Long-Term Care Policies in Michigan

Long-Term Care Policies in Michigan

Long-Term Care Policies in Michigan

Long term care policies vary a lot depending on the insurance provider offering it up to what state it is being offered. There are instances LTC policies only provide assistance either for home health care or for facility care only.

In Michigan, long term care policies must provide home health care benefits at a minimum coverage amount of one-half or 50 percent the coverage amount of nursing home care. They must also include intermediate and basic care in a coverage amount not less than the amount of coverage for skilled care.

Intermediate or custodial nursing care is defined as care that includes assistance in activities of daily living that can be provided by persons without medical skill in a licensed intermediate or skilled nursing care facility. While, skilled care is care that requires daily attendance, monitoring, evaluation and/or observation by licensed health personnel in a licensed skilled nursing care facility.

Michigan's provisions with its LTC policies also include that the policy cannot limit or exclude coverage due to any illness, any health care provider, any geographical location any treatment, medical condition or accident. The only exception to these provisions is the necessity of long-term care as a result of an automobile accident, in which case the individual's no-fault auto insurance provision would become effective.

The policies must also provide a "free look" period which is consists of a thirty (30) day period. Once an individual decides he no longer wants to pursue the policy, he is under no obligation or whatsoever and will still receive a total refund of any premiums he paid. And, the company must also provide a pro-rated refund of premiums paid for the current year.

Moreover, the policies must be a guaranteed renewable although the premium rate is not guaranteed. On the part of the insurance company, it may offer an optional inflation protection rider. The company is required to offer an optional inflation protection rider at the rate of five percent compounded annually. It may charge an additional premium for the inflation protection rider as well.

In situations like a company which previously offered group employees a long-term care policy but then, terminates the benefit, it must offer employees individual LTC coverage with similar benefits of the prior group coverage.

However, the policy can limit coverage for pre-existing conditions, mental or nervous disorders, alcoholism or drug addictions and illness arising from war or armed forces, illegal activities and suicide. However, Alzheimer's or related diseases cannot be excluded from coverage.

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