Increasing Proportion of Seniors: Over the past 50 years, the proportion of seniors has been increasing due to below-replacement fertility and longer life expectancy.
Baby Boomers: As more baby boomers reach age 65, the demand for long-term care will increase, raising concerns about funding.
Long-term Care Facilities
Definition: Facilities designed for individuals who cannot independently manage their daily physical needs.
Not Just for Seniors: Includes younger individuals affected by diseases (e.g., muscular dystrophy, multiple sclerosis) or injuries.
Common Diseases: Dementia and Alzheimer’s are common conditions requiring long-term care.
Financial Implications
Cost: Monthly costs for long-term care facilities can be significant and vary by province in Canada.
Long-term Care Insurance
Purpose: Offsets the ongoing costs of long-term care.
Types of Coverage:
Home Care: Assistance provided at home.
Respite Care: Temporary placement in a facility for caregiver relief.
Assisted Living: Services for those who are mostly independent but need some support.
Nursing Home Care: Full-time supervision and care.
Providers of Long-term Care
Sources:
Provincial governments.
Not-for-profit organizations.
Religious organizations.
For-profit businesses.
Costs and Coverage
Cost: Varies between $900 to $6,000 per month, depending on the province and level of subsidy.
Insurance Policies:
Standalone or Rider: Available as standalone policies or as riders to life/critical illness insurance.
Age: Typically issued to individuals 65 and under.
Benefit Models: Indemnity (direct payment to facility) and expense reimbursement models.
Coverage Details
Non-Provinicial Expenses: Covers expenses not included in provincial healthcare plans.
Waiting Period: Typically 0 to 90 days.
Underwriting: Medical underwriting is required.
Benefit Calculation: Based on daily maximum benefit x days of care.
Claims Process
Eligibility: Must be unable to perform two or more Activities of Daily Living (ADL).