Benefit Triggers and How They Affect LTCI Policies
Nobody bought a long term care insurance policy and felt excited about using his long term care insurance benefits. As a matter of fact, many dread the day that they will qualify for long term care as this signifies the loss of independence.
However uncomfortable many policyholders were with the idea of preparing for the day that they will have a caregiver or nurse feed, bathe, dress, and move them from the bed to another point of the house, they still went to purchase a long term care insurance (LTCI) policy because more than the fear of subjecting themselves to the high cost of care they fear leaving their families impoverished.
Responsible individuals plan their future with an LTCI policy but it is not enough to just purchase this type of insurance product and wait for a benefit trigger to occur. It is very important to study each component and variable which comprise your policy.
Among the parts of an LTCI policy which buyers focus on when they are in the process of negotiating for this product are the maximum daily or monthly benefit amount, maximum benefit period, elimination or waiting period, and the inflation protection.
It is normal for anybody to put his attention on the amount of benefits that he will receive from his policy someday since the main reason people buy an LTCI policy is to protect their assets from being wiped out by the soaring cost of care.
Unfortunately, it is not enough to secure a policy with a big amount of benefits. There are certain conditions that you have to meet before you can receive the benefits from your policy. This area of your policy is very important that you should take the time to read it and familiarize yourself with it lest you wind up not receiving anything from your LTCI policy.
How Do You Qualify for Long Term Care Insurance Benefits
According to LTCI experts, an insured individual will only qualify for the benefits of his LTCI policy once a benefit trigger occurs. Now there are two general ways to specify a benefit trigger and one is the need for assistance with the activities of daily living or ADL.
When a person is incapable of performing any two or all of the ADLs which are eating, bathing, dressing, transferring or walking from one point to the house to another, toileting, or continence he instantly qualifies for long term care.
In the past, some insurance companies marketing and selling LTCI policies have been placed in hot water as they were accused of not paying the claims of their policyholders. It turned out that the complainants do not really qualify for benefits since they did not meet the benefit trigger that is specified on their policies.
For instance, blindness is not on the list of ADLs so an insured person who becomes blind due to an accident or illness cannot claim his benefits. But if he cannot perform two or all of the ADLs because of his blindness then that’s a different story.
Cognitive impairment due to Alzheimer’s or other forms of dementia is another way of qualifying for long term care insurance benefits. Since every LTCI company has its own underwriters, there will be slight discrepancies in the benefit triggers so to be safe read your policy before signing.
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