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Long Term Care Health Insurance

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Long Term Care Insurance Plan -How Do I Qualify for Benefits?

When the member of the long term care insurance plan requires supervision to protect themselves from threats to their safety and health as well as due to severe cognitive impairment in addition if the policy holder is unable to perform without substantial assistance from another individual at least two out of six of the activities of daily living (ADLs) the long term care insurance plan will pay a set amount of an insured's costs. Benefit triggers can vary by policy. In a qualified policy these activities of daily living are: transferring, continence, bathing, toileting, eating and dressing . When the benefits of a long term care insurance plan are triggered, the policy will pay up to a preset maximum daily benefit for a specified time period, till the policy holder no longer needs a long term care insurance plan, or until the policy holder has exhausted their benefits.

A long term care insurance plan holder must also fulfill the waiting elimination/period period before collecting any policy benefits.
The "elimination period"/"waiting period" is the deductible. Waiting periods vary in time frame. There are numerous options available on most long term care insurance company contracts, but 90 day waiting periods are most commonplace. An insured is liable for all costs related to their long term care expenses during the waiting period. The policy provider will begin paying benefits as soon as the long term care insurance plan holder has met the requirements for a claim and the waiting period is fulfilled,

Important note: A long term care insurance plan can vary in benefits and coverage. In addition, company policies vary by state. You should clearly understand what the benefit triggers are under any policy that you consider.