What Happens If My Long-Term Care Policy Lapses?

If you were under the impression that Medicare will continue to provide for your long-term care needs, including payments to a nursing home, this could be a catastrophic mistake that follows a missed premium due to your long-term care insurance policy.

Not paying your long-term care insurance policy premiums eventually gives that company license to cancel your policy. This means that after the grace period has expired, you will not be able to use that policy for long-term care expenses. If you have a policy and it lapses, the specifics of how that process is handled falls to your insurance company.

The insurance company, however, could potentially reinstate your policy back to the dated lapse if you request reinstatement and can show that there is no change in health since the time your policy lapsed. In addition, you will need to pay all past due premiums at that point in time. There are usually four primary opportunities to keep your long-term care policy active.

These include paying your premium on time regularly, paying within the policy grace period after a payment has lapsed, responding to a written lapse notice submitted to you by the insurance company, and requesting reinstatement after the policy has lapsed. If your policy has lapsed and you have not been able to get it reinstated, you will not be eligible to tap into the benefits provided by the long-term care insurance company.

Once your policy has lapsed and is no longer eligible for reinstatement, you will have to use another avenue to pay for your long-term care insurance expenses. Remember that Medicare does not cover long-term care insurance payments that go to a nursing home. Schedule a consultation with an experienced elder law attorney to discuss your case in further detail.        

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