There is a common misconception that with long-term care insurance, pre-existing conditions are not allowed. This is the first misconception that many individuals have regarding long-term care insurance. The truth of the matter is the pre-existing conditions do not matter when purchasing a long-term care insurance policy. They do however matter in other aspects. The following is an overview of the situations where pre-existing conditions and long-term care insurance can matter and can prevent long-term care insurance policies from going into effect.
No Primary Insurance
One of the easiest ways for an individual to find themselves in a long-term care insurance issue is when no primary insurance is there. The primary insurance may not be in place due to a pre-existing condition. This is when a pre-existing condition can affect long-term care insurance coverage. If a major medical plan does not allow a pre-existing condition but the individual still chooses to purchase long-term care insurance then the long-term care insurance may still go into effect but the out-of-pocket cost may be drastically higher. This situation varies depending on the need for long-term care insurance, the issue with long-term care insurance and various other aspects related to the long-term care issue.
It should be noted that the primary insurance factor in regards to pre-existing conditions and long-term care insurance may no longer be an issue once the new Healthcare Reform Act is approved. Under the new healthcare Reform Act, insurance companies can no longer deny insurance coverage to individuals based on pre-existing conditions. This means that an individual who may have a pre-existing condition that would lead to possible long-term care issues would be able to obtain a primary major medical coverage plan that could be billed first and then allow for billing to go to the long-term care insurance policy which reduce out-of-pocket costs and increase the quality of healthcare for the individual.
Combination Insurance Coverage
There are certain situations where an individual may have a primary major medical plan but have other combination insurance coverage that do not allow for pre-existing conditions. In these situations a pre-existing condition can affect long-term care policies. In this scenario an individual would have major medical coverage but have a gap insurance plan that does not allow for a pre-existing condition that occurred after the major medical coverage is purchased prior to the gap insurance being purchased. This may cause some confusion for insurance billing when a long-term care issue occurs. If the individual has major medical, gap insurance and long-term care policies there may be a holdup at the gap insurance point. This is due partially to the fact the gap insurance will not cover the pre-existing condition and may cause a holdup in the paperwork prior to the remaining balance being sent from the major medical to the long-term care policy.
These are the two scenarios where pre-existing condition can affect long-term care insurance. However, in general pre-existing conditions do not affect the purchasing of long-term care insurance policies or how long-term care insurance policies are instilled. However, in the situations of pre-existing conditions can complicate matters long-term care insurance policies and do need to be taken into consideration. If you are unsure of your pre-existing condition will have a conflict with the billing of your long-term care insurance policy then you will need to discuss this with your insurance policy representative to ensure that you have the proper coverage and your pre-existing condition will not affect or will only slightly affect long-term care insurance policy.