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Indemnity vs Reimbursement?

Indemnity vs Reimbursement?

August 17, 2023

What type of policy should I buy-Indemnity vs Reimbursement? What are the differences? 

Indemnity Long-Term Care Insurance Policy:

Definition: An indemnity LTC insurance policy provides the policyholder with a predetermined daily or monthly benefit amount upon meeting the criteria for receiving long-term care services. The policyholder is paid a fixed amount regardless of the actual costs incurred for care services.

Benefits:

  1. Flexibility: Indemnity policies offer greater flexibility to policyholders in how they use the benefit payouts. Policyholders can use the funds as they see fit, whether for professional care services, informal caregiving by family members, or any other related expenses.

  2. Simplicity: Indemnity policies are relatively straightforward. Policyholders receive a fixed benefit amount, making it easier to understand and plan for their care needs.

  3. Predictable Payouts: Policyholders know exactly how much they will receive from the insurance company, which can help them budget for their care expenses.

Disadvantages:

  1. Potentially Inadequate Coverage: The fixed benefit amount might not fully cover the actual costs of care, especially if care services are more expensive in the future due to inflation or other factors.

  2. Risk of Overpayment: If the policyholder's care expenses are lower than the fixed benefit amount, they might end up receiving more than they actually need, which could be seen as wasted premiums.

Reimbursement Long-Term Care Insurance Policy:

Definition: A reimbursement LTC insurance policy reimburses the policyholder for the actual expenses incurred for eligible long-term care services, up to a specified limit or maximum daily or monthly benefit.

Benefits:

  1. Coverage for Actual Expenses: Reimbursement policies cover the actual cost of care services, providing a more accurate reflection of the policyholder's needs.

  2. Protection Against Inflation: Some reimbursement policies offer optional inflation protection riders, allowing the policy's benefits to increase over time to keep up with rising care costs.

  3. Less Risk of Overpayment: Policyholders are only reimbursed for the actual expenses incurred, reducing the risk of receiving more than needed.

Disadvantages:

  1. Less Flexibility: Policyholders might be required to submit receipts and documentation for reimbursement, which can be more cumbersome compared to the flexibility of an indemnity policy.

  2. Complexity: Reimbursement policies can be more complex to understand, as the benefit payout is contingent on the actual expenses incurred and the policy's terms and conditions.

  3. Potential Out-of-Pocket Expenses: If the actual care costs exceed the policy's maximum benefit limit, the policyholder may need to cover the difference out of pocket.

In summary, indemnity LTC insurance policies offer more flexibility and predictability in benefit payouts, but they may not cover all actual care costs. Reimbursement policies provide coverage for actual expenses, potentially with inflation protection, but may involve more documentation and could lead to out-of-pocket expenses if care costs exceed policy limits. The choice between the two types of policies depends on individual preferences, financial situation, and risk tolerance.