Understand what is covered by long-term care insurance.
Not all long-term care insurance policies cover all services, nor do they all pay the same for similar services. Don't hesitate to ask your agent as many questions as it takes to clearly understand your policy.
Covered services
Some of the most common long-term care services are covered by long-term care insurance, including:
- Home health-care services, which must include skilled nursing care and physical therapy.
- Personal care in your home, which may include some homemaker services such as running errands or housekeeping.
- Adult day service.
- Assisted living care.
- Nursing home care.
Other services offered by some policies include hospice care, respite care, care after a hospital stay, or caregiver training for family members.
Services not covered
Long-term care policies may exclude coverage—either completely or for a limited time—for some conditions, including the following.
Pre-existing conditions: An illness or disability for which you receive medical advice or treatment in the six months prior to applying for long-term care coverage may be excluded for up to six month after the policy's effective date.
Mental health and nervous disorders: Coverage of some mental health and nervous disorders may be excluded, but the policy must cover Alzheimer's disease and other age-related disorders. However, a company can deny coverage to a person already suffering from Alzheimer's.
Care by family members: Most policies will not pay members of your family to take care of you, though some will pay to train family members to be caregivers.
Other exclusions: Texas long-term care policies may exclude coverage for certain conditions resulting from such things as alcoholism and drug addiction, commission of a felony, or intentionally self-inflicted injuries. Consult with a long-term care insurance agent for more information.
