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Most Long-Term Care Insurance Beneficiaries Satisfied With Coverage


Compared with a decade ago, the vast majority of long-term care claimants are satisfied with their coverage and interactions with the insurance company, according to a survey sponsored by America's Health Insurance Plans.

Compared with a decade ago, the vast majority of long-term care (LTC) claimants are satisfied with their coverage and interactions with the insurance company, according to a survey by LifePlans of 1291 beneficiaries from 11 major LTC insurance companies that constitute the majority of LTC insurers.

The current survey results were compared with 2005 data from a HHS study that examined data from individuals who were beginning to receive benefits. The survey was administered on behalf of America’s Health Insurance Plans (AHIP).

The cross-sectional survey of LTC claimants in 2015 and 2016 found that a great majority (94%) say the benefits paid by their policy are sufficient to meet their current care needs, and most report that they assess their caregivers to be reliable (89%), understand their caregivers (82%), feel safe with them (96%), get along well with them (91%), and believe their caregivers always provide high-quality care (88%).

Overall, approximately 4 in 5 claimants are very satisfied with their caregiver, even if there may be specific components of the care or relationship with which they’re not completely satisfied. Nearly 9 in 10 individuals had no problem knowing what their policy covered. Slightly more than 3 in 4 claimants believed their LTC insurance allowed them to access higher-quality providers.

The telephone survey of claimants comprised individuals who received home care (45%), were in assisted living (31%), nursing homes (17%), and other settings (about 7%). On average, individuals had been receiving benefits for 2 years, and the average value of total claims paid at the time the insurance companies provided their data was $118,986 per person. On average, $134,731 was paid to individuals in a nursing home, $95,589 to those in assisted living, and $76,784 to those receiving paid home care services.

The survey data suggest that, compared with a decade ago, there have been improvement in claims management practices that have led to greater levels of consumer satisfaction among claimants on a number of factors. Today 78% of claimants found filing a claim to be easy; in 2005 about 64% found it easy. For every 100 people making claims today under their LTC insurance, only 2 are likely to have had a disagreement about coverage that was not solved to their satisfaction.

LifePlans and AHIP concluded that LTC insurance today is achieving multiple goals for policy holders, including helping them afford services, giving them access to high-quality care, reducing burdens on families, providing choice of service settings, and enabling them to receive care when they need it, without delay. In addition, the recent data show that LTC coverage parameters comprise only one element of satisfaction, and not even the most important one.

“People’s experience with providers as well as how smoothly they are able to navigate the claims filing processes are particularly important to the overall level of satisfaction with their policy,” LifePlans concluded in the report. The company recommended that LTC insurance companies should examine how to empower claimants by providing information about how to choose a caregiver so that the provider selection process can also be improved, and explore ways to help claimants navigate the provider system to help ensure that the paid caregiver experience is as positive and effective as possible.

Currently there are more than 7 million people in the United States with LTC insurance, and more than a quarter million are receiving benefits.

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