Long Term Care Insurance Waiting and Benefit Periods – Which Are Best For You?

UPDATED: Jul 14, 2023Fact Checked

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Jeffrey Johnson

Insurance Lawyer

Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 14, 2023

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UPDATED: Jul 14, 2023Fact Checked

Most long term care insurance policies contain some sort of waiting period before the policy is triggered and an insured can begin receiving benefits. Insurers include these because much of the expense stemming from an illness or injury is usually realized up front – and the less the insurer may have to pay, the less your premium might be. Another factor in the price of your premium is the amount of time that they insurer will continue paying benefits. Bob Scott, a partner at the Advocate Law Group, explained both concepts.

Waiting periods

Waiting periods are an important aspect of the policy. Consumers should find out if they start collecting benefits the day they require some assistance and need in home care because they’re no longer able to bathe or care for themselves. Or is there a 30 day waiting period, a 90 day waiting period, a 120 day waiting period, 6 months or a year? The longer the waiting period, the lower the premium because the insurance company is not paying out on the first dollar. So, a waiting period helps people significantly reduce premiums.

Benefit periods

The second point is to find out how long the insurance company will be paying benefits? For example, if I (the insurance company) agree to pay benefits for up to a maximum of two years from the date the benefits start, I have significantly limited my potential exposure. On the other hand, if I agree to pay benefits for up to five years, I have two and a half times greater possible exposure. If I have lifetime benefits, I could have a much longer benefit pay out period and therefore I have to charge more premium. I would think most people would be far better off having a longer waiting period before the benefits begin and a much longer duration period for the length of time the benefits are payable.

Recommendations

While consumers need to weigh the pros and cons of both waiting and benefit periods, Scott offered the following recommendation, “The danger that people face is they might have a stroke rendering them disabled and that they may live a long time during which care is required. That could be a significant financial catastrophe. With that being said, I would suggest that most people consider a six month waiting period, but have the benefits payable for life.”

Exploring Case Studies: Long-Term Care Insurance Waiting and Benefit Periods

Case Study 1: Short Waiting Period, Limited Benefit Period

John opted for a long-term care insurance policy with a short waiting period of 30 days and a benefit period of two years. While his premium was relatively higher, he had the advantage of receiving benefits sooner in case he required assistance. However, the limited benefit period exposed him to potential financial risks if he needed care for a longer duration.

Case Study 2: Long Waiting Period, Extended Benefit Period

Sarah chose a long waiting period of six months but secured a policy with lifetime benefits. This decision resulted in a lower premium, allowing her to save on insurance costs.

However, the longer waiting period meant that she would need to cover her care expenses during that time. Nevertheless, having lifetime benefits provided her with the assurance of long-term coverage if she required care for an extended period.

Case Study 3: Balanced Waiting and Benefit Periods

Michael decided on a balanced approach by selecting a waiting period of six months and benefits payable for life. This choice allowed him to strike a middle ground between cost savings and long-term coverage.

He would have to cover his care expenses during the waiting period, but once the benefits kicked in, he would be assured of financial support for the remainder of his life.

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Jeffrey Johnson

Insurance Lawyer

Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

Insurance Lawyer

Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.

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