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I am tempted to cancel my spouse's LTC premiums because it has a 90 day elimination period and the premiums are rather high ($350/month).?

I am tempted to cancel my spouse's LTC premiums because it has a 90 day elimination period and the premiums are rather high ($350/month). Will we ever see the benefits?

My spouse is 87 years of age and has been covered by John Hancock LTC insurance since the age of 81. Her policy has a 90 day elimination period (benefits begin to payout 90 days after an M.D. certifies she can no longer perform 2 of the 6 Activities of Daily Living. She was hospitalized for four days recently for slow heart rate and doctors reviewed her heart medicine, added a new medication, discontinued 3 others. A physical therapist, provided by Medicare, discovered she was not taking the correct medicine, and double the proper dose. She is mobility impaired due to severe forward curvature of her spine upward from the middle of her back.

We're under increased financial strain due to the fact that we lost $1,050/mo in rental income.

The benefits payout is only be for 12 months (based on the Daily rate times 365 days). Obviously her benefits will last longer if she receives in-home care rather than skilled nursing care. Obviously, to stop paying the premiums at this point means we forfeit the accumulated cash benefits.

Her policy has a 90 day elimination period. I realize we must wait 90 days from her date of eligibility before we receive the first dollar of benefits. During that 90 day period do I have to demonstrate to the LTC insurance company that I incurred ongoing expenses for her care?

4 Answers

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  • 4 years ago

    Nothing accumulates for those first 90 days, other than time to trigger the coverage.

    Can you get away without it, sure. I would speak with a financial advisor and I would also contact the nicer nursing homes in your area. Many will not accept a patient without an LTC policy as they will eventually be forced to accept Medicaid rates at some point after assets have been diminished.

    Do you really want your spouse in a state-run nursing home?

  • 4 years ago

    If you can afford to pay the $7,000 a month average for a nursing home, you don't need to keep the LTC coverage.

  • 4 years ago

    She is already in need of benefits. You cancel now and you will be up the creek later in bills.

  • ?
    Lv 7
    4 years ago

    Sounds cheaper than the cost of a nursing home.

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