Mod 2 set 4 -LTC

Question 1

what does LTC stand for?
what is the problem of LTC (in terms of demand for it)?
is it covered by OHIP?

Answer 1

• long term care
• the problem is that many elderly are living longer, the demand for LTC will increase
• LTC is costly and will lead to economic insecurity for the elderly, provincial health plans don’t cover it

Question 2

What is covered for the payments of LTC in Ontario? Who are costs set by?

Answer 2

personal and nursing care is paid for
but the room and board is paid for by the individual
- costs are set by the ministry of health and are universal

Question 3

Why do governments not subsidize retirement homes?

Answer 3

• these people generally have less needs
• probably don’t qualify for nursing home
• also those on a nursing home waiting list may be staying here (in retirement home)

Question 4

What makes people go into LTC (aka essential elements of LTC)? Where are these services provided?

Answer 4

• the need for medical, personal or social services.
• this need could come from old age or an accident
• could be provided at a home or at own home

Question 5

LTC services assist individuals in what type of ADL’s?

Answer 5

eating, bathing, dressing, going to the washroom, transferring

Question 6

what are the 3 basic types of LTC?

Answer 6

1. skilled care
   - for individuals that require skilled medical attention
2. personal care
   - assistance with ADLs
3. Supervisory care
   - need supervision, for those with cognitive impairment

Question 7

why is LTC insurance not popular in Canada?

gained traction

Answer 7

• costly and complicated to administer
• not many insurers offer it (only 2)
• lack of understanding about what is covered by OHIP

Question 8

what are the 3 types of LTC insurance policies?

Answer 8

1. reimbursement policy
2. indemnity policy
3. income policies

Question 9

what is the reimbursement policy

pros/cons

Answer 9

some or all out of pocket LTC expenses are reimbursed (up to a limit) receipts given

• pro: least expensive, most efficient
• con: least flexible

Question 10

indemnity policy?

pros/cons

Answer 10

given a daily limit to spend, spend more = out of pocket, spend less = keep it

• pro: price well, less chance of fraud
• con: prone to premium rate increases, not as flexible

Question 11

income policy?

pros/cons

Answer 11

designated a daily, weekly, monthly limit regardless of services received

• pro: most flexible
• con: most expensive, more chance of fraud

Question 12

what do the LTC insurance policies exclude?

Answer 12

• mental disorders

- addictions

Question 13

what are benefit triggers?

Answer 13

they explain how and when the benefits are going to be received
-ex if someone can’t perform 2/6 ADL’s or if someone fails a memory test

Question 14

What does LTC Include?

Answer 14

• Nursing Home Care
• Home Care
• Community Care