Could Using Your Long-Term Care Insurance Also Stop the Premium Payments?

Yes, using an existing long-term care insurance policy may also mean you no longer have to pay premiums while a contractual waiver of premium applies. The policy determines the conditions and timing. Opening a claim by itself is not permission to stop paying.

You’ve paid for the policy for years. Now you’re trying to understand what it can pay toward care. It’s worth asking about the premium, too: does that expense continue once benefits begin?

Most Policies Waive Premiums When Benefits Begin

At Amada Senior Care Tuscaloosa, most policies we encounter waive premiums once the contract’s requirements are met and covered benefits begin. We have seen exceptions, including some large indemnity policies. That’s why we check the actual provision before a family counts on the savings.

What Does “Waiver of Premium” Mean?

A waiver of premium suspends the requirement to pay premiums under the conditions set out in the contract. It is a feature to verify in an existing policy, not something to assume applies to every type of coverage.

For a family arranging home care in Tuscaloosa or Northport, the practical question is simple: “Does this policy waive premiums for the benefits we’re using, and if so, when?”

Ask the carrier to point to the provision and explain the answer in writing. You want to know both what triggers the waiver and which date applies to your claim.

Does The Premium Stop When Opening A Claim?

Don’t assume it does. Opening a claim, being found eligible, satisfying an elimination period, receiving benefit payments, and having a premium waiver take effect are separate questions. Ask which requirements must be met for this particular waiver.

For a fuller explanation of payment milestones, read Long-Term Care Insurance Approved but No Payment Yet in Tuscaloosa? (https://www.amadaseniorcare.com/tuscaloosa-senior-care/ltci-approved-no-payment-yet/).

Keep premiums current until the carrier confirms a change to your payment responsibility. If a bill arrives while the claim is under review, ask about it promptly rather than treating the pending claim as an explanation for skipping it.

What If Premiums Continue After Benefits Begin?

Start by asking the carrier whether the waiver has been approved and its effective date. A benefit payment and a bank draft do not, by themselves, tell you whether an error has occurred.

Have recent premium notices, the benefit decision, and the dates of the drafts available. Ask whether premiums collected for a period covered by the waiver need an adjustment or refund. The answer depends on the policy and the carrier’s records; don’t assume a refund is owed before checking.

Also ask how automatic payments will be handled. The carrier should explain what it will change and what, if anything, the policyholder needs to do. Keep that confirmation with the policy file so the next relative helping with finances doesn’t have to reconstruct the conversation.

Does The Waiver Last Forever?

Not necessarily. Ask what happens if benefits stop, the person recovers, or the care arrangement changes. A waiver is not the same as cancelling the policy or making it permanently paid-up.

Genworth’s premium guidance (https://www.genworth.com/customer-support/ltc-premium-changes/my-options) gives a useful carrier example: policyholders receiving benefits with an applicable waiver do not pay an increased premium while that waiver applies. If they recover and benefits stop, future increased premiums become due. Your own contract needs to answer how a waiver ends and how payment resumes.

That matters when care needs change. Someone should be watching both the benefit correspondence and premium notices so a resumed bill doesn’t get overlooked.

What If Your Policy Keeps Charging Premiums?

Ask for the reason before assuming the carrier has made a mistake. The waiver may not apply to the benefits being used, its conditions may not yet be met, or the policy may not provide the waiver you expected.

Some large indemnity policies Amada has encountered have continued premiums. We treat that as experience with those contracts, not a rule for every indemnity policy. Check the wording in your policy and ask the carrier to explain how it applies.

Even when premiums continue, the policy may still provide useful care benefits. Put the confirmed premium expense alongside the confirmed benefits and family-paid costs when discussing the care budget.

Five Questions To Ask About Premium Payments

1. Does our policy include a waiver? Ask whether it applies to the benefits and care setting being used.

2. What starts the waiver? Confirm the contract’s conditions and the effective date for this claim.

3. Should we keep paying now? Obtain carrier confirmation before changing payments or automatic drafts.

4. Do any collected premiums need adjustment? Ask the carrier to check payments against the confirmed waiver period.

5. When could premiums resume? Find out what ends the waiver and how future bills will be communicated.

Keep the answers with the policy. If an answer is still pending, keep that item on the list rather than counting it as settled.

Should You Start Care To Stop Premiums?

Care should reflect actual needs, and a claim must meet the policy’s requirements. A possible premium waiver is one part of understanding the household costs. It does not create eligibility or make unnecessary services covered.

If a parent already needs help, though, don’t leave the premium question out of the review. Families deserve to understand the coverage they have been paying for and what changes when they use it.

Frequently Asked Questions About LTCI Premium Waivers

Is a waiver the same as cancelling the policy?

No. A contractual waiver changes the premium obligation while its conditions apply. Cancelling coverage is a separate action with different consequences.

Will every LTCI policy stop premiums during home care?

No. Check the applicable waiver provision, covered benefits, and claim status. Amada’s experience with most policies is not a guarantee about your contract.

Can Amada help us check this before care begins?

Yes. We review existing policies and help identify questions for the carrier. There is no separate fee for policy review, activation assistance, or ongoing claims administration. Care services themselves still have charges.

Bring the policy, recent premium notice, and any claim correspondence to Amada Senior Care Tuscaloosa for a free LTCI review. We’ll help you check what the policy may pay for and what happens to the premiums along the way.

About the author: Len Everts, CLTC, CDP, co-owns Amada Senior Care Tuscaloosa, Birmingham, and Shelby. Len and Ginger provide or review LTCI support across all three offices. Len holds the Certified in Long-Term Care designation and is a Certified Dementia Practitioner.