title: Private long-term care insurance: after coverage restrictions is there anything left?
abstract: Private long-term care insurance has been suggested as a solution to the crushing burden of out-of-pocket expenditures for nursing home and home health care. This paper examines the effects of common policy restrictions among currently marketed policies, more than a million of which have been sold. Using a conditional probabilities model and data from the 1985 National Nursing Home Survey (NNHS), we estimate likelihood of policy compliance for 31 combinations of policy restrictions. Compliance estimates range from 8.5% to 91.9%. Results indicate that prior hospitalization and prior skilled care clauses represent significant stumbling blocks for policyholders seeking benefit payments.
authors.affiliation: School of Public Health, University of North Carolina, Chapel Hill.
authors.forename: C E
authors.initials: CE
authors.lastname: Wilson
authors.forename: W G
authors.initials: WG
authors.lastname: Weissert
mesh_terms: D003625:Data Collection; D004608:Eligibility Determination / Q000379:methods*; D006699:Home Care Services / Q000191:economics; D007342:Insurance Benefits / Q000706:statistics & numerical data; D007353:Insurance, Long-Term Care / Q000458:organization & administration*; D009735:Nursing Homes / Q000191:economics; D011336:Probability; D014481:United States