Long-term Care FAQ

• What do long-term care insurance policies cover?

  Many of today's policies cover short or long-term nursing home stays and a wide range of home care services, such as skilled or non-skilled nursing care, physical therapy, home making, and the services of home health aides provided by state licensed and/or Medicare certified home health agencies. Some policies may also cover adult daycare, respite care for the caregiver, and other specialized or alternative forms of care.

• What is not covered?

  All policies contain limitations and exclusions--otherwise, premiums would become unaffordable. Some exclude coverage for pre-existing conditions for six months. Other policies may not cover certain mental and nervous disorders, alcoholism, drug abuse, or an intentionally self-inflicted injury. Many policies will not cover long-term care provided by family members.

• How long can I collect benefits?

  Long-term care policies generally limit benefits to a maximum dollar amount or a maximum number of days and may have separate benefit limits for nursing home care and home health care within the same policy. For example, a policy may cover five years of nursing home care and two years of home health care.
  

• Do long-term care policies have limitations for pre-existing conditions?

  Yes. The law allows companies to include a 90-day or 180-day pre-existing clause in the policy. This means you would not receive long-term care benefits during the first six months after your policy was issued for any condition or illness that was diagnosed or that you were treated for during the 90 or 180 days immediately before the effective date of your policy. You would pay for any services related to the pre-existing condition during this period.

• Can the policy be canceled by the insurer?

  Yes. If you fail to pay the premium, the policy can be canceled. If you provide inaccurate health information on the application, the company may cancel the policy during the first two years.

• Will I be covered if I need long term care due to Alzheimer's disease?

  You may not be able to purchase long-term care insurance after you have been diagnosed with Alzheimer's disease, but once you have a long-term care policy in force Minnesota law does not allow companies to limit benefits just because you develop Alzheimer's or your health deteriorates.

• How do I find out if I qualify for Medical Assistance or Medicaid?

  The standards for eligibility for Medicaid change frequently. You can get complete information from your County's Human Services office or by calling the Senior Linkage Line at 1-800-333-2433.

• Must I be hospitalized before being admitted to a nursing home to be eligible for benefits?

  No. Minnesota State law prohibits a company from requiring prior hospitalization as a condition for benefits.

• Can my premiums be increased once I purchase a policy?

  Most premiums for long term care are "level," meaning they don't automatically increase as you age or your health status changes. However, the insurance company can raise rates for an entire rating class of people in the state, after review and approval from the Minnesota Department of Commerce.

• Is it advisable to switch policies if a better deal comes along?

  There might be situations where canceling an existing policy and buying a new one makes sense. Just remember that your premiums are based on your age at the time of purchase and could be much higher for the new policy. In most cases, any waiting periods for pre-existing conditions with the new replacement policy will be waived, but you should verify this in writing with the new company or agent. None of the premiums you paid for the old policy will give you any benefit. Never drop an old policy before making sure the new one is in force.

• If I decide I don't want this policy once I review it, can I get my money back?

  Absolutely. State law gives you the right to review the policy for 30 days with the option to cancel for a full refund. Your 30 days begin when you actually receive the policy.