term Care Services Be Delivered?

Long-term care insurance benefits typically include reimbursement for extended, supportive care received in any of the following settings:

• Your home
• A skilled nursing facility
• An adult day care center
• An assisted living community

Who Qualifies for Long-Term Care Insurance?

Individuals who are currently in good health can typically qualify for long-term care insurance. Most carriers won’t approve individuals who are over the age of 75 or those who have been diagnosed with a debilitating condition.

When Should You Purchase Long-Term Care Insurance?

Because premiums are often lower for younger individuals, long-term care insurance is often recommended for individuals in their 50s and 60s.

What Benefits Does Mutual of Omaha Long-Term Care Insurance Offer?

Mutual of Omaha's long-term care plans are customizable, so policyholders can purchase the type and amount of coverage that fits their needs and budget. However, most policies pay for standard long-term care, such as residential care in an assisted living or skilled nursing facility. Coverage typically includes room and board, personal care services and basic supplies. Mutual of Omaha typically also pays for in-home services or adult day care for policyholders who wish to remain in their residence and covers respite and hospice care as needed.

Mutual of Omaha long-term care insurance may also pay for:

• Care coordination: Once an individual is eligible to receive benefits, they're assessed by a care coordinator, who helps develop an individualized care plan and may arrange for the policyholder to receive the appropriate services. A care coordinator may also perform a facility assessment to determine the safety and adequacy of a residential community providing long-term care.
• Bed reservations: Individuals who are absent from their care facility may receive a bed reservation benefit, which pays for the bed to be held until they return.
• Durable medical equipment: The purchase or rental of durable medical equipment, such as wheelchairs and walkers, may be covered if included in an approved care plan.
• Home modification: Mutual of Omaha may pay for some or all of the cost of home modifications intended to make a home safer or help the insured individual remain in their residence. Home modifications may include the installation of a personal medical alert system.
• Waiver of premium: While receiving long-term care, a policyholder won't have to pay the premiums on their policy.
• Cash benefits: In lieu of reimbursement for covered services, insured individuals may opt to receive a cash benefit, which can be used to pay for care services.
• Alternate care options: Policies typically allow for the reimbursement of treatment services that don’t exist at the time the policy is written, if recommended by the care coordinator once an individual is eligible to receive benefits.

Potential policyholders may also add on several optional benefits at an additional cost, including:

• Shared care: Shared care options are designed for spouses who hold identical policies. With this benefit, a policyholder who has used up all their benefits may access a portion of a partner’s benefits.
• Inflation protection: Mutual of Omaha’s inflation protection option increases the maximum amount of benefits by a predetermined amount each year to help account for the rising cost of services.
• Partner security benefits: Through this option, a percentage of a policy’s monthly reimbursement allowance may be allocated for a partner’s care expenses.
• Return of premium: Policyholders who purchase a return-of-premium rider may receive at least a partial refund of premiums paid if they haven’t fully used their benefits.

How Much Does a Mutual of Omaha Long-Term Care Insurance Policy Cost?

The cost of Mutual of Omaha LTC insurance can vary depending on the coverage options you choose. Factors that may influence premiums include:

• Your gender
• Your marital status
• Your age when you purchase a policy
• The policy's maximum daily coverage amount
• The policy's maximum duration of coverage
• The type of benefits, including optional riders

Premiums may also be subject to increases.

Is Underwriting Required for a Mutual of Omaha Long-Term Care Policy?

Yes, medical underwriting is typically required by Mutual of Omaha before approving an applicant for coverage. The underwriting process typically includes a review of the following information:

• The application
• A health questionnaire
• A phone and/or in-person interview
• Medical records
• A physician's report and/or medical evaluation

What Is Mutual of Omaha’s Elimination Period?

Mutual of Omaha's long-term care policies include an elimination period, which is the number of days between a policyholder’s diagnosis and initial receipt of relevant services and when reimbursement begins. Each day after receiving a service counts toward the elimination period, even if the policyholder doesn’t receive a covered service.

Plans typically only include a single elimination period. If an individual is discharged from long-term care and then subsequently requires additional services, no new elimination period is required.

Will Mutual of Omaha Long-Term Care Insurance Pay a Relative to Provide Care?

No. Mutual of Omaha won’t pay for services provided by a family member. 

Is Long-Term Care Insurance Right for You?

Although long-term care insurance can be expensive, the high cost of extended services and supports may make it a worthwhile purchase as long as you can afford the premiums, particularly because Medicare and private health insurance don’t typically cover care that isn’t medically necessary. Even supplemental policies usually don’t cover these types of services.

Although some Medicaid programs reimburse for long-term care, you may need to spend down your assets before coverage kicks in. Because long-term care insurance may eliminate the need for Medicaid, it can help protect your home and nest egg if you need extended services.

If you’re not sure whether LTC insurance is right for you, it may be helpful to consider the following factors:

• Whether family can provide any essential care
• What services are covered under LTC insurance
• The cost of premiums
• The duration of benefits

Some life insurance policies may also offer long-term care riders that provide similar benefits, eliminating the need for a standalone LTC plan.