5 - Private Insurance Plans for Seniors

A "reimbursement policy" pays what amount of covered Long-Term Care expenses?

Actual covered expenses up to the daily maximum A "reimbursement policy" pays the actual covered expenses up to the daily maximum.

Qualified Long-Term Care policies may take into consideration an applicant's pre-existing conditions for a maximum of not more than __ month(s) prior to the effective date of coverage.

6 If a pre-existing condition waiting period applies, the policy must not exclude coverage for any pre-existing conditions that occurred more than 6 months prior to the effective date of coverage. These conditions cannot be excluded beyond 6 months after the policy is issued.

Which of the following will a Long Term Care plan typically provide benefits for?

home health care A Long Term Care policy will typically pay for home health care.

Which of the following types of care is typically not covered in a Long-Term Care policy?

Acupuncture

Under a Long Term Care policy, which benefit would be typically excluded or limited?

Alcohol rehabilitation Addictive behavior rehabilitation is normally excluded or limited under a Long Term Care policy.

Nursing home benefits must be provided for at least 12 consecutive months in which of the following types of policies?

Long-Term Care Long-Term Care policies are designed to provide nursing home benefits on an extended basis of at least twelve consecutive months.

Medicare Part B does NOT cover *occupational therapy * inpatient hospital services *physician and surgeon services *medical equipment rental

The correct answer is "inpatient hospital services". Medicare Part B is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services, and supplies not covered under Part A.

Long Term Care policies will usually pay for eligible benefits using which of the following methods?

Expense incurred Most long-term care policies pay on a reimbursement (or expense-incurred) basis, up to the policy limits.

If a retiree on Medicare required five hospital stays in one year, which policy would provide the best insurance for excess hospital expenses?

Medicare Supplement In this situation, a Medicare Supplement policy would provide the subscriber the best coverage for excess charges.

Which Long Term Care insurance statement is true?

Pre-existing conditions must be covered after the coverage has been in force for six months Pre-existing conditions are those for which medical advice or treatment was recommended by or received from a health provider within 6 months preceding the effective date of an individual long-term care policy.

What is the MINIMUM number of Activities of Daily Living (ADL) an insured must be unable to perform to qualify for Long Term Care benefits?

2 A qualified Long Term Care policy must stipulate that the insured be incapable of performing at least two of the ADL's without assistance for at least 90 days to qualify for benefit

How long is the typical free look period for Long Term care insurance policies?

30 days Most Long Term Care policies require a 30-day free look period.

The individual most likely to buy a Medicare Supplement policy would be a(n)

68-year old male covered by Medicare Medicare Supplements are available to those covered by Medicare.

Medicare Part C is

available to those who are enrolled in Medicare Part A and Part B Medicare Part C (Medicare Advantage) is offered by private insurers and available to those who are enrolled in Medicare Part A and Part B.

The guarantee of insurability option provides a long-term care policyowner the ability to

buy additional coverage at a later date In long-term care insurance, the guarantee of insurability option provides the insured with the ability to purchase additional insurance at a later date without evidence of insurability.