Most people who require long-term care would much rather get that care in their own home or community than in a nursing home or other institution. Unfortunately, it hasn’t always been easy for them to do.

In the past, individuals who needed long-term care were usually placed in nursing homes, even if they were perfectly capable of living safely in their homes or a less institutional setting with the appropriate services and supports. But in 1999, the U.S. Supreme Court ruled that this arrangement was a violation of the Americans With Disabilities Act and began requiring states to provide citizens with better access to long-term care in a less restrictive setting.

But it’s still been an uphill battle.

State Medicaid programs are required to cover nursing home care, but not home- and community-based care. And although all state Medicaid programs cover some of this care, coverage is often limited and there are often long waiting lists for services.

Affordable Care Act offers new support
Under the new healthcare law, the dream of receiving long-term care at home instead of in an institution can finally become reality for millions of Americans. With financial incentives made possible by programs created or funded by the ACA, states can now access federal funds for people who need long-term care but want to avoid being placed in a nursing home, giving them access to services in a home or community setting.

The Community First Choice Option (CFCO) is just one example of the options available under the ACA. This program gives participating states greater access to the federal portion of the federal-state Medicaid funding partnership for home and community-based attendant services.

Another option is the Money Follows the Person (MFP) program, which enables those who need long-term care to move out of institutions and into their own homes or other community-based settings.

Some other options include:

  • Home and Community-Based Services State Plan Option
  • State Balancing Incentive Payments Program
  • Demonstration Grant for Testing Experience and Functional Assessment Tools (TEFT)

What does this mean for your customers?
In short, it means greater freedom and affordability for long-term care. Unfortunately, most people don’t have insurance that covers long-term care, so they end up having to pay for it out of pocket. Although home and community based care can be less expensive than nursing home care, it’s still costly and can quickly eat up a person’s savings.

With the new flexibility offered by the Affordable Care Act, now is a good time to educate your prospects and customers about their expanded options – and stress to them how vital it is to include long-term care insurance in their overall financial planning.

No one likes to think about needing long-term care. But for most of us, it’s not a matter of if, but WHEN. The Affordable Care Act makes it easier for people to get the care they need in the settings they prefer. And you can help them make it even easier to afford that care with LTC insurance.

When you’re ready to help your clients prepare for the inevitable need for LTC, request a long-term care insurance quote from the experts at DIS.



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