›› What is Long Term care Insurance?

Long-Term Care is a term that is used to describe an array of services that are available to people with prolonged illnesses, disabilities or cognitive disorders. LTC services include health, medical, personal care, and social services, as described below. Long Term Care Insurance Consumers Guide

You buy health insurance for the same reason you buy other kinds of insurance, to protect yourself financially. With health insurance, you protect yourself and your family in case you need medical care that could be very expensive. You can't predict what your medical bills will be. In a good year, your costs may be low. But if you become ill, your bills could be very high.  To begin you should compare rates and plans from 2 or 3 different sources. Choose the plan or company that suits you best.

Compare NJ Long Term Care Insurance Policy Costs Here

›› What does NJ Long Term care Insurance Include or cover?

•Assistance with activities of daily living (ADL's) such as eating, bathing, dressing, toileting, transferring, continence. •Around-the-clock skilled nursing care for those with prolonged physical illness, disability, or cognitive disorders, such as Alzheimer's. •Custodial care in an Assisted Living Facility. •Homemaker care, Adult Day care, Hospice care, Respite care. •Personal care for basic instrumental activities of daily living (IADL's), such as cooking, cleaning, laundry, or bill paying.

What types of LTC policies are available in New Jersey?
•Tax Qualified (TQ) •Non-Tax Qualified (NTQ) •Nursing Home Only •Home Health Care Only •Nursing Home/Assisted Living/Home Health Care
Congress passed the 1996 Health Insurance Portability and Accountability Act (HIPAA) to establish portability for health insurance when you leave employment. An amendment to the Act established TQ Long-Term Care policies to encourage private citizens to establish security for their twilight years. More recently, the popularity of TQ policies has declined in market share, as the strict benefit triggers of TQ policies make it more difficult to qualify for policy benefits.
Annual or Lifetime Maximum: Some plans limit the amount that the insurer is responsible to pay.

Will my health condition be taken into account?
Companies that sell LTC insurance "underwrite" their coverage, which is a technique for evaluating the risk of offering you a policy based upon factors such as your medical health, age, physical lifestyle and the like. Underwriters, who are employed by insurance carriers, look at your health and health history before they decide to issue a policy. You also may be able to purchase coverage through an employer's group policy without any underwriting examination of your health.Insurance company underwriting practices affect the premiums charged now and in the future. Some companies perform what is known as "short-form underwriting," which involves asking a few questions over the phone about your general health history, such as whether you have been treated for any sickness or disease in the past three years, or whether you have been hospitalized within the past year. Other companies have more thorough underwriting practices that involve the completion of extensive applications, reviewing your medical records and, sometimes, requiring medical exams. If you have certain disabling or life-threatening diseases, Underwriters may refuse to issue a policy. No matter how the company underwrites, you will be required to answer certain questions concerning your health and your medical history so the company can decide if it will insure you. If the information you placed on the application is wrong, the company may decide to rescind or cancel your policy. Most LTC policies have a termination of coverage provision (sometimes called a "Incontestable Clause" ), which allows the carrier - for up to two years after the effective date of coverage - to terminate your policy because of erroneous information or misrepresentations contained in an application. Generally, this provision also allows the company to terminate the policy even beyond that two-year period if evidence of insurance fraud is involved.

What will happen if I have a Pre-Existing medical condition?
Most LTC policies have a "Pre-existing Condition" provision, which defines a period of time that must pass after the policy's effective date in order for the policy to pay for care related to a health problem. In New Jersey, pre-existing condition limitations in long-term care insurance shall not exclude coverage for more than six months after the effective date of coverage under the policy for a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the policy's effective date. A few companies will cover a pre-existing condition during the first six months of a policy's term, so long as that pre-existing condition was disclosed on the insurance application. If information about a pre-existing condition is not disclosed, the Time Limit on Certain Defenses Provision will be triggered, and the policy could be canceled.

What are popular options of LTC policies available in New Jersey?
•Third Party Notice - Allows you to designate someone whom the insurance carrier should contact in case you forget to pay your monthly bill. •Waiver of Premium - Monthly premiums are waived 90 days after benefits start. •Restoration of Benefits - After use of most of your policy benefits, the original benefit value of your policy is restored after a 6-month benefit-free period. •Nonforfeiture Benefits Rider - A policy feature that returns at least part of the premium to you in the form of a reduced paid-up policy if you cancel your policy or let it lapse. •Inflation Protection Rider - A policy option that provides for increases in benefit levels to help pay for expected increases in the costs of LTC services. •Bed Reservation - If you are hospitalized while confined to a nursing home, some policies will pay to reserve your bed in the nursing home for a specified period. •Care Coordination Benefit - A Personal Care Specialist is assigned to coordinate with contracted health care agencies/facilities for your nursing home/home health care. •Return of Premium Benefit Rider - Upon your death, a premium refund to a pre-selected beneficiary/estate (minus benefits paid).

What may not be covered or excluded from coverage?
•Injury or sickness for which benefits will be payable under any worker's compensation claim or occupational disease law. •Injury from declared or undeclared war. Suicide, attempted suicide, or self-inflicted injury. Injury resulting from alcoholism, drug abuse, or narcotics addiction. •Injury resulting from participation in a felony, riot, or insurrection. Depending upon the policy you purchase, there will be other exclusions. Different insurers will have assorted exclusions depending on the home state compliance regulations under which each policy is written.

"NJ Health insurance pays the medical costs of the insured if the insured becomes sick due to covered causes, or due to accidents. The insurer may be a private organization or a government agency."