After many hours of asking yourself all the pertinent questions, looking into expenses, and on-going deliberation, you have find and reach the conclusion that it is time to purchase some long-term health insurance to ease you through your golden years, just in case you require some additional long-term nursing home or in home health care services. Luckily, in New York State, all individual policies for long-term coverage must have a renewable guarantee, which means you have the right to receive the coverage in your policy, without changes, provided you pay all your premiums when they are due.The health insurance company must obtain permission from the Insurance Department to make changes to a policy, unless it applies to all members in a group covered by a policy.
Long-term health insurance policies all have certain limits on benefits and some may excludes certain benefits completely; therefore, it is best to choose the policy that best suits your own personal needs.If you sign any policy be sure you understand what is the benefit limitation and exclusions are in that policy.If you do not understand the term used in a policy, ask a reputable health insurance agent to discuss it with you.
The most commonly excluded or limited benefits within a long-term health insurance policy include:
- Maximum Policy Benefit
- Waiting Period or Elimination
- Policy Exclusions
- Pre-existing Condition Limitation
- Daily Benefit Amount
The New York State Insurance Department requires the optional benefits listed below must be offered at the time the policy is purchased. Many policies today also include the following optional benefits, but at an increased price:
- Inflation Protection Benefit
- Reduced Paid Up Benefit
- Non-forfeiture Benefit
- Shortened Benefit Period
It is important to understand that Medicare doesn’t pay for most long-term care services; therefore, individuals shouldn’t rely on their Medicare to look after them if they require long term care services.Since medicare doesn’t pay for custodial care, but if it is required nursing services are covered on a limited basis. In order to receive any care from Medicare you must:
- Require daily nursing skills for your condition
- Have been in the hospital for three consecutive days, not counting day of discharge
- Be admitted within 30 days after a hospital visit
- Receive same treatment in hospital that you are receiving nursing care for
- Receive documentation by a medical professional that you require this skilled nursing.