Home Page |  About Us  |  FAQ's  |  Providers  | Applications  | California Birth Profiles  Contact Us 

HomeLong Term Insurance Group Insurance
LONG TERM GROUP INSURANCE

Conditions to the Payment of Benefits

All policies will require you to meet certain “conditions” after the “benefit triggers” have been met and before benefits will be paid.

Elimination Periods: The Elimination Period (sometimes called a “Waiting Period” or “Deductible Period”) is the period of time you must wait after you qualify for care, and are eligible to receive benefits before the company will begin paying for your care. You choose the length of the Elimination Period when you buy the policy. The most common options are 0 days, 30 days, 60 days, 90 days or 100 days. Some policies only make you meet the Elimination Period once during the life of the policy, others apply it again after you have gone for a certain period of time without needing care. In most situations the elimination period will be satisfied by a day of either in home care or institutional care. The premiums are usually more for short elimination periods and less for a longer one. Be sure to ask your qualified agent to explain these differences.

The elimination or deductible period is the length of time that the insurer pays no benefits. If you select a 0-day Elimination Period, the policy will begin paying on the first day you qualify for care. If you choose one of the other periods you will be responsible for paying the full cost of your care for these days.

Example: If you choose an Elimination Period of 60 days, you will be responsible for the cost of the first 60 days of your care. If you are in a nursing home that charges you $100 per day, you will pay approximately $6,000, before the policy starts paying. If you leave the nursing home before the 60 days expires and the policy only pays for institutional care, it would pay nothing for that period of care.

If you qualify for benefits in a home care setting most long-term care insurance policies apply a day towards your Elimination Period for any day you actually receive care (or a home care visit). Therefore, if your plan of care only calls for 3 visits per week you will only satisfy 3 days towards your Elimination Period. Some companies offer a more liberal interpretation of this definition. For example, the policy might say that if you have one home care visit per calendar week that you have satisfied 7 days towards your Elimination Period. In this example, you would satisfy your Elimination Period more quickly.

Several companies now utilize a “calendar day” definition for the elimination period. Once the insured has been certified as being chronically ill each calendar day counts towards the elimination period, regardless of whether formal long-term care services are received. This allows the insured person to get informal care from family or friends during the elimination period. After the elimination period has been satisfied formal paid care can begin.

The premium cost is usually higher if you choose the shorter Elimination Periods and is lower if you choose a longer period. In addition a premium might be higher when the company uses a more liberal “counting” of home care Elimination Period days. Also, make sure that the Elimination Period days that are accumulated either in a home care or institutional care setting are combined to satisfy your overall elimination period. Be sure to ask your qualified agent to explain this.

Long Term Insurance | Bluecross Long Term | California Long Term Insurance | Kaiser Long Term |

Long Term PPO plans| Long Term Medical plans | Long Term Dental Insurance |

Long Term Group Insurance | Long Term Blueshield | Long Term Health Insurance |

Long Term Health plans | Long Term Health net | Long Term Pacificare | Long Term Medical Quote |

Long Term Aetna PPO plans | Long Term Insurance Quote | Long Term HMO plans |

Long Term Life Insurance | Long Term Dental plans