Long Term Care
Introduction to Long-Term Care | Long-Term Care Worksheet | Long-Term Care Quote | Long-Term Care Information | Long Term Care Links  

 

LONG TERM CARE WORKSHEET
Once you have obtained more than one quote on a Long-Term Care insurance policy use this worksheet to compare policies. You can fill in the boxes while on the computer then print it, or you can first print the form then fill in the boxes with a pen or pencil. These policies can be quite complex, this form should simplify the process helping you understand the difference among the various policies.
Policies
Policy 1
Company Name
Policy Name
Tax Qualified (Yes/No)
Yes
No
Risk Class Preferred/Standard
Benefit Period (1 to 10 years, lifetime)
(0, 30, 60, 90, 180, 360)
Elimination Period needs to be met only once (Yes/No)
Yes
No
Policy 2
Company Name
Policy Name
Tax Qualified (Yes/No)
Yes
No
Risk Class Preferred/Standard
Benefit Period (1 to 10 years, lifetime)
(0, 30, 60, 90, 180, 360)
Elimination Period needs to be met only once (Yes/No)
Yes
No
Policy 3
Company Name
Policy Name
Tax Qualified (Yes/No)
Yes
No
Risk Class Preferred/Standard
Benefit Period (1 to 10 years, lifetime)
(0, 30, 60, 90, 180, 360)
Elimination Period needs to be met only once (Yes/No)
Yes
No
Benefit Eligibility Policy 1 Policy 2 Policy3
____ of 6 ADLs or cognitive impairment
MD certifies disability (Yes/No) Yes
No
Yes
No
Yes
No
Written plan of care (Yes/No) Yes
No
Yes
No
Yes
No
Waiting period satisfied (Yes/No) Yes
No
Yes
No
Yes
No
Expense must be incurred (Yes/No) Yes
No
Yes
No
Yes
No
Home & Community Care
(Yes/ No & at What Percent of Daily Benefit)
Nurse or Licensed therapist (Yes/No and %)
Yes
No
Yes
No
Yes
No
Adult Day Care (Yes/No and %) Yes
No
Yes
No
Yes
No
Hospice Care (Yes/No and %) Yes
No
Yes
No
Yes
No
Respite Care (Yes/No and %) Yes
No
Yes
No
Yes
No
Equipment/home modifications (Yes/No and %) Yes
No
Yes
No
Yes
No
Caregiver Training (Yes/No and %) Yes
No
Yes
No
Yes
No
Home health aide/assistant (Yes/No and %) Yes
No
Yes
No
Yes
No
Homemaker Services (Yes/No and %) Yes
No
Yes
No
Yes
No
Chore Services (Yes/No and %) Yes
No
Yes
No
Yes
No
Bed Reservation
(Yes/No) If yes, how many days in a calendar year? Yes
No
Yes
No
Yes
No
Facility Benefits
Facility Benefits (Yes/ No & at What Percent of Daily Benefit)
Nursing Facilities
Yes
No
Yes
No
Yes
No
Assisted Care and Alzheimer’s Facilities (Yes/No and %) Yes
No
Yes
No
Yes
No
Spousal Discount
(Yes/No & at What Percent of Premiums) Yes
No
Yes
No
Yes
No
Waiver of Premium
(Yes/No) If Yes:
How long do you have to be in the Facility before it begins?
Yes
No
Yes
No
Yes
No
Does it apply to Home Care? (Yes/No) Yes
No
Yes
No
Yes
No
Guaranteed Renewable
Guaranteed Renewable (Yes/No) Yes
No
Yes
No
Yes
No
Inflation Option
Inflation Option
(Yes/No)
Simple or Compound
Percent
Yes
No
Yes
No
Yes
No
 
Nonforfeiture Benefit Option (Yes/No) Yes
No
Yes
No
Yes
No
Restoration of Benefits (Yes/No) Yes
No
Yes
No
Yes
No
Pre-existing Condition
If they apply to you, what are the limitations?
Additional Options/Special Features
Annual Premium (amount)
 

A.M. Best Rating – A.M. Best Company is a rating service that assigns to insurance companies rating opinions, a Best’s Rating. The Best’s Rating represents an opinion based on a comprehensive quantitative and qualitative evaluation of a company’s financial strength, operating performance and market profile. To view an explanation of Best’s Rating profile go to A.M Best Rating Page
Tax QualifiedMost policies issued are tax qualified. Be sure the one you purchase is tax qualified. There are two issues concerning taxes: premiums and benefit payments. In a tax qualified policy you may be able to add the premium to your deductible medical expenses. You may be able to deduct the amount of premium that is more than 7.5% of your adjusted gross income. The maximum long-term care premium you can add to your other deductible medical expense is based on your age at the end of each tax year.
Risk ClassificationApplying for a long term care policy is similar to life insurance. Approval is subject to underwriting, an exam is required, medical records are often checked and depending on the outcome of the underwriting evaluation the person applying could receive a preferred, standard or a decline risk classification. Premiums for a standard policy are higher than a preferred policy.
Daily BenefitWhen applying for long term care insurance one of the decisions to make is amount of the daily benefit.
Most of the policies sold today use the expense-incurred method. With the expense-incurred method daily benefits are paid to you or your provider up to the limits of your policy. The insurance company must decide if you are eligible for the benefits (see benefit eligibility) and if your claim is for eligible services. An eligible service may be a facility approved by the insurance company or it may be a nurse or equipment or home modification approved by the insurance company, or it may be a service that is included in your policy. In the indemnity method the insurance company only needs to decide if you are eligible for benefits (see benefit eligibility) then pays benefits to you up the limits of the policy.
Benefit PeriodThe amount of time the policy will pay benefits. The longer the time the more costly the policy. This is another variable decided when applying
Elimination PeriodThe elimination period is the amount of time before the insurance company will start paying benefits, the longer the wait the less expensive the policy. Another variable decided upon when applying for the policy. Some long term care policies require the elimination period be satisfied only once.
Benefit EligibilityTo be eligible for benefits most companies require 2 of the six ADLs. The six ADLs are bathing, continence (control of bodily functions), dressing, eating, toileting, and transferring. Cognitive impairment refers to deterioration or loss of intellectual capacity resulting in the need for another person’s assistance or verbal cueing to protect yourself or others such as Alzheimer’s disease.
Hospice Care - A program or facility that provides palliative (soothing of the systems) care and attends to the emotional, spiritual, social, and financial needs of terminally ill patients at a facility or at a patient’s home.
Respite CareThis feature provides benefits that enable your caregiver to take a needed break from care giving duties by paying for a substitute provider. It usually ranges from 14 to 30 days depending on the policy chosen.
Bed ReservationIf you need to leave your long-term care facility for a period of time for temporary hospitalization your accommodations will be reserved paying up to your daily benefit amount. The benefit usually ranges depending on the policy from 14 to 30 days.
Spousal DiscountIf husband and wife apply together some companies award a spousal discount. The discount range from 10% to 50%. Some companies have one policy covering both husband and wife.
Waiver of PremiumPremiums are waived usually once benefits start which is when the elimination period is met. Some policies also refund premiums paid during the elimination period. Some companies will also waive the premiums on the spouse if the two policies are issued by the same company.
Guaranteed RenewableAs long as you pay on time, your coverage can never be cancelled. However, that does not mean the insurance company cannot raise the premiums you are paying. To do so, they must raise the rates for all similar policies sold in your state.
Inflation OptionMost insurance companies offer the inflation option. The benefit could be increased on a simple or compound basis. If the increase is simple, the benefit increases by the same dollar amount each year. If the increase is compounded, the dollar amount of the benefit increase goes up each year resulting in a much larger increase over a number of years. Most policies offer a 5% inflation option. Your premiums are increased based on your attained age at the time of the increase of benefits.
Nonforfeiture Benefit OptionNonforfeiture Benefit Option provide reduced, paid-up protection if the policy lapse. In most cases the policy must have been in force for at least three years and the reduced benefits equal the total of premiums paid.
Restoration of BenefitsIf benefits are not needed for a period of time, usually 180 days, then the benefit period will be fully restored.
Pre-Existing ConditionA Pre-Existing Condition is a condition for which medical advice or treatment was recommended by, or received from, a provider of health care services within up to 6 months prior to the policy effective date.

 

     
 
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