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for your policyholder peer group if the insurer experiences a high level of claims When investigating policies, beware of those that have an optional renewability clause This option provides the insurer the ability to renew the contract, not you You also want to make sure that you understand the insurance company s policy of preexisting conditions While many contracts don t have any language in them regarding preexisting conditions, others do These clauses allow the insurer to not pay benefits for any physical or mental problems you had at the time you purchased the policy Some policies have permanent preexisting clauses, while others will only keep them in force for 6 to 12 months When Do Benefits Begin These days, long-term care policies have several definitions of when the insured person can begin receiving benefits These are usually referred to as triggering events or definitions of disability Many policies then follow a triple-trigger policy, which allows the person to be covered as long as they meet one of the following three conditions:
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1 The insured is unable to perform a specified number, usually two or three, of daily living activities These activities come from a list and include walking, getting in and out of bed, eating, dressing, using the bathroom, and bathing Some policies allow for certain cognitive abilities like short-term memory to be included in the list of daily activities, but many don t The insured has a cognitive impairment, which typically means the deterioration or loss of the individual s intellectual capacity This will be measured by clinical evidence and standardized tests Parkinson s Disease and Alzheimer s Disease are examples A physician certifies that the insured needs long-term care as a medical necessity This condition can be very liberally applied since the individual s own doctor is usually the certifying physician
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The use of all three conditions is the most beneficial to the person purchasing long-term care insurance, but most insurance companies only use the first two benefit triggers
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Who needs long-term care insurance Not everyone needs long-term care insurance However, for the majority of people, it s advisable There are certain things to consider when deciding if long-term care insurance is for you I Is there a history of debilitating illness in your family If you have many family members who have had some form of cancer, heart disease, or any other type of prolonged illness, the chances that you will also suffer from that are higher than if most of your family members were healthy This will also increase your chances of needing long-term care I Are you male or female Unfortunately, it s a fact of life that more women need longterm care than men because women have longer life expectancies than men do, which increases their need for care I Can you afford the premiums This is a very important factor because long-term care insurance isn t cheap Plus, with all the different types of add-ons you can choose from, your premium may be more than you can feasibly afford I Are you healthy If you wait until you have a disease such as Alzheimer s, you become uninsurable and you will have to pay for any longterm care out of your pocket Purchasing long-term care while you are healthy ensures that the coverage is there when you need it What Kind of Coverage Do You Need When choosing the type of coverage for your policy, do some research beforehand, so that you know how much local nursing homes are charging, either on a daily or annual basis Or, if you don t want to stay in the area where you are currently living, check out the nursing homes closer to where you would like to be It s important
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