Long Term Care Insurance – South Africa

South Africa`s Long term care insurance is the type of health insurance that has unique features such as long term cover. With characteristics similar to those of standard health policy, this cover is not widely known. Another aspect that makes it unique is that unlike most insurance plans, it covers the expenses related to supplying facilities designed to help the disabled people maintain their regular daily routines. Consequently, Long term insurance policies reimburse the policyholder with a daily amount to cover crucial services to help them with activities that may include bathing, eating as well clothing among other things. Remarkably, the aspect, of paying for the supply of facilities, is unique to the South Africa long term insurance scheme and is still not offered by health insurance covers all over the world including some insurance companies domestically. As you would know, most health care covers only provide medical help for a limited period of time.

Another of their drawback is that they are fairly unequal and offer short term assistance. As with other insurance plans, there are factors that you consider before you apply. There is a specific question that you need to answer before you apply for the long term care insurance. This question is do you want the cover to take care of you at home or at a nursing home? There are also three choices, to consider such as Assisted living home, home health Aid or Nursing home cover.

Who is this cover for?

This policy is basically designed for individuals paralysed temporarily or permanently. The paralysis may be caused by a particular medical condition and the individual may want to continue to lead a self-sufficient life like they used to previously.

Due to lack of knowledge, this type of cover is confused for old age insurance. Most people think the policies are designed for people over the age of 60 years. In reality, medical conditions that could have a long-term negative effect on your health at any moment irrespective of your age are plenty. The devastating result at the end of the day could be a disability and helplessness. When such an occurrence takes place, you will need the nursing aspect of the long-term care insurance cover so that you do not entirely rely on others for your day to day activities.

In the event of such an accident happening to you, you may need the help from others to perform daily activities. However, if the condition is permanent, over a period of time you may become a burden to those offering help. So, for self-assistance and flexibility during your disability, it is imperative that you currently review these diverse insurance plans that also offer a variety of healthcare services.

It has emerged that most medical aid policies sold by various insurance companies are designed to cover you only for a particular term of your life thus providing a limited care only, as already indicated above. Consequently, such policies are inherently difficult to understand and do not provide long term cover.

The importance of the long term insurance cover

You may still be enjoying a healthy and active lifestyle right now and feel that such a cover is not relevant for you, well history has proved that a change in health fortunes cannot be predicted. You can sleep a healthy man or woman tonight and wake up in a different health state and your fortune changed for the worst. Future health risks should be taken into consideration at all times and taking out a long term insurance cover should be a priority. Most people reckon life, car, and household insurance are the only important covers to acquire, well they are wrong. You can get sick and require care and without insurance you may find the going tough.

While you might not realize the importance of getting such coverage today since you are amongst those fortunate people living a healthy and active lifestyle, you should always take into consideration future risks for your health, as this is the most valuable asset you have. However, you may not qualify for long-term care insurance if you are already sick or currently getting long-term care services because the majority of individual policies will ask for medical guarantees. As a result, you won`t qualify for a guarantee and subsequently means you do not qualify for a long term insurance cover as well. Fortunately, certain group policies do not have the medical underwriting. You better shop around if you already have a poor health.

Most policies on the market are all-inclusive. They include care and services in a variety of long-term care settings such as your home, with the option of skilled nursing care included. Other small yet crucial aspects normally covered in a home setting are therapies such as occupational, speech and rehabilitation and help with personal care. Depending on a policy, homemaker services such as housekeeping and meal preparation are covered.

Other settings covered include adult care centres, Hospice care, Respite care, residential care facilities, Alzheimer`s special care facilities and nursing homes among others. The most important aspect not covered by most health insurance policies as put forward above is the paying of facilities meant to make the life of the disabled individual easier.

What is excluded from the policy?

All insurance policies have in print things that are excluded from Long-term care policies. Exclusions are regulated in different countries for their domestic use. The following are the general Long term care policies exclusions.

  • A Care supplied by a next of kin
  • A care provided outside South African borders, fortunately, most insurance companies are beginning to offer international benefits as well.
  • A Care that is consequent to an endeavour at suicide or a deliberately self-caused injury
  • Treatment for alcohol abuse or drug misuse
  • There are other exclusions that a policy buyer will have to look out for when they purchase this insurance cover. It will do you good if you do some research prior to settling for insurance with one specific company.

Factors affecting the total cost of your long term care policy

Typically the cost of your long-term care policy depends on the following factors. Age is of enormous importance when you purchase the policy. If you are young typically your premiums are smaller compared to of that of a person who is older. The logic is that as a young person you will pay your premium for a long period of time although a young person can also be disabled at a young age.

Secondly, the maximum amount the policy will pay per day. In case you require a huge payout, the huge amount will also have an effect on the size of your premium. Thirdly, the number of days or years, that the policy will compensate the policyholder, is crucial as well for the determination of the costs. In essence, if you decide you want to be covered for a few years, your premium won`t look like that of another person with similar circumstances but different terms. And finally, if you add any discretionary benefits particularly those that swell with price increases it will increase the cost of your cover.


Long Term Care Insurance – SA Insurance Providers (4)