California Partnership for Long Term Care

Tips on How to Select a High Quality Policy

The complexity of insurance policies can make the process of selecting the program that works for you challenging. When considering purchasing a policy, here is a list of questions to ask an agent:

 

  • Does your policy have automatic built-in inflation protectionProtects the policyholder from covering the difference between what the insurance policy will pay, which is based on the costs of services when you purchased the policy, and the actual cost of care when you need it. Every Partnership policy is required to have this protection, and the state highly recommends that you protect yourself by only purchasing a policy with inflation protection.?
  • What type of care managementA process to assess, plan, coordinate and monitor long-term care needs and services. Care management/care coordination takes an all-inclusive look at a person’s total needs and resources, and links that person to a full range of appropriate services, using all available funding (and informal) sources./care coordination does it include?
  • What is the minimum daily benefitThe amount of benefits a policy will pay each day until the total value of the policy is exhausted. The daily benefit is no less than 70 percent of the average daily private pay rate in a nursing home in California at the time of purchase. Currently in California, it is $170 a day.?
  • What are the monthly home and community-based careAdult day care or adult day health care or Alzheimer's day care benefits?
  • What is the elimination periodAn elimination, deductible or waiting period is the number of days one must wait after the company certifies eligibility for benefits but before the policy begins paying for care. Some policies have no elimination period and pay benefits from the first day. The most common waiting periods available are 30, 60 or 90 days. The policyholder is personally responsible for the costs of long-term care expenses during the elimination period. The policy premium will be lower if a longer elimination period is selected, but the policyholder will pay the full cost of care during that time. It is recommend that it be no more than 30 days on policies of less than two years and no more than 90 days on other policies.?
  • What is the residential care benefitIt should cover at least 70 percent of the minimum daily benefit.?
  • What is the home care benefitIt should cover at least 50 percent of the minimum daily benefit.?