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While there is a growing body of knowledge concerning the motivation for the purchase of long-term care insurance policies, little is known about who claimants are and how the presence of private insurance affects their behavior, or on how LTC insurance affects the level and mix of services consumed. This research aimed to analyze the experience of private long-term care insurance claimants and compare it to non-insured disabled individuals in both community and institutional settings. Two specific areas were explored: the effect of private LTC insurance on the behavior and experience of unpaid caregivers of community dwelling disabled elders; and its effect on elders receiving care at home (HC), in nursing homes (NH) and in assisted living facilities (ALFs). The study used data from eight of the largest long-term care insurance carriers (to obtain a sample of disabled elders living in all three service settings who are receiving insurance benefits), the 1994 National Long-Term Care Survey (to obtain a sample of community- and institutional-dwelling individuals without private insurance) and the 1995 National Nursing Home Survey (to obtain a sample of nursing home residents without private insurance). Administrative data from the insurance companies containing policy design and claims information was added to supplement in-person interviews.
The study concluded that private LTC insurance is achieving its goals: helping disabled elders to remain in their homes while at the same time relieving family caregivers of some of the burdens of caregiving. The vast majority of claimants was satisfied with their insurance policies, understood the coverage provisions, and found it easy to file claims. Although the average daily insurance benefit for all claimants at the time of the study was $83, daily charges were an average of $90 for ALF claimants and $123 for nursing home claimants. On average, the monthly insurance benefit paid to nursing claimants was about 23% higher than that paid to assisted living facility claimants, making the uncovered liability for nursing home claimants a little over $1000 per month. Most respondents indicated that they used their own income and assets to cover these costs. For over 70% of those claimants receiving care at home, insurance benefits covered all of the costs of care. However, despite the increased financial protection provided by private LTC insurance, forty-six percent of NH claimants, 35% of HC claimants and 28% of ALF claimants felt their needs were not being met in at least one activity of daily living. This may have been due to a number of things, including the use of personal income to cover care, the quality and/or responsiveness of facility staff, or in the case of claimants receiving care at home, paid caregiver scheduling difficulties and/or service availability.
Publications
Cohen, M., and Miller, J. 2002.
Policy Brief: The Impact of Private Long-Term Care Insurance on Claimants: Formal and Informal Care in the Community.
NY: Home Care Research Initiative, Center for Home Care Policy and Research, Visiting Nurse Service of NY.
Cohen, M., and Miller, J. 2002.
Policy Brief: The Use of Nursing Home and Assisted Living Facilities Among Private Long-Term Care Insurance Claimants: The Experience of Disabled Elders.
NY: Home Care Research Initiative, Center for Home Care Policy and Research, Visiting Nurse Service of NY.
Cohen, M., Miller, J., and Weinrobe, M. 2001
“Patterns of Informal and Formal Caregiving Among Elders With Private Long-Term Care Insurance.”
The Gerontologist, 41(2): 180-187.
Miller, J. and Cohen, M. 2001
“The Use of Nursing Home and Assisted Living Facilities Among Privately Insured and Non-Privately Insured Disabled Elders.”
Caring Magazine, April: 12-15.
Cohen, M., and Miller, J. 2000.
"Private Long-Term Care Insurance: New Study Looks at Claimants, Needs."
Healthcare and Aging: Quarterly Newsletter of the American Society on Aging's Healthcare and Aging Network, 7(2):4-7.
Cohen, M. 1999.
"Landmark data on home care released at Florida LTC meeting."
LTC News and Comment: New Views on the Financing of Long-Term Care, 9(8):1-2.
Cohen, M. 1999.
"Study finds LTC plans enhance family care."
National Underwriter, 103(36):5.
Reports
Cohen, M.A., Weinrobe, M., and Miller, J. 2000.
"Informal Caregivers of Disabled Elders with Long-Term Care Insurance."
Supplementary Report Submitted to the Robert Wood Johnson Foundation Home Care Research Initiative and The Department of Health and Human Services.
Cohen, M.A., and Miller, J. 2000.
"The Use of Nursing Home and Assisted Living Facilities Among Privately Insured and Non-Privately Insured Disabled Elders."
Supplementary Report Submitted to the Robert Wood Johnson Foundation Home Care Research Initiative and The Department of Health and Human Services.
Cohen, M.A., Weinrobe, M., and Miller, J. 1999.
"Multivariate Analysis of Patterns of Informal and Formal Caregiving among Privately Insured and Non-Privately Insured Disabled Elders Living in the Community."
Supplementary Report Submitted to the Robert Wood Johnson Foundation and The Department of Health and Human Services.
Cohen, M.A., Miller, J., Murphy, E., and Weinrobe, M. 1999.
"A Descriptive Analysis of Patterns of Informal and Formal Caregiving among Privately Insured and Non-Privately Insured Disabled Elders Living in the Community."
Final Report Submitted to The Robert Wood Johnson Foundation Home Care Research Initiative and The Department of Health and Human Services.
Other published work where work is prominently featured
Lankford, K. 2001.
"Arm Yourself While You Can: Those collecting on long-term-care policies wish they had better benefits."
Kiplinger's Personal Finance, March: 98.
McGrath, E. 2001.
"Betting the Ranch."
Time Magazine, May: G5.
National Alliance for Caregiving and LifePlans, Inc. 2001.
The MetLife Study of Employed Caregivers: Does Long Term Care Insurance Make a Difference?
New York, NY: Metropolitan Life Insurance Company, March.
Charsky, D. 2000.
“Saving for Rainy Days.”
Advance Magazine, 3(8): 54-56.
Charsky, D. 1999.
"Patterns of informal and formal caregiving among privately insured and non-privately insured disabled elders living in the community."
Long Term Care - The Newsletter of the Society of Actuaries: Long-term Care Insurance Section, 1.
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