Long Term Care

North Carolina Long Term Care Insurance Information & Statewide Cost Data

Long Term Care includes services provided to seniors and people with disabilities or chronic conditions that render them unable to perform activities of daily living such as bathing, dressing, transferring, etc. Our loved ones may also need supervision or assistance in basic functions as they choose to remain in their homes. Thus, Long Term Care includes not only care in nursing and assisted living facilities but home and community services as well. The Long Term Care settings in North Carolina likewise include adult care homes, continuing care retirement communities, multi-unit assisted housing with services, and hospice care.

Genworth Financial, one of the top insurance companies in the country, conducted a study of various Long Term Care settings in North Carolina and the 2012 median cost of services in some key areas:

Region Homemaker Services Hourly Rate
Home Health Aide Hourly Rate
(Medicare Certified)
Assisted Living Facility Monthly Rate
(Private room)
Nursing Home Daily Rate
(Semi-private room)
Nursing Home Daily Rate
(Private room)
Asheville $19 $21 $2,450 $211 $231
Burlington $17 $18 $2,250 $211 $222
Charlotte - Gastonia - Concord $17 $19 $2,850 $195 $210
Durham - Chapel Hill $18 $18 $2,850 $194 $208
Fayetteville $15 $16 $2,775 $171 $186
Goldsboro $15 $16 $2,100 $190 $210
Greensboro - High Point $16 $17 $3,199 $205 $227
Greenville $17 $17 $1,966 $176 $186
Hickory - Lenoir - Morganton $16 $17 $3,000 $184 $203
Jacksonville $18 $19 $2,500 $194 $202
Raleigh-Cary $18 $19 $3,525 $185 $212
NC-Rocky Mount $18 $18 $2,900 $191 $210
Wilmington $16 $18 $3,684 $175 $188
Winston-Salem $17 $18 $3,650 $196 $208
Rest of State $16 $17 $3,000 $181 $193

The number of people in North Carolina seeking Long Term Care services is increasing as the senior population continues to grow. According to one of the pioneering studies of the North Carolina Long-Term Care Policy Office, North Carolina's senior population is growing faster compared with other states, and is expected to reach more than 1.6 million in the year 2020. The state is estimated to rise in ranks, in terms of states with the highest percentage of senior adults, from 31st to 11th by 2025.

The study also revealed that seniors account for half of those requiring Long Term Care services. Baby boomers (born between 1946 and 1964) have less family members who can provide their Long Term Care needs. This is may be due to the fact that baby boomers, on the average, have fewer number of children compared with their parents. They also have higher divorce rates compared with their parents. Thus, many baby boomers remain single.

All these factors contribute to increase in demand for Long Term Care. The demand also entails the huge challenge of paying for these Long Term Care services. Only 40% of baby boomers have pensions. Another alarming fact is North Carolina's low savings rate of about 4%. Currently, many residents rely on publicly-funded LTC programs. Medicaid is the primary public medical assistance provider in the state of North Carolina. The N.C. Medicaid program has served about 19% of the total state population in 2007, or 1 out of 5 every resident in the state. Nearly 10% and 16.2% of the total recipients were seniors and residents with disability, respectively. These groups account for 65% of total Medicaid expenditures, amounting to about $5.6 billion combined. Medicaid enrollees have increased by 2.3%, compared with data of previous year.

The state of North Carolina is working to look for ways to further strengthen the Long Term Care system in order to meet the demands. The government is looking at one promising solution – a collaboration of private and publicly financed Long Term Care which is affordable yet of high quality, for the people of North Carolina. Residents are urged to take larger responsibility for their future care needs through private Long Term Care insurance. The North Carolina General Assembly is considering legislations with regards to Long Term Care. The North Carolina Department of Health and Human Services (DHHS) made recommendations to promote personal financing of Long Term Care. The Division of Aging will work alongside the Governor's Advisory Council on Aging, the Senior Tar Heel Legislature, and other agencies to consider the Long Term Care Insurance Partnership Program. This includes laying out the foundation for a national model and reciprocity agreements with other states.

A resolution was introduced by the North Carolina General Assembly in March 1, 2001. Known as House Joint Resolution 328, it is a joint resolution "urging Congress to adopt incentives that encourage the purchase of private long-term care insurance and to eliminate federal barriers to the expansion of Medicaid long-term care Partnership plans." The General Assembly urges Congress to enact federal incentives such as allowing covered persons to qualify for Medicaid assistance when benefits of qualified Long Term Care policies are exhausted; and federal tax deduction.

Finally, the NC General Assembly in the 2006 Session directed the North Carolina Department of Health and Human Services to develop a Public-Private Long-Term Care Partnership Program.

North Carolina Long Term Care Insurance Partnership Program

The North Carolina Long Term Care Partnership is a partnership program between the State of North Carolina and private insurance companies that became effective on January 1, 2011. The Program entitles qualified policyholders to disregard their assets equivalent to the dollar value of benefits paid to them by their insurance policies during the Medicaid eligibility process if and when they would need the said federal and state regulated health insurance program.

Only long term care insurance policies that comply with the guidelines mandated in the Deficit Reduction Act of 2005 (DRA) shall be treated as Partnership policies.

Features of North Carolina Long Term Care Insurance Partnership Policies

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