the answers. You just need to know how to ask the right questions.
Will asking these questions make the insurer pause? So what? You’re
spending significant dollars to buy significant potential coverage. You have
a right to look closely into the details of your purchase. In some cases, you
will be asking about basic policy features the insurer has already included;
in others, you will be addressing more problematic areas. In all cases, the
most consumer-friendly insurance companies understand that long-term
care coverage is a new product for most people. They will welcome your
questions.
Here are some you should ask:
If your policy excludes claims resulting from treatment for alcoholism
or drug addiction, will it pay for a dependency that results
from physician-prescribed medications?
While you may have agreed that you will not qualify for long-term care
benefits if your disability is caused by an addiction to drugs or alcohol,
an addiction to a physician-prescribed painkiller may be a shared responsibility.
Look at your policy to see how your insurer would treat this
eventuality.
Do you automatically provide waiver of premium for both home care
and nursing home coverage without an additional premium if the feature
is not included in the basic policy?
Some insurers treat home care differently from nursing home care when
it comes to waiving benefits. Do you want to be subjected to a special
waiting period before your premiums are waived because you choose to
be cared for at home and not in a nursing home?
When on a claim do the provisions of your inflation rider still apply,
or does the maximum daily benefit in effect at the start of any claim
remain constant?
When you bought your policy, you selected a benefit that would pay you
for several years, often three, four, or five. You may also have bought an
inflation rider, to protect yourself in the very long-term against rising
costs. Now you need the long-term benefits, but have discovered that
each year the cost for your care is increasing by 3 percent to 5 percent or
more. Will the inflation option rider you purchased continue to be operative
while you are on claim?
Who in your company will have access to my medical data contained
on my policy application and information obtained from my doctors?
Your medical data is your own business. It’s private. Your agent has a legal
obligation to respect your privacy, but what about the company’s paper
handlers? Does the insurer have a privacy protection policy in place that
prevents unauthorized employees from having access to your records?
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