Long-Term Care Insurance Brokers

Find the Best Long-Term Care Insurance for Your Client

An estimated 10,000 Americans turn 65 every day according to AARP. Many are concerned with planning for both retirement and future medical needs. Long-term care insurance can be a great way to help current and potential clients mitigate the risk of chronic illnesses that are common in old age. These conditions are not covered by Medicare or standard health insurance policies, meaning your clients could be facing significant out-of-pocket costs if they are not prepared. 

Many people nearing retirement age will consider Medicare, annuities, and life insurance, but fewer know about long-term care insurance. This type of insurance coverage, traditionally speaking, has not quite had the emphasis and exposure that it certainly needs and requires. Some professionals find the subject complex, and it can be a difficult subject to present to a client.

It is important to work with an established brokerage firm that employs knowledgeable professionals. A brokerage agency understands the importance of long-term care insurance planning. Understanding how to find the right long-term care policy can help you retain current clients and attract new ones. 

What is long-term care insurance?

Long-term care insurance is a policy that provides coverage for individuals suffering from long-term or chronic debilitating illnesses. A long-term care policy provides a fund to cover the costs, where Medicare and standard insurance policies do not. Long-term care is coverage for needs like nursing home care, home health care, and personal or adult day care for individuals over 65. The benefit is that private long-term care is more flexible and has better options than public assistance programs. Long-term care insurance can be expensive, and most policies typically have a 90-day waiting period. Working with a knowledgable long-term care insurance brokerage is often crucial to finding a policy that will cover the needs of a client. 

To be eligible to begin receiving benefits from a long-term care policy, an individual must be certified by a physician. Several qualifying factors will make an individual eligible for long-term care. These include those who have a severe cognitive impairment, such as dementia or Alzheimer’s disease, or those who are unable to perform at least two activities of daily living (ADLs). The activities of daily living are activities that are considered essential, which most individuals can do without assistance.

What are the 6 ADLs for long-term care insurance?

The six activities of daily living (ADL) are:

  • Bathing: The individual can clean and groom themselves.
  • Dressing: The individual can dress/undress without assistance.
  • Eating: The individual can feed themselves.
  • Transferring/Mobility: The individual can sit, stand, walk, or move from a bed to a wheelchair and back again without assistance.
  • Toileting: The individual can get on/off the toilet and clean themselves.
  • Continence: The individual can control bladder and bowel functions.

What does long-term care cover?

Long-term care insurance covers the necessary expenses needed for long-term care. For example, a certified nurse providing in-home care for an individual suffering from dementia is covered. However, a neighbor’s child taking out the trash for you would not be covered. The policies also cover a wide range of care types, including: 

Nursing Homes

Nursing homes are also known as skilled nursing facilities. These facilities are for those who require more focus on medical care in a hospital-like environment versus in-home care. Nurses monitor residents around the clock and are always available to provide care on a 24/7 basis.

Assisted-Living Facilities

These are available for individuals who need assistance with ADLs and some medical oversight but do not need the extensive medical help that would require them to be in a nursing home. In assisted-living facilities, individuals often live on their own in apartment-style housing. Nurses are always available to provide onsite care if needed. In addition, assisted-living facilities provide more community-based services such as organized activities and transportation to grocery stores and doctor’s appointments.

Home Health Care

Home health care provides services in-home for those who have chronic illnesses. Certified home health care nurses come to you to assist with medical care, ADLs, and everyday home assistance. Essentially they help with activities individuals are no longer able to do themselves. Home health care includes full-time live-in assistance or limited daily care.

Adult Daycare

Adult daycare is designed for seniors with cognitive impairments. Think of adult daycare as similar to daycare provided for children. These centers are run by certified individuals who understand the impairments they are working with and have medical training. They provide lunches and have activities planned to allow seniors to socialize and engage with their surroundings. 

How do I select the best long-term care insurance for my client?

When reaching out to your clients about long-term care insurance, carefully consider your client’s needs. Those approaching retirement age or those worried about the risk of long-term or critical illnesses should consider long-term care insurance. It is vital to look at basic options for your client. Work with a broker to explore the policies in detail.

There are four options to getting a long-term care insurance policy:

Traditional Long-Term Care

A traditional long-term care policy functions like a homeowners policy. You pay premiums annually if you have a covered claim, you file. However, if you never have a claim, then you never collect benefits from the policy. In industry jargon, it is referred to as a use it or lose it policy. 

Asset-Based Long-Term Care

An asset-based long-term care policy is also sometimes referred to as a linked benefit policy. This type of policy offers tax-free long-term care (living) benefits in addition to or in place of a death benefit.

Life Insurance with a Long-Term Care Rider

Life insurance with a Long-Term Care (LTC) rider is a basic life insurance policy with a specific policy feature (rider) added at the time of application. The rider allows for a certain percentage of the death benefit to be used to pay for long-term care costs. The rider is usually available at an additional cost to the base policy.


Medicaid should be a last resort for LTC. Medicaid requires little to no income before individuals can receive Medicaid assistance. Medicaid is a state and federal cooperative program authorized under Title XIV of the Social Security Act. The program pays for certain medical and health costs as defined in the medical assistance program.

A long-term care insurance broker can walk you through these options and find the best fit for your clients and their needs. 

Frequently asked questions about long-term care.

How are long-term care policies structured?

Benefit periods can range from one to seven years. Lifetime benefits are also available under certain policies. Benefit amounts are specified in either daily or monthly benefits. Premiums between these benefits do not vary by much, but it is essential to keep in mind how much you plan to use your benefits.

For example, if you have a reimbursement style policy with a $150 daily benefit and your care for the day costs $250, you are reimbursed (with receipt or bill) for the $150 daily benefit. The daily/monthly benefit amount is elected at the time of policy application or issue. That amount will be the maximum benefit allowed for reimbursement each day or each month. Any extra expense above the stated amount would be out of pocket for the insured.

What is the difference between indemnity-style benefits and reimbursement-style benefits? 

Reimbursement-style benefits only reimburse qualified long-term care expenses. For example, home health care provided to the insured by a certified home care nurse is eligible for reimbursement. However, a family member who is not certified who provides care would not be reimbursed.

Indemnity-style benefits are much different. Once you meet all of the qualifications to receive the benefits, the carrier will deposit the full benefit amount into your bank account, and you can spend it as needed. These benefits are more common with informal caregiving, such as compensating a family member who is taking care of you or even a neighbor helping you around the house.

Should I sell a long-term care policy through a brokerage general agency?

Working with a long-term care insurance brokerage general agency (BGA) is the best way to save time and find the best long-term care policy options. A BGA will do the shopping for you and help you find the best long-term care products based on your client’s needs. In addition, BGA’s have access to multiple carriers and are compensated by the carriers. Because of this, there is no cost to an agent when working with a BGA. 

How do I find the best brokerage general agency?

There are several approaches to finding a quality BGA. The best place to start is often asking your network for referrals. You can also connect with NAILBA, a leading insurance industry organization promoting consumer choice.

You can also do your research by prospecting several brokerage general agencies in your area. We recommend looking for these qualities in a BGA:

  • Responsiveness and attentiveness. Are they knowledgeable of the policies that best serve you and your clients’ needs?
  • Back-office support. What happens after an application is submitted?
  • A good team instead of just a good salesperson. Make sure that the service is as good as the pitch.

You can also learn a lot about the brokerage by calling them directly and asking pertinent questions, such as:

  • How long have you sold long-term care insurance?
  • Have you had any issues with the state?
  • Who are your primary carriers? 
  • What are their ratings?

EMG can help.

As a brokerage general agency, EMG handles everything from submission to commission. Our team of long-term care experts is devoted to providing consistent support for you. With a dedicated department to assist our long-term care clients, we can provide reliable front-end support and back-office support.

Our goal is to act as a one-stop-shop for anything from enrollment to account maintenance and make sure the process is done efficiently to save you time. Our highly personalized approach gives us the ability to tailor solutions to each client. 

Connect with us by phone, online, or in-person, or schedule a consultation with your sales director on how to grow your business today.

Get Long-term care Quotes

For a long-term care quote request form click here.

For more information or contracting paperwork contact your sales director.

Kristy Fulton
Direct Phone 713.507.1035
Email kfulton@emgbrokerage.com

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