Frequently Asked Questions About Long-Term Care Insurance

Basic Understanding

What is Long-Term Care Insurance (LTCI)?

Long-term care insurance helps cover the cost of care when you need assistance with daily living activities or require supervision due to cognitive impairment. It provides coverage for care in various settings, including your home, assisted living facilities, or nursing homes.

When is the best time to buy LTCI?

The optimal time to purchase LTCI is typically between ages 50-65. Buying earlier means lower premiums and better chances of approval. Waiting too long increases both costs and the risk of being declined due to health issues.

How much does LTCI cost?

Premium costs vary significantly based on:

• Age when purchasing
• Health condition
• Coverage amount
• Policy features selected
• Insurance carrier

Average annual premiums range from $2,000 to $4,000 for individuals in their mid-50s, but can be higher or lower based on specific circumstances.

Coverage Details

What does LTCI typically cover?

Standard coverage includes:

• Home health care
• Assisted living facilities
• Nursing home care
• Adult day care
• Respite care
• Hospice services
• Personal care services
• Homemaker services

How do benefit triggers work?

Benefits typically trigger when you can't perform 2 out of 6 Activities of Daily Living (ADLs): 1. Bathing 2. Dressing 3. Toileting 4. Transferring 5. Continence 6. Eating

Or when you require supervision due to cognitive impairment.

What is an elimination period?

The elimination period is similar to a deductible - it's the time between when you become eligible for benefits and when the insurance company starts paying. Common periods are 30, 60, or 90 days. Longer elimination periods generally mean lower premiums.

Policy Features

What is inflation protection?

Inflation protection increases your benefits over time to help keep pace with rising care costs. Options typically include:

• 3% compound
• 5% compound
• Consumer Price Index-linked
• Future purchase options

What is a shared care benefit?

Shared care allows married couples to share their benefit pools. If one spouse depletes their benefits, they can access their partner's unused benefits. This can be a cost-effective way to maximize coverage.

Can I cancel my policy if needed?

Yes, you can cancel your policy at any time. However, you'll lose all benefits and typically won't receive any premium refund unless you have a return of premium rider.

Claims Process

How do I file a claim?

To file a claim: 1. Contact your insurance carrier 2. Complete claim forms 3. Provide medical documentation 4. Submit care provider information 5. Get physician certification 6. Complete assessment process

How quickly are claims paid?

Once approved, claims are typically paid within 30 days of receiving all required documentation. Ongoing claims are usually paid monthly for continuing care.

Financial Considerations

Are LTCI premiums tax-deductible?

LTCI premiums may be tax-deductible as medical expenses, subject to age-based limits and itemization requirements. Consult a tax professional for specific guidance.

Can premiums increase?

While individual premiums can't increase due to age or health changes, insurance companies can request state approval for class-wide rate increases. These typically affect all policyholders in a specific policy class.

What happens if I stop paying premiums?

If you stop paying premiums:

• Policy will lapse after grace period
• Coverage will terminate
• You may lose all benefits
• Some policies offer nonforfeiture options

Policy Selection

How do I choose the right LTCI policy?

Consider these factors: 1. Financial strength of insurer 2. Policy features and flexibility 3. Premium cost and payment options 4. Coverage amounts and limits 5. Company claims history 6. Policy restrictions and exclusions 7. Inflation protection options 8. Additional riders available

Need More Information?

Contact our LTCI specialists for personalized guidance:

• Phone: (844) 424-6000
• Hours: 8 AM - 8 PM ET

Remember: Every situation is unique. These answers provide general guidance but may not apply to your specific circumstances. Always consult with a licensed insurance professional for personalized advice.

Have additional questions? Our experienced team is here to help you understand your long-term care insurance options.