So, you have decided to purchase a long-term health insurance policy but you notice that there are all kinds of conditions and options listed in the documentation that you do not really understand. Like most contracts, some of the language used is not so easy to understand, we recommend you ask a reputable insurance agent to explain the terms of the contract, or you read the material below and see if this makes those conditions and optional more understandable to you.
Waiting Period or Elimination: The waiting period or elimination period is the amount of time required to wait before the health care services and will be paid for by your long term policy. During this waiting period, you are personally responsible to cover the costs of your long-term care out of your pocket.New elimination periods can be imposed for each period you require long-term care services, and shorter periods of health care services have a tendency to increase the cost of your coverage.
Maximum Policy Benefits: This is the maximum period of time or the maximum dollar value in which the policy you got will pay for the long-term benefits you receive.Most policies have several options available including one to ten year long-term care services, dollar amount limit, or lifetime benefits.Policies with maximum dollar amount values are calculated x number of years the benefit has been chosen for, x 365 days, x the daily amount of benefit chosen.
Under these policies once you reach your dollar value or time limit, the insurance company will pay for no additional long-term health care services. It is also important to note whether the policy you are interested in purchasing has a separate long-term nursing home or home care policy benefit, as this will cover you for continuous days spent in a nursing home or receiving home nursing care.
Policy Exclusions: All long-term insurance policies have a list of exclusions with some of the more common ones including:
- Mental illness with the exception of Alzheimer’s Disease, senile, dementia, or demonstrable organic diseases.
- Alcoholism and drug addiction
- Self-inflicted injuries
- Coverage while outside the United States or its possessions
- Government nursing facility where a charge is made and you are must pay it personally.













