Long Term Care Coverage

When does this long term care health insurance coverage kick in?

This is the critical aspect of the long term care health insurance and something you have to understand clearly when buying it.

The long term care health insurance policy must state the conditions that must be met in order for benefit's to start. Here are some things to consider; which affect both when benefit's will be paid as well as how much benefit will be paid:

  1. You will want long term care health insurance benefit's to commence when you are unable to perform some specified number of activities of daily living. Usually, these would be due to restriction of mobility and commonly would include bathing, dressing, eating and going to the toilet on your own. There is also something called 'transferring' which includes your ability to move from place to place or from a bed to a chair for instance.
  2. You will want long term care health insurance benefit's to commence when you are suffering cognitive impairment. Now this condition is a tricky one. Some kinds of cognitive impairment are typically covered while others are not. Be sure you understand which are covered in your long term care health insurance policy.
  3. You will want long term care health insurance benefit's to commence when a health doctor certifies that long-term care is necessary. This may occur under a variety of circumstances, but your doctor will be able to evaluate this on an ongoing basis.
  4. In some cases, long term care health insurance policies will not pay unless you have a previous hospitalization. This condition is a tricky one and can mean that you will not receive benefit's unless you've first been hospitalized. Since many elderly may not require hospitalization, but may require a higher level of care for other reasons, you should ensure your policy does not have this stipulation.
  5. Your long term care health insurance benefit's could be paid from two years to a lifetime. Obviously, if your benefit period is shorter you might run out of coverage when you still require it. However, unlimited benefit's are very expensive. Your best bet? To select a coverage period of at least 4 years, which is less expensive than lifetime coverage, but longer than the average nursing home stay. This is playing the odds in your favor.
  6. You might want to consider a waiting period before long term care health insurance benefit's commence. You can actually keep the costs of long-term care insurance down by having a waiting or "elimination" period on your policy. This is the equivalent of a deductible. Your premiums will be lower in exchange for having to pay for the initial period out of your own pocket.
  7. You should have inflation protection if you are buying long term care health insurance and you are under 50 and in good health. This is a difficult choice for some, but you should consider it. If you are buying long term care health insurance at 50 you may not need benefit's for 20 years or more. At that time, the costs of long term care may be significantly higher - but you've only paid for a certain level of coverage. If you get an endorsement for inflation protection, it doesn't matter when you buy your policy - you will be covered. Also, it makes more sense to buy this coverage when you are younger, because the premium payment period is longer and you are likely to get the long term care health insurance at a lower monthly rate.
  8. You might want a guaranteed renewable long term care health insurance policy. This ensures that a company cannot refuse to renew your policy. However, your premiums can go up if the long term care health insurance company increases the premiums for a whole class of plan participants.
  9. You might also want a long term care health insurance policy which waives premiums once you begin to receive benefit's. Again, this might cost you more up front, but will save you money once you or your family member needs long-term care.
  10. If you don't get waiver of premium you'll likely want to have a third party notified if the policyholder forgets a payment. It could be disastrous to have benefit's stop because a policy was cancelled due to non-payment.

Researching your policy is key. Click on the links above to start researching the individual health insurance companies.

Don't forget to look at the other pages like: Health Insurance, how do I choose a health policy, group health insurance and individual health insurance, health insurance questions, long term care and save money health insurance to make an informed decision.

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