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a LifePlans, Inc., and Center for Health and Long-Term Care Research, Waltham, MA
b Clark University, Worcester, MA
Correspondence: Marc A. Cohen, PhD, LifePlans, Inc., 2 University Office Park, 51 Sawyer Road, Waltham, MA 02154. E-mail: Mcohen{at}lifeplansinc.com.
Decision Editor: Laurence G. Branch, PhD
Purpose: The purpose of this report is to provide basic descriptive information on community-dwelling, disabled, private long-term care (LTC) insurance policyholders who have accessed policy benefits. We focus on how benefits are used, whether claimants feel they are getting appropriate value from their policies, and what the patterns are of formal and informal service use. Design and Methods: Data were obtained from a nationally representative sample of 693 LTC insurance claimants who were receiving benefits while living in the community and 424 of their informal caregivers. Eight of the largest LTC insurance companies representing about 80% of the market participated in the study. Results: LTC insurance benefits are well targeted; they serve those truly dependent on ongoing care. The vast majority of claimants are satisfied with their policies, understand their coverage, and find it easy to file claims. Because of their LTC benefits, substantial numbers of disabled elderly individuals report that they are able to remain at home instead of being forced to seek institutional care. The availability of LTC benefits reduces stress among informal caregivers. For most claimants, formal care did not replace informal caregiving. Implications: As the LTC insurance market continues to grow and mature, there will be changes in the profile of claimants, the service delivery system, and the design of policies. Expansions in the private market will be associated with a greater number of disabled elderly remaining in their homes with a maintenance of and enhanced resiliency of informal support networks.
Key Words: Chronic care service use • Home care • Long-term care claimants
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