You should review how the policy pays benefits as policies pay benefits in different ways. Some policies pay a fixed amount for each day you are confined in a nursing home or each day you receive community-based care, regardless of the actual cost of the care. Other policies pay according to the provider’s actual charges up to a fixed daily amount or a percent of the charges.
Duration of Benefits
You should also examine the period of time benefits are paid. Depending on the policy, benefits may last for only one year or for the rest of your life. In general, plans that provide payments for longer periods of time are more expensive. You may select from several options when you first buy the policy. However, you may not be able to increase the benefit amounts at a later date without proving insurability.
Policy Limits
Policies frequently limit benefits to specific types of services provided by specific types of facilities or agencies. For example, services provided in the home may be limited to those provided by a licensed home health agency. Other types of personal care, help with household chores, or other services may not be covered. One policy may cover ambulance service to and from the hospital, but the same type of policy offered by another company may not.
Policy Definitions
You should review the policy’s definitions regarding the types of facilities covered. The state of Wisconsin has licensed, certified, and registered facilities that provide differing levels of supportive care, personal care, and nursing services. Long-term care policies usually do not cover any care in a community-based residential facility.
Premiums
You should determine whether premium payments are based on issue age or attained age. Issue age premiums will increase only if premiums are increased for everyone insured under the policy form. Attained age premiums automatically increase as one ages. Be sure to compare prices when you compare policies.