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Long Term Care Insurance Policy Benefits

To insure adequate long term care coverage, it’s a good idea to understand the long term care insurance policy features and benefits.

Long Term Care Insurance policy benefits may include the following:

  • Facilities Care Coverage
    Daily nursing home benefits cover room and board and skilled or custodial care in an institution. Assisted living facilities are also covered.

  • Home and Community Care Coverage
    Home health care covers services of licensed nurses, aides and therapists. Coverage of non-licensed providers varies between policies.

  • Benefits Period
    How long benefits should last depends on what you can afford to pay in premiums over the years. Buy the longest benefit period that you can reasonably afford, 5 years minimum.

  • Inflation Protection
    A benefit that keeps the policy’s buying power in pace with future cost of health care. There are 3 types of inflation protection: automatic 5% annual compounding; automatic 5% simple interest; and option to buy more coverage at periodic intervals without reapplying.

  • Elimination Period
    The elimination period is the time a person has to pay out-of-pocket for services before the long term care insurance takes over. Most will offer 90 day elimination or you could pay a higher premium for a zero day elimination period. The definition of elimination period varies with the long term care insurance companies. Some policies can require elimination to be met in a certain calendar period while others may require elimination to be consecutive days of care. Read and understand the elimination period in the contract.

  • Stated Period Policy vs. Pool of Money
    Your policy will list a total dollar amount of benefit for over the stated term. In a stated period policy, your contract will only pay up to the number of years you selected no matter that you used less than the maximum benefits per day. A $100 per day policy for 5 years would end at 5 years even if the policy only paid $50 per day.

    A pool of money policy is superior to the stated period policy. A pool of money policy will let you stretch the benefits years if you do not take out the maximum daily amount.
    This option is usually referred to as the ‘maximum lifetime benefit amount’.
    Indemnity Claims Payment – Under this option, the long term care insurance company will send you a check once a month for the maximum allowable daily, once you qualify for benefits. You don’t have to file claims for every expense.

  • Shared Benefits
    This option allows couples to transfer benefits to each other from the same policy or between policies.

  • Non-Forfeiture Benefits

  • Waiver of Premium
    Your payment of premiums may be waived when the benefits under the policy are being received. There may be restrictions and a certain number of days care under the policy may have to pass before it takes effect.

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