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Long-term care policy insurance

What are the tradeoffs to consider in selecting a long-term care policy insurance?

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The points that need to be considered while choosing a long-term care policy are

• Age of the individual: Individuals must consider coverage at the earliest possible age. The general requirement is between the ages of 40 and 80. When the individual is younger, the options are many and the premiums are lower.

• Amount of coverage needed: This can be just to cover going to a hospital and can be extended to adult day care or home based health care and the premium will change accordingly.

• Daily or monthly coverage preferred: When an individual needs higher coverage, the premium will be higher.

• Benefit period: This is generally 2-6 years, but there are also lifetime benefit period and the premium will change accordingly.

• Inflation protection feature: This is offered by only a few companies but is very useful

• Non-Forfeiture Benefit: This helps in receiving benefit even after the premium payments are stopped.

• Insurance company: the reputation, services to clients and experience help in determining the right insurance company.

• Elimination period: the length of the period when the expenses had to be made by the individual himself before the insurance company takes charge. The payoff of the company will not be effective until a certain period, say 0, 60 or 90 days.

  • Average length of stay for coverage
  • Reimbursement vs indemnity: If the plan covers the whole or part of the actually incurred expenses.
  • Internal limits vs aggregate limits: Limits for reimbursement and other expenses
  • Degree of coinsurance

It is necessary to ensure that the policy covers all types of care, irrespective of the service being provided at home, nursing facility or home. The disability tradeoffs to consider includes the:

  • Elimination period
  • Benefit period
  • Amount of benefits: This must be nearly 60-70% of the gross pay when added to the individual’s other income
  • Accident and sickness coverage
  • Guaranteed renewability
  • Accessibility and adequacy factors 

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