What does long-term care insurance not cover?
It generally does not cover care from your own family (unless the policy allows it), medical and hospital bills that health insurance or Medicare handle, or care excluded by the policy — such as injuries from substance abuse or, often, care received outside the U.S. Exclusions vary by policy.
Long-term care insurance pays for help with daily living, not medical treatment — so several things fall outside it. Common exclusions and limitations include:
- Care from family members, unless you have a cash/indemnity policy or a specific family-care benefit (see paying family caregivers).
- Medical and hospital care that Medicare or your health insurance already covers — LTC insurance is not health insurance.
- Care needed because of excluded causes, such as intentional self-injury, or alcohol and drug abuse.
- Care outside the United States, which many policies limit or exclude.
- Pre-existing conditions during any stated waiting period.
Exclusions vary from policy to policy, so the "Exclusions and Limitations" section of the outline of coverage is worth reading closely before you buy.
General information only. This is educational and not insurance, legal, tax, or financial advice. Rules and products vary and change — confirm the specifics with a licensed professional.
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