Expenses that are not usually
covered are specific to each policy type and sometimes by state.
This is where working with a long term care specialist can be of tremendous
benefit to you and your family. In order to find out the specific
exclusions, ask to review a specimen policy for the policy that you
are considering. Your agent can provide this and you can review
the exact language and exclusions that are pertinent to you or your
family.
The biggest expense that you
should be aware of is the elimination or waiting period. During
this time, you are responsible for all expenses. These can be
counted as days of care received or calendar days. Knowing this
can save you thousands of dollars.
Other typical exclusions include
war, suicide attempt, drug addiction, alcoholism or a preexisting condition.
Basic items of comfort such as toiletries, television rental, beauty
and hair charges are generally excluded. Prescription drug charges
are generally excluded, as well.
There may be exclusions as
to the payment for services that is given by family members.
This is a partial list of typical
exclusions. Be aware that policies and benefits do change.
Additionally, many policies have a provision that allows for the payment
of excluded benefits if they are petitioned for and approved in advance
as part of an approved care plan.
Your relationship with a knowledgeable, caring agent will go a long way to determining and understanding the important exclusions and benefits pertaining to the policy that you are considering. Once a claim needs to be submitted, their assistance in the claims process can be invaluable in ensuring a smooth process.
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