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General Policy Terms
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How satisfied are you with the basic coverage offered by this policy?
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Cancellation by Insurer
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Although prohibited in some states, does this plan have a provision allowing the insurer to cancel your policy upon written notice to you?
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Cancellation for Non-Payment
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If the insurer cancels your policy due to non-payment, is there an acceptable timeframe for receiving the written notice and for appealing the cancellation?
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Coverage Duration
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How does the timeframe this coverage is in force and any disqualifying events fit your needs?
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Coverage Maximums
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Does the amount of available insurance meet your current and future needs?
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Coverage vs. Cost
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Comparing the coverage this policy offers, is it offered at a competitive price?
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Meets Your Need
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Evaluate the degree to which this insurance policy meets your overall financial, health, life and liability needs both now and in the future. If you are not sure, ask a professional.
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Policy Renewal
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Is the plan or policy guaranteed to renew regardless of your current or future health status?
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Insurance Agent
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How would you rate your insurance agent's overall helpfulness and knowledge?
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Agent Helpfulness
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How would you rate the agent's understanding of your situation and ability to provide solutions from which to choose?
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Agent Knowledge
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Is the agent knowledgeable and able to answer all your questions?
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Agent Relationship to Insured
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Evaluate your reason for considering this policy; is it for emotional reasons, do you feel obligated due to a friendship or does the policy really compliment your financial goals?
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Agent Status
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Does the agent represent one company or many companies? With limited access to other insurers, premiums could be higher.
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Insurance Provider
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How would you rate the overall interest, information and support the insurance provider has given you?
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Affiliations
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Does the insurer have affiliations with other business concerns (e.g. business partnerships and working relationships) that might translate to reduced premiums?
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Claims Processing
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How easy is this insurer's overall claims process?
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Company Rating
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How is the insurer rated by the standard rating services?
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Recommendations
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How would you rate the experience of others attempting to collect benefits from this insurer?
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Cost
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How do you rate the overall cost of this insurance coverage?
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Cost Management
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Evaluate the options available to you to reduce your overall cost of coverage.
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Association Discount(s)
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Evaluate any discounts given to policyholders for belonging to associations. (e.g. AARP, Alumni Association, Professional Associations)
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Preferred Discount
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Does this policy have a preferred discount option?
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Spousal Discount
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Does this policy provide for a spousal discount if you and your spouse are insured with the same carrier?
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Premiums
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Rate your overall cost of insurance.
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Affordability
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Evaluate your ability to afford premiums based on current income.
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Payment Frequency
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Does the insurer provide payment intervals which meet your needs (monthly, quarterly, semi-annual, etc.)?
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Payment Options
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Does the insurer provide various payment options (EFT, check, credit card, etc)?
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Payment Source
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Have you evaluated the best way to pay for this coverage, whether it be cash from your income or cash from income producing investments?
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Premium Amount
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Rate the premiums being charged for this policy or plan. For higher limits and health risks, you would expect to pay a higher price.
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Coverages
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Evaluate the coverage afforded you by the Long Term Care insurance policy or plan you are considering.
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Benefits
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Evaluate the overall benefits of this policy and determine its applicability to your specific needs.
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Bed Reservation Benefit
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Does the policy include a Bed Reservation benefit.
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Benefit Period
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How does the benefit period meet your needs and goals?
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Care Coordination Advisor
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Does the policy have a no-pay option for a Care Coordination Advisor?
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Caregiver Training Benefit
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Does the policy have a caregiver training benefit?
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Comprehensive Monthly Indemnity Benefit
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Evaluate the level of comprehensive monthly indemnity benefits offered by this policy. (e.g. range is typically $0 - $1,000)
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Recovery Benefit
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Evaluate the Recovery Benefit provided by this policy.
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Respite Care Expenses
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Does the number of fully paid days of care meet your needs (e.g. 15, 30, 45, etc)?
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Care Types
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Evaluate the types of care you need and the availability of this care in your policy or plan.
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Adult Day Care
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Evaluate the level of Adult Day Care provided by this policy.
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Alternative Plan of Care
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Does this policy have an Alternative Plan of Care benefit?
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Continuing Care
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Evaluate the level of Continuing Care provided by the policy.
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Custodial Care
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Evaluate the level of Custodial Care provided by this policy.
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Home Health Care
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Evaluate the extent of home health care provided by this policy.
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Home Daily Payments
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How well do the DAILY payment maximums for home health care meet your needs?
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Nursing Care
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Evaluate the need and availability of nursing care in your policy or plan.
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Nursing Daily Payments
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How well do the DAILY payment maximums for nursing home care meet your needs?
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Home Care
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Evaluate the level of paid, round -the-clock, Nursing Home Care.
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Intermediate Care
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Evaluate the level of Intermediate Nursing Care provided by this policy.
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Respite Care
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Evaluate the level of Respite Care provided by this policy.
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Service Types Offered
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Evaluate the inclusion of the various service types in the plan you are considering.
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Curing
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Evaluate the range of curing services provided for in the policy.
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Diagnostic
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Evaluate the range of diagnostic services provided for in the policy.
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Maintenance/Personal Care
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Evaluate the range of maintenance and personal care services provided for in the policy.
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Mitigating
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Evaluate the range of health mitigating services provided for in the policy.
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Preventive
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Evaluate the range of preventative services provided for in the policy.
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Rehabilitative
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Evaluate the range of rehabilitative services provided for in the policy.
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Therapeutic
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Evaluate the range of therapeutic services provided for in the policy.
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Treating
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Evaluate the range of treatment related services provided for in the policy.
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Policy Features
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Evaluate any limits placed on you due to policy definitions, eligibility or limitations.
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Policy Considerations
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Evaluate policy provisions to determine their impact on your out of pocket costs, coverage limits, or other policy terms.
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Policy Eligibility
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Do you fit the eligibility requirements for this policy?
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Activities of Daily Living
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What is the minimum number of Activities of Daily Living (ADL) necessary before benefits are triggered?
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Basic Eligibility
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Given your known risk factors and your current or anticipated health situation, how do the policy eligibility requirements fit you?
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Age Criteria
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Are you within the required age range for this insurance policy?
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Asset Minimums
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Do the assets you are protecting with this long-term care policy meet the minimum plan requirements? (If not, there might be more appropriate asset preservation options.)
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Health History
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Does your health history affect your ability to acquire this protection?
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Income Minimums
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Evaluate your income relative to your expected premium payment. Insurers will only issue policies to those who can afford the premiums.
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Mental Conditions
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If you have a prior or existing mental condition, are this policy's qualification criteria appropriate for your situation?
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Occupational Risk
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To what extent does your current occupation disqualify you for insurance or raise the premiums beyond affordable limits?
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Pre-existing Conditions
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How well are pre-existing conditions covered by the plan?
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Adult Conditions
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To what extent are adult related pre-existing conditions covered by the plan?
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Child Conditions
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To what extent are children's pre-existing conditions covered by the policy or plan?
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Waiting Period
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How reasonable are any waiting periods for your pre-existing conditions?
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Recreational Risk
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To what extent do your recreational activities affect your ability to obtain coverage with this provider?
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Chronically Ill Diagnosis
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What is the minimum number of chronically ill diagnoses before benefits are to be paid?
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Cognitive - Self Protection
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To what degree do you have to be cognitive for your own self-protection?
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Grace Period
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Does the length of the grace period meet your needs?
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Inclusion/Cognitive Disorders
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Does the policy address existing conditions for Alzheimer's disease, senile dementia and Parkinson's disease?
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Probationary Period
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Does this policy have enough probationary period options to meet your needs?
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Tax Liability
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Would the maximum payout amount of this policy cause you to incur possible tax liability for exceeding IRS maximums?
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