Long term care is the continuum of a broad range of maintenance and health care to the chronically ill, disabled, or mentally challenged. Services may be provided on an inpatient (rehabilitation facility, nursing home, and mental hospital), outpatient, or at-home basis. Most people begin to consider long term care after age 55.

Daily Indemnity Policies

Most products today provide daily indemnity. The policy pays a set amount per day for care in a nursing home or for home health care. No policy provides coverage for all expenses. Some companies have provisions for future inflation adjustments. This is an evolving product. All policies have some outright exclusions such as self-inflicted injury, acts of war, and chemical or alcohol dependency. A policy will usually contain some form of pre-existing condition clause which states that there will be no coverage for any condition for which the insured was previously treated within a certain time frame. There is a great incentive in the premium structure to attract younger applicants. Coverage and age based premiums differ widely. Very few companies issue new policies beyond the age of 80 or 85.

The Policy Trigger

Newer policies begin paying benefits when the claimant can no longer perform certain activities of daily life (ADLS). This is called the trigger of the policy. It means that the benefit payments can begin in some plans without prior hospitalization. When the policy owner needs assistance in the prescribed number of ADLS, the benefits are triggered. This may require anywhere from two to five activities. The following are some of the features and explanations for the characteristics of a long term care insurance policy. Agents selling these contracts must be health licensed just as they are with other health based insurance plans such as disability income.
  1. Daily Indemnity Coverage
  2. Institutional Care
  3. Intermediate Nursing Care
  4. Custodial Care
  5. Home Care
    • Home Health Care
    • Skilled Care
    • Personal Care
    • Adult Daycare
    • Respite Care
If you have questions about our long term care products, please contact us. We'd be happy to answer any of your concerns.

(513) 424-6871

tom@newsadinsurance.com
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