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# Some Common LTC Policy Provisions

Respite Care - Respite care is normally associated with hospice care. With this benefit, the patient is admitted to a nursing home for needed care for a short period of time, or the policy will cover the cost of replacing for a short period (a day or weekend, for example) the primary care giver â€?usually a family member â€?who's looking after an elderly person in the home.

Home Health Care - The majority of current LTC policies cover home health care as an alternative to nursing home care. Home health care is provided in the insured's home and must begin within a specified period of time following a nursing home stay. The home health care benefit is typically 50- to 60% of the regular daily nursing home benefit. Home health care is an extension of intermediate custodial care; in other words, the patient requires some health care, but is able for the most part to function without the need for confinement in a nursing home. This type of health care might include physical therapy and some custodial care, such as meal preparations.

Adult Day Care - Many of today's long-term care policies also provide for adult day care to allow the primary care giver to continue working at his or her regular job. Either provided in the insured's home or at a day care facility, adult day care is basically social and health care services for functionally impaired adults. Typically included are transportation to and from the day care center along with a variety of health, social and other related activities. This care usually also includes meals and certain medical services. Specialized care for Alzheimer's victims is generally also included in adult day care benefits.

Exclusions - A major advancement of current LTC policies is that most now cover Alzheimer's disease and other organic-based mental illnesses, which formerly were often excluded. Every insurance policy, however, has some exclusions. Each should therefore be studied carefully to determine what's covered and what is not. Typical LTC exclusions are wars and acts of war, alcohol or drug dependency, self-inflicted injuries, mental illness and nervous disorders with no verifiable organic cause, and treatment provided without cost to the insured (such as that received at a veteran's hospital).

Pre-existing Conditions - Most LTC policies don't cover conditions that existed during a specified period of time immediately before the policy effective date (usually six months). A few policies, however, do not have this exclusion.

Professional Care Advisor - Coverage may be provided for the services of a care coordinator to help design the most appropriate plan of treatment for the insured.

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