Almost all studies reviewed cite policy cost as the main reason why people do not buy coverage for LTC needs. Table 5, which tracks buyers over the last decade, summarizes the important reasons given for not purchasing a policy (HIAA, 1990, 1995, 2000).
|TABLE 5: Reasons Not to Buy LTC Coverage|
|Very important reason not to buy||2000||1995||1990|
|Costs too much||54%||57%||58%|
|Waiting for better policies||28%||32%||41%|
|Too many conditions to be met before receiving benefits||25%||30%||N.A.|
|Confusion about which policy is the right one||18%||28%||54%|
|The spouse could not get a coverage||17%||11%||20%|
|Don't believe insurers will pay as promised||15%||21%||36%|
|Do not mind using own income to pay for LTC||11%||15%||22%|
|Do not think will ever need services||10%||9%||15%|
|Believe Medicaid will pay||9%||12%||20%|
|Can rely on family to help with LTC||6%||8%||9%|
Waiting for a better policy and having to meet too many conditions are also primary obstacles for buying insurance. However as a non-purchase reason, the latter has diminished over time. This suggests that either potential buyers today are spending more time researching the market and are therefore happier with their choice, or that insurance companies are offering better policies than they once did, or that both of these conditions are true. Confusion about which policy is the right one and believing that Medicaid will pay for LTC have also diminished in importance over time. It seems that the individuals examining the insurance have become more educated about the different policies on the market and are more aware about who pays for LTC (in the absence of private insurance).
The percentage of people who say they do not believe the insurer will pay as promised has also decreased over the last decade, this indicating that there is an increase in consumer confidence in the product. This may be a function of enhanced consumer protection standards and more uniform coverage brought about by passage of the Health Insurance Portability and Accountability Act.