Code of Maine Rules › 02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION › 031 - BUREAU OF INSURANCE › Chapter 425 - LONG-TERM CARE INSURANCE › Appendix 031-425-C

Current through 2024-29, July 17, 2024
Things You Should Know Before You Buy Long-Term Care
				  Insurance
Long-term Care Insurance
A long-term care insurance policy may pay most
								of the costs for your care in a nursing home. Many policies also pay for care
								at home or other community settings. Since policies can vary in coverage, you
								should read this policy and make sure you understand what it covers before you
								buy it.
[You should
not
buy this insurance
								policy unless you can afford to pay the premiums every year.] [Remember that
								the company can increase premiums in the future.]
(
Drafting Note:
For single premium
				  policies, delete this bullet; for noncancelable policies, delete the second
				  sentence only.)
The personal worksheet includes questions
								designed to help you and the company determine whether this policy is suitable
								for your needs.
Medicare
Medicare does
not
pay for most
								long-term care.
Medicaid
Medicaid will generally pay for long-term care
								if you have very little income and few assets. You probably should
not
buy this policy if you are now eligible for
								Medicaid.
Many people become eligible for Medicaid after
								they have used up their own financial resources by paying for long-term care
								services.
When Medicaid pays your spouse's nursing home
								bills, you are allowed to keep your house and furniture, a living allowance,
								and some of your joint assets.
Your choice of long-term care services may be
								limited if you are receiving Medicaid. To learn more about Medicaid, contact
								your local or state Medicaid agency.
Shopper's Guide
Make sure the insurance company or agent gives
								you a copy of a book called the National Association of Insurance
								Commissioners' "Shopper's Guide to Long-term Care Insurance." Read it
								carefully. If you have decided to apply for long-term care insurance, you have
								the right to return the policy within 30 days and get back any premium you have
								paid if you are dissatisfied for any reason or choose not to purchase the
								policy.
Counseling
Free counseling and additional information
								about long-term care insurance are available through your state's insurance
								counseling program. Contact your state insurance department or department on
								aging for more information about the senior health insurance counseling program
								in your state.
Facilities
Some long-term care insurance contracts provide
								for benefit payments in certain facilities only if they are licensed or
								certified, such as in assisted living centers. However, not all states regulate
								these facilities in the same way. Also, many people move to a different state
								from where they purchased their long-term care insurance policy. Read the
								policy carefully to determine what types of facilities qualify for benefit
								payments, and to determine that payment for a covered service will be made if
								you move to a state that has a different licensing scheme for facilities than
								the one in which you purchased the policy.