Long Term Care Insurance continued

Policy standards ***

Free look is minimum of 30 days from the date of delivery, during which the policyowner may return the policy for a full premium refund if they are not satisfied for any reason. *****

Individual long-term care must contain renewal provisions of "guaranteed renewable". *****

Preexisting conditions look back six months and may exclude for six months. What we mean is that the insurance company may look for conditions for which medical advice or treatment was sought within six months before the effective date of the policy. If the company finds something, they may exclude it from coverage for the first six months.

Limitations and exclusions

A long-term care insurance policy in Florida may exclude the following:

• Preexisting conditions as just described
• Mental or nervous disorders (but not Alzheimer's disease)******
• Alcoholism and drug addiction
• War or act of war (whether declared or undeclared)
• Participation in a felony, riot, or insurrection
• Service in the armed forces
• Suicide (sane or insane), attempted suicide, or intentionally self-inflicted injury
• Aviation (this exclusion applies only to non-fare-paying passengers)
• Treatment provided in a government facility (unless otherwise required by law)
• Services for which benefits are available under Medicare or other governmental program (except Medicaid)
• Any state or federal workers' compensation, employer's liability or occupational disease law, or any motor vehicle no-fault law
• Services provided by a member of the covered person's immediate family
• Services for which no charge is normally made in the absence of insurance.

A long-term care insurance policy may not do the following:

• Be canceled or non-renewed on the grounds of the age or the deterioration of the mental or physical health of the insured.
• Contain a provision establishing a new waiting period if existing coverage is converted to or replaced.
• Restrict its coverage to care only in a licensed nursing home or provide significantly more coverage for such care than coverage for lower levels of care
• Contain an elimination period in excess of 180 days (remember the elimination period is when the insured needs the care and benefits are not being paid)
• Condition eligibility for benefits on a prior hospitalization requirement (but Medicare Part A is allowed to do this). ************