South Carolina Code of Regulations › Chapter 69 - DEPARTMENT OF INSURANCE › Subchapter 69-44 - LONG TERM CARE INSURANCE › Appendix C

Current through Register Vol. 48, No. 6, June 28, 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.]
[Note:For single premium policies, delete this
							 bullet; for noncancellable 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.