MtBook US Leagal Services/在米日系企業・在留邦人のためのリーガルサービス

ヘルスケア法

"Tips to Remember When Selecting a Long-Term Care Insurance Plan"

アメリカ 弁護士 法律事務所 法律  長期介護保険プラン選択基準

  • Before you choose a specific policy, check out the company. Be sure that the company you choose is likely to be around and solvent for a long time. Pick a company with a financial rating of B+ or better from financial-ratings services such as A.M. Best, Moody’s, Standard & Poor’s, and Weiss..
  • Make sure your policy will pay benefits for all levels of care in a nursing home (including custodial care), as well as care in assisted-living facilities or other residential-care facilities..
  • A good policy will pay benefits for home care and hospice care, including in-home personal care to help with activities of daily living..
  • Consider whether the amount of daily benefits provided by your policy will beadequate in the future. You should consider only policies with an inflation adjuster that increases benefits by a set percentage, compounded each year..
  • Do not assume that more years of coverage is always better. Very few people need nursing home care for five years or more. Four years is sufficient coverage for most. Three years may be acceptable if the cost of more coverage is simply too much for you..
  • Six months is a reasonable exclusion period for preexisting conditions..
  • Better policies allow payment of nursing home or home health benefits without requiring a prior period of hospitalization as a condition of coverage..
  • Most policies impose waiting periods (commonly 20 to 90 days after you begin receiving nursing home care or home care) before payments under the policy begin. First-day coverage will increase your premium. Consider self-insuring for the maximum waiting period, since utilizing the maximum waiting period will result in significant savings on premium payments. If you have to pay during the waiting period, the loss likely will not be catastrophic..
  • Avoid policies that pay only for “medically necessary” care; this standard is often too discretionary. Most good policies will cover care when the individual needs help with two or more activities of daily living (bathing, eating, dressing, toileting, transferring into or out of a bed or chair, or continence) or, alternatively, when the individual suffers a cognitive impairment. Be sure your policy covers Alzheimer’s disease and other forms of dementia. More than half the residents of nursing homes suffer some form of dementia..
  • Buy a policy only from a company that is licensed in your state and has agents physically present in your state. Out-of-state mail-order policies may leave you powerless to remedy problems if anything goes wrong .

(Fall 2008)

PageTop