LTC Custodial Care

Long-term care (LTC) custodial care refers to the type of care that is provided to an individual who needs assistance with daily living activities. This care is typically non-medical in nature and is designed to help individuals maintain their quality of life and independence as they age. Custodial care can be provided in a variety of settings, including the individual's home, assisted living facilities, or nursing homes.

An example of custodial care could include assistance with bathing, dressing, eating, toileting, and mobility. Unlike skilled nursing care, which is provided by licensed medical professionals, custodial care can be provided by non-medical personnel, such as certified nursing assistants or home health aides.

Key features of LTC custodial care may include:

• Assistance with activities of daily living (ADLs) such as bathing, dressing, toileting, and eating

• Assistance with instrumental activities of daily living (IADLs) such as managing finances, cooking, and cleaning

• Help with mobility and transferring

• Assistance with medication management

• Personal care services

• Homemaker services

• Respite care for caregivers

• Assistance with cognitive impairments

• Assistance with socialization and recreational activities

It's important to note that custodial care is not typically covered by traditional health insurance plans, but may be covered by long-term care insurance policies or Medicaid in certain circumstances.

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According to Mployer Insights’ 2026 analysis of 76,000+ employer benefit plans, disability insurance remains a major market differentiator, with only 41% of U.S. employers offering short-term disability (STD) and 38% offering long-term disability (LTD). While 60% salary replacement serves as the national standard across both benefit types, standard plan designs disproportionately expose higher earners due to median benefit caps of $1,602/week for STD and $8,273/month for LTD. Furthermore, alignment between STD benefit durations (median 26 weeks) and LTD elimination periods (68% at 90 days) remains a critical area for plan structure optimization.
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According to Mployer Insights’ 2026 analysis of 50,000+ employer health plans, prescription drugs account for over 25% of total benefit expenses, with Tier 4 specialty drugs driving the majority of high-cost claims. While Tier 4 copays average $123 with coinsurance requirements in 31% of plans, individual oncology therapies like Darzalex Faspro ($170,800/yr) and Keytruda ($158,200/yr) frequently exceed average individual stop-loss deductibles ($141,938). To mitigate exposure, self-funded employers are increasingly turning to independent, transparent PBM models and biosimilar substitution—which yields up to a 73% net cost reduction per patient.