Insurance companies want good control. You expect the health problems you need to have to be stable. You will look at how many medications you are taking, how well they are controlled, and for how long. Recent health events or changes in medications can trigger „wait times” as companies want stability. It is important not to lie about your request. If a company discovers that you didn`t tell the truth, they may not pay for the treatment related to the lying condition. You can even cancel your policy. The normal retrospective period to find these errors is 2 years, but if the company can prove that you are intentionally misleading them, this period can last more than 2 years. All policies that cover long-term care services set specific benefit limits and may exclude certain benefits altogether. When choosing a policy that best meets your personal needs, it is important to understand the limitations and exclusions of the benefits included in those policies. The most commonly used exclusions and limitations in long-term care insurance policies are described below: Can an insurance company issue a policy, but refuse you if you need care for a pre-existing medical condition? You can purchase an individual policy from a private insurance company or agent, or you can purchase coverage under a group policy through an employer or association membership. The federal and several state governments offer long-term care insurance to their employees, retirees and families. You can also receive long-term care benefits through life insurance.

Taking out long-term care insurance depends on your age, state of health, retirement goals, income and wealth. For example, if your only source of income is Social Security benefit or supplemental insurance income (SSI), you probably shouldn`t buy long-term care insurance because you may not be able to pay the premium. If you have a large amount of assets, but don`t want to use them to pay for long-term care, you may want to purchase long-term care insurance. Many people buy a policy because they want to remain independent of government assistance or caregiver and do not want to impose on anyone to have to take care of it. However, you shouldn`t buy a policy if you can`t afford the premium or if you`re not sure you can pay the premium for the rest of your life. Maximum insurance benefit: The maximum insurance benefit is the maximum period or amount for which long-term care benefits are paid under the policy. Insurance policies that cover long-term care benefits include maximum amounts of one to ten years, lifetime benefits or an amount limit. Most maximum insurance benefits with monetary limits are calculated by multiplying the number of years of benefits chosen, by 365 days, multiplied by the amount of the chosen daily benefit. Once the benefit limit or time limit under these guidelines is reached, no further benefits will be paid for your continued need for long-term care services. It is important to note that in some long-term insurance policies, the maximum insurance benefit is not the same for all benefits listed in the policy. For example, some home care and home care home policies provide separate maximum benefits for nursing homes and home care.

Some policies also include a separate benefit limit for each individual care period (usually consecutive days of care in a nursing home or during home care without interruption of care for a period specified in the policy). While we can discuss the details of the health issues you are being denied to, it can be instructive to look at the numbers. If you have health insurance, you probably understand that you are covered by the guarantee. The Health Reform Act allows you to purchase health insurance regardless of a pre-existing medical condition. Long-term care insurance (LTCI) is not covered by this rule. LTCI carriers assess the risk that an applicant is likely to live with a condition that could affect their ability to function independently in the future. If you have a pre-existing condition, a LTCI carrier will take this into account when making a decision. Not really. Medicare will pay for a portion of home health care and care from qualified care facilities after a hospital stay — as continuing care. It does not pay for nursing home care or long-term home care.

There are 3 different types of long-term care insurance: traditional long-term care, hybrid long-term care and acute care. A long-term care plan usually defines a pre-existing condition as one for which you have received medical advice or treatment or for which you have experienced symptoms over a period of time before applying for policy. Some companies look further back in time than others. Many companies sell a policy to someone with a pre-existing condition. However, the company cannot pay long-term care benefits related to this condition for a period after the policy takes effect, usually six months. Some companies have longer precondition periods or none at all. In general, the answer is no; The vast majority of insurance companies do not have pre-existing wording in their long-term care insurance contracts. They will approve your application or not.

Elimination or waiting period: The elimination or waiting period is the number of days you must receive long-term care benefits before benefits are paid under the policy. During the elimination or waiting period, you will have to pay privately for the care you receive. A new elimination or waiting period may be imposed for each period of care. Shorter periods increase the cost of coverage. Different policies count disposal periods differently, so please read the policy wording carefully. Some policies may require you to receive formal long-term care services each day to make the day count towards the waiting period. The cost depends on the amount and type of care you need and where you can get it. In 2013, the average cost of nursing home care in the District of Columbia was $74,460 to $91,250 (for a semi-private room) and $86,505 to $102,049 (for a private room) per year. Assisted living facilities reported between $40,320 and $46 to $170 per year, and home care costs ranged from $45,760 to $46,170 per year. If your health disqualifies you from insurance, your best and really only way is self-insurance. Self-insurance requires you to have a plan on how you will pay the bill for long-term care. If you have a plan, you will relieve your family and friends when the time comes.

This option can also be combined with insurance options to find the best solution for your personal situation. Because it can be difficult to find the right company and policy for you and your health condition, it`s easy to understand why it`s important to work with a professional who understands the health policies and qualifications of multiple companies. An experienced insurance agent should collect your medical history and current health status before recommending the companies you are most likely to approve. Make sure you work with an agent who works with multiple insurance companies, not just one, so they can really recommend the best product to you. It is important to note that even though the above conditions have a chance of being accepted by some insurance companies, if you have them in combination with other conditions, the chances of being accepted decrease. The most commonly rejected combinations are conditions associated with height-to-weight ratio and smoking. However, some companies may include a pre-existing six-month clause. That is, if you make a claim within the first six months of a policy`s existence, they could exclude benefits if they are due to a known condition. You may be thinking, „There`s no way I`ll get a cover!” Don`t rely on yourself yet. Each insurer looks at health information a little differently, simply because one doesn`t offer you coverage, another may consider you.

The key is to apply with your best bet first, as a large portion of insurance companies won`t consider you if another company has already rejected your application for coverage. That`s why we recommend talking to our consumer specialists about your specific needs, health and situation. Request information today and find out if you qualify for long-term care insurance. Benefits paid by a tax-eligible care plan are generally not taxable as income. Benefits from a non-taxable care plan may be taxable as income. Ask your tax advisor about the possibility of deducting a portion of the premiums paid in addition to the associated individual tax consequences. Long-term care insurance is an individual insurance policy that can help you if you are unable to care for yourself due to illness or prolonged disability. This policy typically pays for qualified, intermediate, and nursing care in a nursing home.