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Long Term Care

 

Day to day care that a patient (generally older than 65) receives in a nursing facility or in his or her residence following an illness or injury, or in old age, such that the patient can no longer perform at least two of the five basic activities of daily living: walking, eating, dressing, using the bathroom, and mobility from one place to another. There are basically three types of Long Term Care plans:

  1. Skilled nursing care provided only by skilled medical professionals as ordered by a physician. Health Care will pay a limited amount of the associated cost.
  2. Intermediate care provided only by skilled medical professionals as ordered by a physician. This care involves the occasional nursing and rehabilitative assistance required by the patient.
  3. Custodial care provided only by skilled medical professionals as ordered by a physician. The patient requires personal assistance in order to conduct his or her basic daily activities. 

When selecting a Long Term Care policy, some of the more important considerations include:

  1. Renewability - policy should be a GUARANTEED RENEWABLE CONTRACT.
  2. Waiting period - length of time before benefits are paid should not exceed 90 days.
  3. Age eligibility - 18 to age 80.
  4. Length of time benefits are paid - typically the range is 5 - 10 years. It would be preferable to have benefits paid up to life time.
  5. Inflation guard - the benefit level could be automatically adjusted each year according to the increase in the costs charged by the Long Term Care provider.
  6. Premium waiver - after the patient has received benefits for at least 90 days, the patient is no longer required to make premium payments for as long as he or she is under long-term-care.
  7. No increase of premiums with age - premiums should be based on the age at the time of application and should never increase as a result of a change in age. Some plans have limited pay options. E.g. Premiums are paid for 20 years then policy is paid up and no further premiums are required. Premiums guaranteed for five years only, and may change after that. 
  8. No limitations for pre-existing conditions - there should be no PRE-EXSISTING CONDITION limitations.

 

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