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 Long-Term Care Insurance Policy Checklist - PA
 
 
 

The National Association of Insurance Commissioners (NAIC) produces a "Shopper's Guide to Long-Term Care Insurance." This brochure can usually be obtained, at no cost, from your State Insurance Department. The Health Insurance Association of America (HIAA) also publishes a booklet, "The Consumer's Guide to Long-Term Care Insurance," which provides basic information on long-term care. Since several companies offer long-term care insurance, with a variety of coverages and options available, it is important to carefully research the subject and make an informed decision. Long-term care insurance may not be for everybody, so if you are considering a policy, read it carefully. Ask for an outline of coverage that describes policy features. If you have questions, ask them. With the help of an informed agent, you will be able to make an educated decision.

Long-Term Care Insurance Policy Checklist

  1. What services are covered?
    • Skilled care
    • Intermediate care
    • Custodial care
    • Home health care
    • Other care
  2. How much does the policy pay per day for:
    • Skilled care
    • Intermediate care
    • Custodial care
    • Home health care
    • Other care
  3. Does the policy offer a means for increasing benefits to account for expected future costs? If so, how? Is there an additional premium?
  4. Does the policy have a maximum lifetime benefit? If so, what is it?
    • Nursing home
    • Home health care
  5. Does the policy have a maximum length of coverage per "spell of illness" or maximum benefit period? If so, what is it?
    • Nursing home
    • Home health care
  6. How long do I have to wait before pre-existing conditions are covered?
  7. How long do I have to pay, out of pocket, before the policy benefits begin (this amount of time is known as "the waiting period")?
  8. Does the policy require:
    • Physician certificate of need
    • A functional assessment
    • A prior hospital stay for a nursing home or home health care (pertaining to older policies only)
    • A prior nursing home stay for home health care
    • Other
  9. Can the policy be cancelled?
  10. Will the policy cover you if you move to another area?
  11. What is the age range for enrollment?
  12. What does the policy cost? Per month? Per year?
  13. Is the policy a "qualified" long-term care insurance contract?

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Please Note: This Web site is for informational purposes only. You should contact your professional advisors for legal, tax or accounting advice.

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