How to Find the Best Long Term Health Care Insurance in South Florida

How does one find the best long term health care insurance in South Florida? People living in the state of Florida should be aware of the many long term health insurance options that they have. The reason for this is that long term care insurance is becoming very common through the state and in the entire United States, and for this reason it is important to know the various options given to you by an insurance company. You must also know the different types of care that you can receive after being diagnosed with a chronic illness or after you cannot perform two out of the many daily activities. In this article you will find out the long term care health plans in the “Sunshine State” and the many options you have.

Types Of South Florida Long Term Care Health Plans

It is very important to understand that the variety or the extent of what a plan covers varies by company and can also vary by state. For this reason it is very difficult to describe the many plans offered by every single long term care insurance company operating in the state of Florida. We can help you with the two different types of policies that a customer can get when it comes to long term care insurance. Before this however, it is important to mention that you can get long term care insurance at any age and that in the United States people between the ages of 18 and 64 are covered.

1. Non Tax Qualified: This type of long term care insurance is also called NTQ when abbreviated. It was once called “Traditional Long Term Care Insurance because it was the first form of long term care implemented. This type of policy has been in the industry for the past thirty years and it simply includes that for a person to get the benefits specified in the policy, they will need a “medical trigger”. This trigger can only be stated by your own medical doctor or a doctor from the insurance company itself, and from that point on if the trigger is effective you will receive the benefits in the policy. It is important to highlight that the status of the benefits under this plan have not been determined by the United States Treasury Department, which means that you might be at risk for facing a large bill for what the insurance paid.

2. Tax Qualified: Also like the type of policy mentioned above, this policy is usually abbreviated at TQ. It does not need for the person to have a “medical trigger” which makes it much easier for a person to receive benefits. On the other hand the downsides of these plans are that the health plan will have a waiting period (ranging from 30 to 90 days) in which the insured will have to pay for their own medical care. In addition to that a doctor must provide a plan of care and the insured must be unable to perform two out of the many activities of daily living (include dressing, toileting, bathing, eating, transporting, etc). The benefits given to the person under this plan are not taxable!

It is important to highlight that if you work for a place that offers a long term care policy, you must make sure about the company and the language specified in the policy. The reason for this is that many insurance companies that take part in group policies are not regulated by the state and therefore charge more and can raise premiums whenever they feel like it.

Types Of Long Term Care Specified In South Florida Long Term Care Health Plans

As said before policies tend to change from company to company in the state of Florida, as well as in the entire country. It is important to read your policy fully before actually signing it, so that you know what is covered under it and what is not. Like in any other industry, the long term care insurance business offers the customer many different types of long term that can be best for them in the future. It is important to see that the policy covers the type that you want so that you don’t just have to settle for what they give you. The types of long term care found in South FL health care plans will be specified below.

1. Home Care: This is perhaps the most common type of long term care insurance nowadays. This is simply because people don’t want to go around visiting various nursing homes or hospitals and instead they would much rather stay at home enjoying of their own space. Under this category the insurance company usually covers nurses that come to your home and help you out with daily activities. It is important to highlight that some health care plans cover home health aids of personal workers that help you around your home. The average rate in the state of Florida for Home Care is estimated to be between $10 and $16 an hour.

2. Adult Care: This is a new type of long term care option that has emerged for individuals that want to get out of their home, but want to return to it in the same day. They provide senior citizens with programs of social interaction and they usually provide meals five days a week. Some may also have a means of transportation from the person’s home to the care center.

3. Assisted Living: A person should consider this option if they are unable to live at home without help, but they want to remain as independent as possible. In these facilities senior citizens are only helped by staff to take medications on time, bathe, dress and provide any medical care that the person needs. They also have recreation time and provide a great environment for community interaction. In the state of Florida the cost of this type of care ranges from $2,000 to $5,000 a month.

4. Nursing Homes: Perhaps the most expensive of any long term care type, these establishments provide the person with 24 hour nursing care when the person is recovering from an illness of disease. They can also accept patients in the end of their lives and help them out with any medical care that they need. In the state of Florida the cost for a nursing home on average is $206 per day (with Jacksonville at $190 per day, Miami at $236 per day, Orlando at $201 per day, and Tampa at $212 per day).

Tips For Finding A Cheap South Florida Long Term Care Health Plan

There are many things you can do in order to lower your long term care policy quote. The thing that many people don’t understand is that this industry, just like any other insurance business has its ups and downs and that it gives customers a possibility of lowering their coverage. Below you will find three tips that may help you save money on a South Florida long term care health plan:
1. Bundle Insurances: Perhaps this might not be the best option for you, but is can sure save a person a lot of money. Most people that have long term care insurance have some sort of health plan and most Americans have an automobile insurance policy. If you are with a company that offers all three of them do not hesitate to change and put all your insurance needs under a single company. If you do this the company usually rewards you for being a “preferred” customer and you can save up to 10%.

2. Shop Around: The more you shop around and do your homework the easier is going to be to save some money. If you are doing the shopping online, be sure to visit many insurance companies or maybe an insurance comparison website. If on the other hand you are shopping in person make sure you visit three of four companies and get quotes from each them. Shopping around leads to cheaper policies!

3. Look at your Waiting Period: Sometimes you can save a lot of money by expanding your waiting period; however you must only do this if you can afford it. By making your waiting period larger you are taking costs off the insurance company and placing them in your pocket. They will reward you with a good premium.

South Florida Long Term Care Health Plans Vary From Company to Company

As you can assume from the article that you just read, no plan is the same and you should definitely go to insurance companies personally and ask them for their services. If you shop around and are patient however, you can be assured that the best long term care plan for you will be in front of you at no time!

Is Home Health Care For You?

To find out if the disabled person a disabled person is in need of home health care assistance, you should seek the advice of a physician. Be sure to find out the patient you are considering requires professional home health care or home care services.

Professional home health care services givers include the medial aspect such as nurses, therapists, home health care assistants, and other licensed and certified medical caregivers. They are present to administer skilled care to the patient.

Home care services are provided to those who need assistance with tasks such as house cleaning, running errands, cooking, and just being around to assist if the patient needs other tasks such as these performed.

Social workers also play a part in home health care. They can provide counseling for emotional and social problems that the patient may be experiencing. They will direct those who need it to community resources which are available to them. They have various other services to offer as well.

Companions are another part of the care giving team. They are the ones who provide companionship to people who can not stay by themselves. If a disabled person stays by their self having a companion there to assist them can help if an emergency situation should occur.

To be assured that you have the best quality home health care for your disabled family member speak with others who are having or have had the same experience as you are going through.

Make sure that the home health caregiver that you request is experienced in care giving. The caregiver’s supervisor should manage the care provided to make sure the patient is receiving quality health care.

Whether you are hiring a home health care provider on your own or through an agency be sure to conduct an interview. Go over the needs of the patient and make sure the caregiver is capable of providing the type care that the patient needs. Advise the caregiver on medications, physical and mental problems that the patient may have, and how to deal with them. Make sure they know where everything is situated in the house which pertains to patient care. It will help in case of an emergency.

The payment for home health care services may be paid by the patient or some such as a family member. Medicare, under certain guidelines, will pay for skilled caregivers. There are others such as Medicaid, the Veterans Administration, and Social Services have programs which assist qualified patients. There are various other payers such as private insurances and more.

If the cause of illness is a work related incident workers compensation could pay for the home health care needed. In any case, the actual cost of home health care depends on which state the patient resides in.

Medigap Insurance Medicare Supplements Affect on Home Health Care

What’s Covered and What’s Not

Medicare covers therapy, both physical and occupational therapy plus speech language pathology services. It also covers counseling, certain medical supplies, durable medical equipment, as well as assistance with day-to-day activities like bathing, dressing, grooming, eating, and toilet activities. For most of the other medical equipment, Medicare will provide coverage of 80% of its cost.

On the other hand, Medicare will not cover 24-hour home care, delivering meals to your home, and services that are not related to health care like housekeeping. You will also be required to pay 20 per cent for medical equipment not covered fully by Medicare like wheel chairs, walker and oxygen tanks.

On Medigap and the Possibility of Larger Coverage

Medigap, a supplement to Medicare insurance, covers certain services that Medicare doesn’t cover. This might just also be the solution to patients on home health care. When used together with a Medicare supplemental plan, Medigap Insurance allows the patient to enjoy a larger coverage in terms of health benefits.

More often than not, Medigap and Medicare can cover a substantial portion of the costs on home health care. Insurance companies offer a variety of Medigap policies (Plans A through L), but since each type comes with specific benefits, it is best to compare the highlights closely. For one, Medigap policies vary by cost, and many insurance companies require you to have both Medicare Parts A and B in order to purchase a supplemental plan (5).

For senior citizens with both Part A and Part B of Medicare insurance, their home health care situation is, by default, covered. Thus, they get to save 20 per cent of their pocket expenses on medical equipment.

The cost of home health care should not cost an arm and a leg especially with Medicare and Medigap Insurance just within reach. Just keep in mind what your Medicare (and Medigap) insurance benefits are.

Paying For Home Health Care – What Do Medicare and Medigap Cover?

Prescribed only by a physician, home health care is skilled nursing care that aids in the recovery from illness, injury, or surgery in the patient’s home. And fortunately for many seniors who are now opting for care at home, Medicare insurance covers most costs related to home health care.

The government, however, has set some limitations on payouts – you are only eligible if you need intermittent care (usually defined as seven days a week or less than eight hours a day over 21 days or less) (1), physical/occupational therapy or speech language pathology; you are homebound; and the home health care agency providing care is approved by your Medicare insurance program.

In addition to medication administration, general supervision, and therapy services, the Medicare home health benefit covers a number of other necessities, including medical aids and supplies to aid in recuperation. On the occasion, though, you may be required to cover some of the costs associated with home health care. But what can you expect to pay out-of-pocket that’s not covered by Medicare dollars?

Medicare Insurance: Part A and Part B

Hospital Insurance (Medicare Part A) helps cover the costs of your inpatient care at hospitals, skilled nursing facilities, or religious non-medical health care establishments. Part A can also help cover hospice and home health care services. Individuals aged 65 and older are usually automatically enrolled in Medicare Part A and do not have to pay a monthly premium if Medicare taxes were paid while working. If you did not pay taxes, you are still eligible, but you will be required to pay a monthly premium.

Medical Insurance (Medicare Part B) helps cover services such as those offered by your physician and outpatient care. Many seniors maintain their enrollment in Part A, but elect not to use Part B, which requires a monthly premium that is dependent upon income, the requirements of which change yearly. Unfortunately, if you didn’t sign up for Part B when you were first eligible for insurance, your premium may be slightly higher (2).

For questions on your Medicare insurance benefits, you should contact 1-800-MEDICARE or read the handbook mailed to you each year entitled “Medicare and You.”

What’s Covered and What’s Not

Medicare insurance pays for physical and occupational therapy and speech language pathology services, counseling, some medical supplies, durable medical equipment (which must meet coverage criteria), as well as general assistance with daily activities which include dressing, bathing, eating, and toileting. For most other medical equipment, Medicare insurance will cover 80% of its cost (3).

However, Medicare will not cover twenty-four hour care at home, meals delivered to your home, and services unrelated to your care such as housekeeping. Of course, as mentioned above, you will be required to pay 20% for medical equipment not fully covered by Medicare insurance such as wheelchairs, walkers, and oxygen tanks (4).

In some cases, your home health care agency may present you with a Home Health Advance Beneficiary Notice (HHABN), which, simply put, means if your agency is ceasing your care services, you will be presented with a written statement outlining the supplies and services the agency believes your Medicare insurance benefits will not cover as well as a detailed explanation of why. Should this situation arise, you do have recourse – the HHABN lists directions on acquiring the final decision on payment issues or filing an appeal if Medicare refuses to cover costs for home health care. In the meantime, you should continue receiving home health care services, but keep in mind that you will be paying for these services out-of-pocket until Medicare accepts your claims and remits past expenses.

Medigap and Other Out-of-Pocket Expenses

Medigap, a supplemental insurance policy, is sold privately and covers the services and supplies not paid for by Medicare insurance. When used in conjunction, Medigap and Medicare can often cover a large majority of the costs of your home health care. Insurance companies offer a variety of different Medigap policies (A through L), but since each one comes with specific benefits, you’ll need to compare the highlights closely. Medigap policies vary by cost, and many insurance companies require you to have both Medicare Parts A and B in order to purchase a supplemental plan (5).

For seniors with both Part A and Part B Medicare, your home health care situation is usually covered, save for the 20% out-of-pocket expenses for medical equipment. Just remember to keep track of your Medicare insurance benefits (and Medigap if applicable) by verifying with your physician, home health care agency, and insurance representative. Paying for home health care does not have to cost you an arm and a leg, but do be prepared for the occasional (but necessary) out-of-pocket medical expenses.


1. Centers for Medicare and Medicaid Services, Medicare and Home Health Care, page 6
2. Medicare website: “Your Medicare Benefits.”
3. Ibid.
4. Ibid.
5. Medicare website: “Medigap (Supplemental Insurance) Policies.”

Jill Gilbert is the President and CEO of Gilbert Guide, a comprehensive website helping seniors and their loved ones find a senior care provider along with extensive tools and resources to solve the challenges of aging. She is the author of “Leading by Example,” a monthly column in McKnight’s Long-Term Care News, the chief industry publication for long-term care providers. Jill has been interviewed for a CBS News special, was a key presenter at the Pennsylvania Assisted Living Association’s annual conference, and was recently interviewed on San Francisco TalkBack.

Home Health Care Insurance

There are various insurance policies that help pay for or totally cover the costs of home health care. Consumers are reminded to be very cautious when shopping, comparing and buying home health care insurance policies because coverage is often limited. Considering the limitations and loopholes that home health care insurance has, they may be more expensive than other insurance policies. Home health care may only be accounted for by comprehensive insurance policies with pay benefits for nursing homes, assisted living communities, and adult day care.

Types of Home Health Care Insurance

The different types of home health care insurance depend on each policy’s extent of coverage when paying for home health care services. Private insurance usually only pays for part of the home health care costs which include personal and hospice care. Managed care insurance plans may offer some help with home health care costs if the home health care provider is Medicare-certified, these plans also require hefty premiums.

There are also existing home care policies which actually pays for the excess amounts that your original insurance policy does not cover. These supplemental insurance policies cover additional payments on home medical equipment as well. Long-term care insurance cover most medical and nursing services including licensed home health care costs. They may even include personal care as well as services incurred for the upkeep and maintenance of the policyholder’s home. Long term care insurance is paid for in monthly installments based on the individual’s age and health conditions. Many times, the benefits may only be reaped after a pre-defined waiting period, or when the insurance company decides the financial assistance is actually necessary.

Originally, long term care insurance policies were intended to pay for a lengthy stay in a nursing home, yet because of the public demand and preference for home health care, a lot of long term care insurance policies now cover in-home services which may vary greatly according to plans. Considerations regarding pre-existing health conditions and prior hospitalizations usually limit the coverage of these insurance policies.