Long-Term Care Insurance
Coverage paying for custodial and supportive care in nursing facilities, assisted living, or the home, triggered by inability to perform ADLs or cognitive impairment, excluding acute medical care.
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Practice This Concept
Which of the following correctly describes the levels of care covered by long-term care insurance?
Skilled, intermediate, and custodial care, provided in facilities or at home — Long-term care insurance covers a range of care levels: skilled care, meaning daily, medically necessary care by licensed professionals; intermediate care, meaning occasional nursing and rehabilitative care; and custodial care, meaning help with activities of daily living such as bathing and dressing, which does not require professional medical skills. These services can be delivered in nursing facilities, assisted living facilities, adult day care centers, or the insured's home. The product addresses assistance with chronic conditions over time, not acute hospital treatment, and each level triggers different daily benefit amounts.
National insurance concept
Regarding long-term care insurance, what does guaranteed renewability mean?
The insurer cannot cancel the policy, but may increase premiums only on a class-wide basis with regulatory approval — LTC policies are guaranteed renewable: the insurer may not cancel or refuse to renew coverage because of the insured's age or deteriorating health, as long as premiums are paid. Premiums, however, are not guaranteed to stay level; insurers may raise rates, typically on a class-wide basis subject to state insurance department approval. The guaranteed renewability feature protects the insured against individual cancellation while allowing the insurer to adjust rates for an entire block of similar policies, so the individual cannot be singled out but the block can be repriced when claims experience requires it.
National insurance concept
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