West Virginia Code of State Rules › Agency 114 - Insurance Commission › Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER › Series 114-32 - Long-Term Care Insurance › Appendix C

Current through Register Vol. XLI, No. 28, July 12, 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.]
* 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 producer 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 into 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.