7 Ways to Select a Long-Term Care Insurance Policy

October 28, 2010 RSS Feed Print
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Health care costs in retirement will be significant. A sickness or injury that creates a need for long-term care can be financially devastating. This is why purchasing long-term care (LTC) insurance can be such an important part of retirement planning. When considering LTC coverage, pay particular attention to these important policy provisions.

[See 7 Costs to Eliminate Before You Retire.]

1. Elimination period. Also called the waiting period, this is the period of time during which you may require long-term care but before the policy kicks in. In other words, you will have to self-fund 100 percent of your care during the elimination period

2. Benefit period. Not all LTC policies provide lifetime benefits because that would be very expensive. Setting a reasonable benefit period can make the coverage more affordable. Statistically, five years of benefits will cover most long-term events. If you need long-term care for more than five years, you will have to self-fund or use any available Medicare and Medicaid benefits.

3. Benefit amount. Most LTC policies limit benefit payouts for covered services in two ways: daily and over your lifetime. The daily benefit should have some reasonable relationship to the cost of receiving long-term care in your area. The lifetime benefit will be based on the daily benefit as well as the benefit period.

[See 3 Ways Your Home Can Help Fund Retirement.]

4. Covered services. Pay close attention to what types of care are covered. Preferably, you want a policy that includes care in a nursing home or hospice facility (skilled, intermediate, and custodial), an assisted living facility, home care, community care, and respite care. The key service can be home care, so that you can live at home and still receive long-term care benefits. Respite care is when you may need a temporary period of help in or outside the home in case of illness or short-term disability.

5. Inflation protection. This is very important because of the expected rise in LTC costs over time. A compound inflation protection rider will automatically increase your the benefit amount each year by a stated percentage, such as 5 percent, without increasing your premium. Adding compound inflation protection is expensive, but it may be necessary to take advantage of long-term care partnership rules if they have been adopted by your state. If your LTC policy qualifies for the long-term care partnership program, you are allowed to keep more of your financial assets when becoming eligible for government long-term care benefits.

6. Indemnity rider. An indemnity-type LTC policy will pay the full daily care benefit regardless of the actual charges incurred. For example, with many indemnity riders, if you are chronically ill and receiving long-term care at home, you may still receive your full benefit, as long as part of the care involves a non-family member, such as a paid homemaker or private aide service.

[See 5 Benefits of a Second Home in a Retirement Plan.]

7. Benefit eligibility. This is the policy language that defines when you are receiving long-term care that is eligible for benefits. Some policies state that you must be chronically ill, which typically means you are unable for a defined period of time to perform two or more activities of daily living without substantial assistance. Activities of daily living may also be defined in the policy, such as bathing, dressing, transferring in or out of a bed or chair, using the bathroom, continence, and eating.

There are other LTC policy terms that are important (including the premium amount) but the seven listed above are among the most significant. Be sure to discuss and compare them in detail with the salespeople trying to sell you LTC insurance.

Mark Patterson is an engineer, patent attorney, baby boomer, and author of The Failsafe Retirement System. He blogs on matters of personal finance and retirement planning at Tough Money Love and Go To Retirement.

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I live in Missouri and my policy qualifies for the partnership program wherein I am protected from all LTC costs above those covered by my policy. Doesn't Arkansas have similiar laws? If so, you should file with your state insurance regulators and let them take on Prudential. There may also be federal insurance regulators you can get in on the issue.

The insurance company denying me benefits when needed was one of my main concerns when I purchased my policy. But, with the governments' concern over the looming baby boomers needing LTC, many states are now "partnering" with consumers who purchase "qualified" LTC policies, and giving them access to LTC after the policy is used up without meeting normal medicaid rules. I would think that the state would be very defensive on your behalf, since it will be on their behalf as well.

what do you think, Mark Patterson?

Thomas of MO 3:00PM February 21, 2011

hh

karla of WA 8:05PM November 15, 2010

I paid into LTD for years never thinking I'd ever need it but now that I do Prudential is refusing to pay. I have numerous medical tests, doctor statements, etc. that clearly show I cannot work any longer. August 2008 I had to file short term disability which lasted till December. January 2009 I had to re-file again but never got any better so I filed for long term disability. It is now November 2010 and I have yet to have my claim approved. Prudential made me file for social security disability, which I did and have been approved, yet they now say they don't have enough evidence to make a decision in my case. So before you start spending money on long term disability insurance you should ask your insurance rep how many claims they have, how many they approved and how many denied. I would also call several attorneys and see how many cases they have pending and I'm sure you're going to be shocked.

Susie Hannah of AR 4:53PM November 15, 2010

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