The point of long term care insurance is to avoid having to apply for Medicaid and be able to afford a good facility. BUT should you live longer than the policy pays out, yes you need to apply for Medicaid. OR if your policy only pays $100 a day and by the time you move to a nursing home the cost is $400 a day, you will need Medicaid.
If you are thinking that the LTC will be needed in the near future, please reread the policy carefully. If this is one you have had for years & years, doing a review is very VERY important. Try to have some else revie it too. If you have a concern, send your question in writing to the insurance company.
Probably the most common "I Didn't Realize" is that the policy has a period of time of selfpay BEFORE the LTC policy will pay. Could be 30 days, but could be 90 days before it will even kick in. Often this is glossed over by the insurance salesman with their saying that Medicare will pay for up to 100 days post hospitalization stays at the NH........
Also look to see if the LTC policy has an inflation rider. Older policies usually don't. You need to know this to figure out just how much $ you really have from the policy. It may be based & fixed on health care costs from last millennium.....
And in order to use the policy you have to private pay whatever the cost is over what the LTC pays. For those using the LTC policy for at home care, private paying the difference could be a manageable amount of $, and LTC policies can work really well for those able to age at home with qualified caregivers. But if this is for paying for care in a NH, it could be thousands of $ each month private pay in addition to the LTC policy $ to pay the 7k - 15k a mo NH bill. For this situation, going onto Medicaid would be better as once eligible for Medicaid all costs are covered.
As an aside on this, my moms NH did NOT take any LTC insurance. Medicare, Medicaid or private pay only. Billing office told me that the issue for them was that each insurance company had its own reporting required in order to get payments..... And invariably whatever was submitted always needed more information, details, yada-yada whatever to delay payments. Just not worth the headache as they could fill those beds with Medicaid paid residents and the state paid in real time. If this is a trend, then LTC policies will be kinda worthless unless the elder can stay at home & has other $$$ to pay for caregivers beyond the LTC $.
OR if your policy only pays $100 a day and by the time you move to a nursing home the cost is $400 a day, you will need Medicaid.
Probably the most common "I Didn't Realize" is that the policy has a period of time of selfpay BEFORE the LTC policy will pay. Could be 30 days, but could be 90 days before it will even kick in. Often this is glossed over by the insurance salesman with their saying that Medicare will pay for up to 100 days post hospitalization stays at the NH........
Also look to see if the LTC policy has an inflation rider. Older policies usually don't. You need to know this to figure out just how much $ you really have from the policy. It may be based & fixed on health care costs from last millennium.....
And in order to use the policy you have to private pay whatever the cost is over what the LTC pays. For those using the LTC policy for at home care, private paying the difference could be a manageable amount of $, and LTC policies can work really well for those able to age at home with qualified caregivers. But if this is for paying for care in a NH, it could be thousands of $ each month private pay in addition to the LTC policy $ to pay the 7k - 15k a mo NH bill. For this situation, going onto Medicaid would be better as once eligible for Medicaid all costs are covered.
As an aside on this, my moms NH did NOT take any LTC insurance. Medicare, Medicaid or private pay only. Billing office told me that the issue for them was that each insurance company had its own reporting required in order to get payments..... And invariably whatever was submitted always needed more information, details, yada-yada whatever to delay payments. Just not worth the headache as they could fill those beds with Medicaid paid residents and the state paid in real time. If this is a trend, then LTC policies will be kinda worthless unless the elder can stay at home & has other $$$ to pay for caregivers beyond the LTC $.