Tag Archives: Benefit Period

Exploring the Lesser Known Features of Long-Term Care Insurance

Exploring the Lesser Known Features of Long-Term Care Insurance

Buyers of long-term care insurance often focus on just the coverage basics, such as the level of daily benefits, length of coverage, and under what conditions the policy will pay a claim. While these basics form the chassis of the policy, long-term care policies offer a host of other options that may prove beneficial to the policyholder.

Let’s take a look at some of these available options:

Survivorship Premium Waiver– If both spouses obtain long-term care policies from one insurer, some policies will provide a waiver of all remaining premiums if one spouse dies within a certain number of years after the policy is issued. For example, the policy may provide a premium waiver if the policies have been in effect for 10 years before one spouse passes away. The policy might also stipulate that no claims could have been paid during the period.

This feature may be included with the policy automatically or it may be offered as a rider to the base policy for an extra premium.

Shared Pool of Benefits- Instead of each spouse having an individual policy with separate benefits, they can elect to share each other’s benefits if needed. For example, each spouse might have a policy with a 3-year benefit period. Once one spouse has expired 3 years of benefits they have no further coverage, but the other spouse may still have 3 years of coverage remaining. With the shared pool of benefits rider, the spouse receiving care could also access the other spouse’s benefits.

This feature is most commonly offered as rider to the base policy for an extra premium.

Alternate Plan of Care– With our population continuing to age, new ways of delivering long-term care will continue to be developed. Not too long ago, no one had ever heard of adult day care or assisted living facilities.

With the alternate plan of care feature, you can ensure that your policy will never grow obsolete. You, your physician, and the insurance company will develop a plan of care which best serves your needs based on currently available options.

Look for this feature to be included in the policy with no additional cost.

Accelerated Premium Payment Options– Many insureds worry about their ability to afford premium payments during retirement when their income is reduced. Some insurers offer policyholders an option to pay accelerated premiums for a shorter period of time with the benefit of a contractually paid up policy after a certain period. For example, a 10- or 20-year accelerated payment period with no further premiums due afterwards.

This option has several benefits. Business owners may be able to deduct premiums from their taxes during their working years with no further premiums due in retirement. Additionally, with the cost of long-term care increasing rapidly, a contractually paid up policy means no exposure to premium adjustments made by insurers in future years to account for higher than expected claims experience.

Enhanced Elimination Periods– While all policies provide several elimination period options ranging from a 0 day to a 180 day elimination, it’s important to understand how the elimination period can be satisfied.

For example, some policies may credit a week towards your elimination period with just one day of home care received per week. Still another policy may have no elimination period for home care benefits while nursing home or assisted living facility care may require an elimination period.

These are just a few of the lesser-known features of long-term care insurance. There are many other options to consider when selecting a policy, but be sure to compare not only the basics of each policy but the included features and available riders.

Expatriate Insurance: You Shouldn’t Live Abroad Without It

Expatriate Insurance: You Shouldn’t Live Abroad Without It

While living abroad for the next year is an exciting prospect, there is much to be planned for and considered. One aspect that’s often overlooked is extended medical treatment. Most people living abroad would want to return home for treatment and recovery and to be close to loved ones if they become critically ill.

Many mistakenly assume that if a critical illness should arise, then their managed care plan would take care of things. This couldn’t be further from the case. Your health insurance plan in the United States isn’t designed to cover you when you are out of the country for an extended stay. Medicare and Medicaid doesn’t offer any coverage for any medical expense that develops outside the United States. HMOs or Health Maintenance Organizations will generally cover emergency room treatment wherever you are, but routine health coverage is offered through the state provider networks of your resident state. If you use a network doctor, PPOs or Preferred Provider Organizations will cover a greater
portion of the expense.

Some may turn to travel insurance as a source of extended medical treatment coverage. This too isn’t quite the case. Yes, travel insurance will generally provide you with a certain degree of coverage for illness and injury. The amount and extent of coverage is based on what plan you choose. However, the benefit period is usually only six months. So, if your trip is a year long, then you will only be covered for half of your stay and then be responsible for any incurred medical expenses thereafter.

Expatriate health insurance, by its very name, should alert you that this might be the health insurance you’re seeking. In Latin, ex means away from and patria means fatherland. This insurance is geared toward those that will be away from their home, especially stays that extend past six months. Expatriate health insurance is specifically designed so that you don’t have the geographical limitations and restrictions to provider networks that you have in your managed care plan. Coverage is often only half of the problem when trying to navigate a foreign health system. The expatriate health insurance will also help when dealing with language barriers, transportation to U.S. health care centers, and currency exchange.

Expatriate health insurance plans are divided into two categories:

The first is the basic expatriate plan. This plan offers coverage for care in-hospital and in-patient, meaning it will cover areas such as a hospital
stay, services from a number of medical providers, and ambulance transportation.  Home health nursing care and emergency dental services are also usually covered. Enhancements to the basic plan, such as outpatient services, certain therapy services, and prescription drugs, may be purchased for an additional cost. Many of the basic plans will also offer emergency medical evacuation coverage for an additional cost, which will immediately transport you from wherever you are to the nearest advanced medical treatment center in the event a medical emergency should arise. Most medical evacuation coverage will also include a return fare.

The second category is the comprehensive expatriate health insurance plan.  This is useful if you require more extensive medical coverage, such as for dietary, psychiatric, eyes, ears, chiropractic, osteopathy, rehabilitation, labor and delivery, and home nursing care needs. Certain prescription medications and diagnostic testing may be covered as well.

Like any health plan, the expatriate coverage usually has certain exclusions and restrictions. Most carriers will generally not cover preexisting
conditions; injuries from war, rioting, and terrorism; and those with hazardous occupations. In cases of preexisting conditions, certain carriers may underwrite it for an additional cost.

Expatriate Insurance

Expatriate Insurance

Expatriate Insurance: Playing Safe While Living Abroad

You have the opportunity of a lifetime to live abroad for the next year.  You’ve planned every part of your stay down to the last detail – or so you think.  Have you thought about what will happen if you become so ill that you require extended medical treatment?  Even if you live in the most cosmopolitan of cities, if you become critically ill you will want to return home to be near family and friends while you recover.

You may believe if that scenario arises, you can depend on your managed care plan.  However, your stateside health insurance plan is not designed to cover extended stays out of the country.  Health Maintenance Organizations (HMOs) cover emergency room treatment anywhere, but typically offer other coverage through provider networks in the state where you live.  Preferred Provider Organizations (PPOs) cover a larger percentage of medical expenses if you visit network doctors, which are usually local.  Medicare offers no coverage at all for medical expenses incurred while living outside the United States.

What about travel insurance?  Your instinct tells you this is where you will find the coverage you need.  It seems logical, but it isn’t quite correct.  Travel insurance usually offers coverage for a period of six months.  Should you become sick or injured during the benefit period, your treatment is only covered until you reach the end of the six months.  After that point, you would be responsible for your own medical expenses.

So what alternative do you have to make sure this trip doesn’t end up costing you far more than expected because of unanticipated medical bills?  You can purchase expatriate health insurance.  The name tells you exactly what the coverage offers.  It is derived from the Latin language in which “ex” means away from, and “patria” means Fatherland.  This insurance is especially developed for people who will be away from their home country for six months or more.  Expatriate health coverage is designed to overcome the problems with the geographic limitations and restrictive provider networks that are associated with your managed care plan.  It also helps a sick or injured expatriate deal with language translation, currency exchange, and transportation to Western treatment centers when trying to navigate through the maze of a foreign health care system.

There are two types of plans. The basic plan offers coverage for in-patient or in-hospital care including your actual hospital stay, various medical service providers and transportation by local ambulance. You can purchase enhanced basic plans that may also include outpatient visits, some therapies as well as prescribed drugs. At-home nursing care and emergency dentistry are also covered typically.

If you require more extensive coverage, comprehensive plans can be obtained for much higher premiums. Comprehensive plans may cover psychiatry, rehabilitation, home nursing, childbirth, eye and ear specialists, dietitians, psychotherapists, chiropractors and osteopaths. Diagnostic tests and prescription drugs may also be covered.

Emergency medical evacuation coverage is available in a number of the basic plans. However, almost all plans allow you to include it for an additional charge. This coverage provides for immediate transportation from anywhere in the world to the nearest medically advanced treatment center for in-patient emergency conditions. Generally such plans also allow for reasonable return fare to your country of residence.

All these health plans have some restrictions and exclusions. If you are employed in a hazardous occupation some plans will not cover you. Pre-existing conditions, either known or unknown at the time you apply for coverage, are usually not covered. Depending on the condition, however, some carriers may be willing to underwrite it for an added charge. Injuries resulting from war or riot are not covered. Some plans do cover acts of passive war and terrorism such as an injury that occurred while you were an innocent bystander.

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