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Re: Medical Necessity Trigger

Posted by Matt McCann on November 01, 2002 at 00:33:20:

In Reply to: Re: Medical Necessity Trigger posted by Bill Lindgren on October 30, 2002 at 22:20:45:

: : : Not quite, Matt. As you've described it, you're saying that the medical necessity trigger is simply a redundant trigger, equivalent to the 2 of 6 ADL trigger or the cognitive impairment trigger. That is incorrect.

: :
: : No, not quite what I said. I said in real life, the reason most MD's will indicate a person needs care is because they are ADL dependent or need supervisory attention due to a memory problem.

: : So to get a non-tax qualified policy just to get the medical necessity trigger is not very helpful in the real world. It would be rare where that trigger would help anyone.

: I think Scott is correct - the proof being that the companies who do continue to offer the non-tax qualified plans with a medical necessity trigger (CNA's PS1 is an example of a good policy)
: don't charge you much more for that (in the CNA example I think it's about 5% more). So, obviously, the insurers don't really expect to be burned much by the trigger.

That proves my point, the trigger doesn't, in the real world, add many claims. Meaning it is not worth going with a NTQ policy IF you think it would trigger easier. The only real benefit if the NTQ is the lack of a 90 day cert of care ... but then it would be on short-term care policy, not long-term.

Follow Ups:

Re: Medical Necessity Trigger : : : : Not quite, Matt. As you've described it, you're saying that the medical necessity trigger is simply a redundant trigger, equivalent to the 2 of 6 ADL trigger or the cognitive impairment trigger. That is incorrect. : : : : : : No, not quite what I said. I said in real life, the reason most MD's will indicate a person needs care is because they are ADL dependent or need supervisory attention due to a memory problem. : : : So to get a non-tax qualified policy just to get the medical necessity trigger is not very helpful in the real world. It would be rare where that trigger would help anyone. : : I think Scott is correct - the proof being that the companies who do continue to offer the non-tax qualified plans with a medical necessity trigger (CNA's PS1 is an example of a good policy) : : don't charge you much more for that (in the CNA example I think it's about 5% more). So, obviously, the insurers don't really expect to be burned much by the trigger. : : That proves my point, the trigger doesn't, in the real world, add many claims. Meaning it is not worth going with a NTQ policy IF you think it would trigger easier. The only real benefit if the NTQ is the lack of a 90 day cert of care ... but then it would be on short-term care policy, not long-term.

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