DEPARTMENT OF LABOR AND REGULATION

DIVISION OF INSURANCE

DISCLOSURE FORM

THINGS YOU SHOULD KNOW BEFORE YOU BUY LONG-TERM CARE INSURANCE

Chapter 20:06:21

APPENDIX F

SEE: § 20:06:21:53.02

‎Things You Should Know Before You Buy

Long-Term Care Insurance

Long-Term

• A long-term care insurance policy may pay most of the costs for your care in

Care

a nursing home. Many policies also pay for care at home or other community

Insurance

settings. Since policies can vary in coverage, you should read this policy and

make sure you understand what it covers before you buy it.

• [You should not buy this insurance policy unless you can afford to pay the

premiums every year.] [Remember that the company can increase premiums

in the future.]

• The personal worksheet includes questions designed to help you and the

company determine whether this policy is suitable for your needs.

Medicare

• Medicare does not pay for most long-term care.

Medicaid

• Medicaid will generally pay for long-term care if you have very little income

and few assets. You probably should not buy this policy if you are now

eligible for Medicaid.

• Many people become eligible for Medicaid after they have used up their

own financial resources by paying for long-term care services.

• When Medicaid pays your spouse's nursing home bills, you are allowed to

keep your house and furniture, a living allowance, and some of your joint

assets.

• Your choice of long-term care services may be limited if you are receiving

Medicaid. To learn more about Medicaid, contact your local or state

Medicaid agency.

Shopper's

• Make sure the insurance company or agent gives you a copy of a book called

Guide

the National Association of Insurance Commissioners' "Shopper's Guide to

Long-Term Care Insurance." Read it carefully. If you have decided to apply

for long-term care insurance, you have the right to return the policy within

30 days and get back any premium you have paid if you are dissatisfied for

any reason or choose not to purchase the policy

Counseling

• Free counseling and additional information about long-term care insurance

are available through your state's insurance counseling program. Contact

your state insurance department or department on aging for more informa-

tion about the senior health insurance counseling program in your state.

Facilities

• Some long-term care insurance contracts provide for benefit payments in

certain facilities only if they are licensed or certified, such as in assisted

living centers. However, not all states regulate these facilities in the same

way. Also, many people move to a different state from where they purchased

their long-term care insurance policy. Read the policy carefully to determine

what types of facilities qualify for benefit payments, and to determine that

payment for a covered service will be made if you move to a state that has a

different licensing scheme for facilities than the one in which you purchased

the policy.

Source: 28 SDR 157, effective May 19, 2002; 33 SDR 230, effective July 2, 2007.