Long Term Care Insurance Checklist

print and fill out for each policy you are considering

Company Name

Policy Name or ID Number

Plan Design:

Issue Ages

Benefit Period

Daily Benefit

Elimination Period

Home Care

Services and Benefits:

Total Nursing Home Benefit

Elimination One-time

% for Assisted Living Facility

HHC Daily Benefit % of NH

HHC (daily, weekly, monthly)

Adult Day Care

Home Health Aide

Homemaker Services

Respite Care

Hospice Care

Equipment

Caregiver Training

Other features:

Care Management

Waiver of Premium

Survivorship Benefit

Guaranteed Purchase Option

Alternate Plan of Care

Policyholder Premium Increase

since '95

Optional Benefits:

Inflation Protection

(simple, compound, % per year)

Restoration of Benefits

Nonforfeiture

Discounts and Pricing:

Discounted Premium Classes

Affinity Discount

Spousal Discount

Rate Classes

Basic Payment Mode

Premium Increase since 1995