Merritt Personal Lines Manual: Long-Term Care Insurance: Basics: Key Questions

The following is a checklist of LTC policy features that you should consider. You'll want to make copies of this checklist and fill in the appropriate answers when you compare policies from different insurance companies.

TYPE OF POLICY BENEFITS

Does the policy provide benefits for the following and how long will benefits be provided?

Skilled nursing care Yes No Length: __________________

Intermediate care Yes No Length: __________________

Custodial care Yes No Length: __________________

Home health care Yes No Length: __________________

Does the policy have a maximum benefit amount expressed in dollars or time? Yes No

If so, what is the maximum benefit? ________________________________

Does the policy contain nonforfeiture provisions? Yes No

Does the policy contain any of the following optional policy benefits?

Adult day care Yes No

Hospice care Yes No

Inflation protection Yes No

Home health care Yes No

AMOUNT OF BENEFITS

Are policy benefits paid on a reimbursement basis? Yes No

If so, what is the percentage? __________%

How long will benefits be provided? _________________________

Are policy benefits paid on an indemnity basis? Yes No

If so, what is the daily benefit for each level of care? _______________________________________________________

How long will benefits be provided? _______________________________

Does the policy have a maximum lifetime benefit? Yes No

If so, how much is it? _________________

POLICY PROVISIONS

How long is the elimination period? _________________________

How long is the benefit period for each level of care? _______________________________________________________

Does the policy require prior hospitalization? Yes No

If so, for how long? _______________________________

Does the policy base benefits on the ability to perform the activities of daily living? Yes No

If so, how many activities must you be unable to perform to trigger coverage? ______________________________________________________ ______________________________________________________

Is the ability to walk one of the activities that triggers coverage? Yes No

Does the policy provide purely custodial care? Yes No

Is there a waiver of premium provision? Yes No

POLICY EXCLUSIONS OR LIMITATIONS

Does the policy cover Alzheimer's disease? Yes No

Does the policy cover pre-existing conditions? Yes No

If so, after how long? ___________________________________

What are the policy's other exclusions?

Mental or nervous disorders Yes No

Alcoholism or drug addiction Yes No

War or act of war Yes No

Participation in a felony, riot or insurrection Yes No