What is Long-term Care Insurance?

Long-term care insurance is meant to cover financial support and/or assistance services for a person who cannot carry out Activities of Daily Living (ADL) and needs continual care. ADLs are six basic daily activities: 

  • standing up and lying down
  • dressing and undressing
  • bathing
  • eating and drinking
  • walking
  • continence

The inability to perform several of these activities usually constitutes a long-term care insurance event. 

These policies are most commonly associated with fulfilling the needs of the elderly, but it is important to remember that they can be just as applicable to a younger person that encounters disabling conditions. 

Through the Kupat Cholim

Long-term care insurance offered through the Kupat Cholim is a group insurance plan provided by the health fund in association with a private insurance company.

The policy is not like the other supplemental insurance plans offered by the Kupah in the following ways:

  • There is no obligation to accept every applicant to this plan.
  • The group insurance is for a limited period, and the insurance company is entitled not to renew it at the end of the period.
  • This insurance has no connection to the Health Basket and should be regarded the same as any group health insurance policy.

Comparison

Since Long Term Care Insurance is a private insurance policy, you can compare the terms of the proposed policy from the Kupat Cholim to any other policy offered by a private insurance company. A registered insurance agent can help you determine which policy is suitable and purchase it directly from the insurance company.

One who considers buying long-term care insurance should look into the following details:

Claims and Benefits
  • How is the insurance event defined?
    • How many ADLs does it take to define the insurance event? (In most cases, the qualifying situation is the inability to perform three or four ADLs)
    • Are mental frailty and Alzheimer’s included in the definition of the insurance event?
  • How long can benefits be paid? (Possible periods are three years, five years, and unlimited. The duration has an effect on the level of premium.)
  • What is the level of the monthly benefit? 
    • Can the monthly benefit be enlarged?
    • Does the level of insurance benefits depend on the insured’s age?
  • Are the insurance benefits given in the form of indemnification (against actual expenses) or of compensation?
  • Does the policy cover nursing care in the insured’s home?
    • Are receipts required in the case of at-home care?
  • Does the policy have a nonforfeiture benefit, i.e., an entitlement to partial benefits even if the insurance is terminated? 
Costs
  • Is the insurer allowed to change the premium for insureds at large (in contrast to a declared change in premium that is adjusted to the age of each insured), and under what conditions?
  • Is it possible to buy a policy in which the premium does not change as the insured ages?
  • What rights does the insured have in the event of an increase in premiums? (According to some policies, if the premium scale is raised the insured may pay the old price for reduced benefits and/or become eligible for a nonforfeiture benefit.)
  • Is the insured excused from paying premiums while receiving monthly benefits?
  • Are the premiums for at-home care different from those upon admission to a nursing institution?

 

Related pages:

9 thoughts on “Long Term Care Insurance

  1. bs’d
    Dear Sirs:
    I have encountered 2 kind of problems:
    (1) My husband had a head injury in the IDF; he got only a 50% disability although he was never able to hold a regular job after the injury which had left him with bi-polar disorder and other mental problems. Our requests for evaluations and services were constantly shuttled back and forth from one agency to the other. Our application for a foreign worker was never acted upon. When my husband was admitted full-time to a residential facility two years ago, his home helper for 18 hours/week got “lost” and he never got a helper at ..all since he has lived in the residence.
    apbring this to your attention because I feel that interaction with Misrad Ha Bitachon is particularlychallenging problem for any Israeli.

  2. bs’d
    (1) continued.
    Any necessary interaction with local social services at the Matnas adds an additional layer of bureaucracy to the situation.

    (2) My husband is 72; I am 68. I do not recall ever being told about the possibility of purchasing additional long-term-care insurance that could extend beyond 5 years. Our Kupat Leumit branch secretary says that she did tell us and that my husband declined to sign on. Perhaps they had this discussion in Hebrew–in which case I never understood even if I was present?
    Is there any way that I can now purchase this insurance?

    (3)
    I thought that I had read in a short news article, in English, that there was a new law which stated that persons who were members of a group long-term insurance policy (I have Miftach Simon group policy thru Misrad Ha Bitachon) could self-pay and purchase insurance for more than 5 years and that the company must agree to extend their insurance coverage regardless of what preexisting conditions might be present.
    Miftach Simon says there is no such law. I wrote to the Ministry of Insurance and never got an answer. Do you have any information about such a law?

    Thank you for your attention.

    Kol ha Kavod for your extraordinary undertaking in starting The Shira Pransky Project!!

    Yours truly,

    Chanie Kreisel

    • Chanie, The best advice we can give is to enlist the help of social worker that can help you navigate each of these institutions. You can make an appointment with a social worker at your kupat cholim, take advantage of the Bituach Leumi counseling service for the elderly, contact the social services department at the ministry of absorption, or make an appointment with the misrad herevacha. Don’t be afraid to ask for someone who can communicate well in English. The important thing is to find a social worker that is willing to help you with each of the pieces of this picture.

      As far as a long term care policy, it is likely true that there is no obligation to extend, but if you think there is some law regarding the Misrad Habitachon policy specifically, an assistance professional intimately aware with that body needs to be consulted.

      Good luck, thank you for the encouragement, and please contact us again.

  3. I applied for long term care just 3 days before my 70th (English) birthday with Meuhedet which has been our kupat since our aliyah in 2008. I am a very healty and fit 70 y.o. Do you think I will qualify?

    • Hi Sarah, If it’s long-term care insurance, that means that it is a private insurance sold through Meuhedet and decisions regarding approval or rejection are therefore made solely by the insurance company based on various specifics including age and medical history and we are not in a place to make such a judgment call, but hope you did find some useful information on this page and on our site in general.

  4. We have had long term care insurance in Dallas for almost 10 years. My wife and I are both 58. What is the cost a of a typical plan? We are making aliya this summer and will want to see if it will be affordable.

    • Hi Mark, Basic healthcare coverage as well as supplementary healthcare coverage are bought through the health plans, which cannot discriminate based on pre-existing conditions, etc. The health plans also offer long-term care insurance, which is private insurance “repackaged”, which you can also buy directly from the private insurance companies. Because it is private, they take medical history, age, etc. into consideration and can refuse or limit coverage accordingly. This would also dictate cost. It is always recommended to shop around; the health plans may offer better rates as they sell in the context of collective, as opposed to individual policies, but not necessarily. You should also know that the government provides a Long-Term Benefit for those who qualify regardless of whether or not they have private long-term care insurance. Read more about it here: http://www.kolzchut.org.il/en/Long-Term_Care_Benefit.

  5. I applied for long term insurance and was denied. I am a type 2 diabetic on an insulin pump. My diabetes is very well controlled. I have no complications. My doctor informed the insurance of how well I’m doing. They didn’t reconsider. Is there any way I can get long term insurance?
    Thank you.
    Suzan

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