Follow
Share

I'm seeing conflicting information online about this. On their insurance company's website it says "The benefit period is the period of time used to calculate the lifetime payment maximum. Your coverage is based on this lifetime payment maximum, not a certain period of time."


I'm wondering if they don't use the max amount allowable each month, can they make their funds last longer than five years?

This question has been closed for answers. Ask a New Question.
Find Care & Housing
If their policy is like my Mom's (or any other policy I've seen), yes, the policy covers a dollar amount equal to the annual coverage times five years, which can be stretched out over their lifetime or until the total coverage amount is paid out, whichever comes first.

You can confirm this by reading the policy "evidence of coverage" and finding the total coverage amount. There will likely be a list of definitions that spells out how the total coverage amount is adjusted for inflation and how it is reduced for claims paid. Mine also has a page for each category of benefit that spells out "When will benefits end?" and states

"This benefit will be paid as long as:
 the Conditions for Receiving Benefits are met; and
 the Total Coverage Amount has not been reached.
(The Total Coverage Amount is shown in the Schedule of Benefits.)"

If they are not yet receiving benefits and have inflation protection, they should receive an annual "schedule of benefits" listing the updated total coverage amount and the maximum for daily or monthly coverage.

If they are on claim, the "explanation of benefits" should have a summary showing the payment for the current period, the total amount of plan payments, and the lifetime coverage remaining.

These documents should be available through an online portal once an account has been set up.
Helpful Answer (2)
Report

Call the long-term care insurance company that produced the policy and ask them this question and they will explain how the coverage works.
Helpful Answer (2)
Report

Good question! I hope somebody replies because I would like to know the answer too. Momma has a long term care policy and she has been in assisted living for almost five years. Also she does not use up all of her benefit money in a month. I was reading somewhere about a death benefit. That some of that money she did not use up every month she would or her estate would receive it after she is deceased but it might have something to do with what kind of policy you have. I have read mommas policy again but cannot find anything about this. I was thinking I could call them. I talk to them all the time.
Helpful Answer (1)
Report
Frebrowser Aug 2023
I am not familiar with a death benefit for long term care policies, other than a return of premium death benefit if the policy holder dies young (before 65 or 75) and premiums paid in exceed benefits paid out. It seems unlikely that this would apply to her situation.

If it was a life insurance policy with a long term care rider, there would be such a benefit, but unlikely to pay much after five years of care.

You are right, though, asking them directly would give you an answer for her specific situation.
(1)
Report
Here is a very thorough explanation:

https://www.ltcnews.com/resources/faq/what-is-a-benefit-period-on-a-ltc-insurance-policy
Helpful Answer (1)
Report
akababy7 Aug 2023
Good article but I didn't read anywhere about what happens if you do not use up all of your Dailey allowance and if you do not can you use that money for future payments for assisted living which I think was the op question. My question too because momma is in the same boat. Did I misunderstand?
(1)
Report
The total benefit is calculated by the monthly benefit amount selected when the policy was bought multiplied by the number of months in the benefit period.

The amount of money can be thought of as a checking account.

You should call the insurance company customer service line and have them walk you through it.

Or post this question on www.bogleheads.org; there are a couple of LTCi experts there.
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter