The most important thing you should look at when purchasing a
long-term care policy is the benefit triggers. The triggers are a
set of conditions that must exist before you can begin receiving
coverage.
Most policies will generally require you to have an acute medical
condition that requires skilled nursing care before your benefits
kick in. The best coverage, and most expensive coverage, comes from
policies that allow you to start receiving benefits if you suffer
from a cognitive impairment such as Alzheimer's disease.
Some of the most commonly used benefit triggers are certain
activities of daily living that you can no longer perform on your
own. Most policies require that you can no longer perform two or
three of the daily activities. They often include:
Bathing, for instance, is usually the first activity that a
person is unable to perform, according to the National Association
of Insurance Commissioners. You can qualify for benefits under a
policy that includes bathing as an activity easier than you can that
doesn't include bathing. Ideally, you want a long-term care policy
that requires the inability to perform two daily activities.
Good long-term care policies cover all levels of care, including
custodial and personal care, in many different settings. Those
setting should include:
" Adult day care - sites that provide personal care and
recreational services on a daily basis.
" Assisted living facilities - living quarters that provide
individualized personal care and health services for those who need
help, when they need help.
" Facility care services - these are licensed agencies that
provide skilled nursing care and therapy in home or at site.
" Nursing facilities - residential sites for people who need
full-time medical care. Most stays are for a short rehabilitative
period after an illness or injury.
You should know what types of services and facilities are covered
by your long-term care insurance policy. If you don't go to an
approved type of facility, you could find the company will refuse to
pay for your care.
Ask if the policy includes a nonforfeiture benefit, which is an
additional long-term care coverage you purchase that protects the
policy's value if you drop it or let it lapse. This benefit will
offer some protection for your investment, but it will increase your
premiums. If you are confident that you will always be able to pay
your premiums, even if they go up, you can lower your overall cost
by passing on nonforfeiture benefits.
A waiver of premium will allow you to stop paying your premiums
during the time you are receiving benefits. Read your policy
carefully to see if there are any restrictions or limitations to
this benefit. Some policies will require that you be in a nursing
home for 60 to 90 days before your premiums are waived.
The majority of long-term care policies are guaranteed renewable
- the insurance company guarantees you the right to renew your
policy. It doesn't give you the right to a fixed premium. Premium
amounts usually increase over time. You won't be singled out for a
rate increase, no matter the amount of your claims, but you should
know that state regulators often grant increases in premiums to
insurance companies to cover a large number of expensive claims
overall.