| Accelerated Premium Options |
You may limit your premium payments to ten years or to age 65 with this option. You will pay a higher
premium during the limited payment period to cover the cost of coverage after your premiums stop.
Top |
|
| Activities of Daily Living (ADLs) |
Everyday functions and activities that you perform without help from others. ADL's are Bathing, Continence,
Dressing, Eating, Transferring, Toileting (See specific activity for definition). Insurance companies may vary slightly on the definitions.
Top |
|
| Acute Care |
The care you receive directly relating to a short-term medical condition. Acute care services are covered
by health insurance, Medicare and Medigap policies.
Top |
|
| Assisted Living Facility |
If you do not need constant care, the more home-like atmosphere of an assisted living facility is an
excellent and usually less expensive alternative to a nursing home.
Top
|
|
| Attending Physician Statement |
A statement from your personal physician or another medical specialist concerning your health history
and current health status.
Top |
|
| Bathing |
Washing oneself by sponge bath, taking a bath in the tub or taking a shower, or the task of getting
into or out of a tub or shower.
Top |
|
| Bed Reservation Provision |
If your stay in a nursing or assisted living facility is interrupted because you are hospitalized and
you are receiving benefits under your policy, the policy will continue to pay you benefits if a charge is made to reserve your accommodations.
These benefits will count towards the maximum lifetime benefit of the policy.
Top
|
|
| Care Referral Assistance |
Assistance with finding the best type of long-term care providers for you or your family.
Top |
|
| Chronic Care |
The care that is required for long-term physical illnesses, a disability, or a cognitive impairment.
Savings, assets, Medicaid (after spending down), and long-term care insurance pay chronic care costs.
Top |
|
| Cognitive Impairment |
A condition that results in the deterioration or loss in your intellectual capacity. Diagnosis is made
by clinical evidence and standardized tests that measure your impairment.
Top
|
|
| Compound Inflation Protection |
For an additional initial premium, your daily/monthly benefit(s) will increase by an amount equal to
5% of the daily/monthly benefit amount in effect during the prior policy year. The annual increase in automatic and will occur on each policy
anniversay. In addition, your lifetime benefit will increase proportionately. (See Simple Inflation for comparison)
Top |
|
| Continence |
The ability to voluntarily control bowel and bladder function, or, in the event of incontinence, the
ability to maintain a reasonable level of personal hygiene.
Top |
|
| Custodial Care |
Personal care that is not covered by medical insurance or Medicare to help you meet personal needs
such as bathing, and dressing as a result of a disability, illness, or simply advancing age.
Top |
|
| Daily Benefit Amount |
The maximum dollar amount that will be paid to you daily when recieving benefits.
Top |
|
| Dressing |
The ability to put on or take off all items of clothing and any braces, fasteners or artificial limbs.
Top |
|
| Eating |
The ability to feed yourself by getting food into the body from a receptacle like a plate, cup or table
or by feeding tube or intravenously.
Top |
|
| Elimination Period |
This is the deductible for long-term care insurance policies. It's the period during which you pay
for your care on your own before the insurance benefits begin. This is also called the waiting period.
Top |
|
| Facility Care Only |
Coverage restricted to care in a facility such as a nursing facility, an assisted living facility,
a hospice facility, a rehabilitation facility, an Alzheimer's facility or a residential care facility.
Top |
|
| Fixed Benefit Policy |
A policy that does not include a Compound or Simple Inflation Protection feature. Daily or monthly
benefits and maximum lifetime benefits remain fixed at the original amount.
Top
|
|
| Guaranteed Renewable |
Your policy is Guaranteed for life. The only way the policy can be canceled is if you fail to pay the
premiums that are due. (The insurer reserves a limited right to increase premiums by class or state).
Top |
|
| Home Care |
Home care benefits may include home care aides and homemaker aides who work through a licensed home
health care agency. They can provide assistance with personal care needs, such as bathing and dressing, and with other needs like housekeeping,
shopping and meal preparation. Care may also be provided by a nurse, a therapist, or other service provided by and through the licensed agency.
Top |
|
| Hospice |
A facility that provides a formal program of care for the terminally ill whose life expectancy is less
than 6 months provided on an inpatient basis as directed by a physician. It must be licensed or registered in the state of operation.
Top |
|
| Indemnity Policy |
A policy where full benefits are paid for each day "covered services" are received, regardless of the
cost of the services. For example, if you have $100 available for home care benefits in a day and you pay $35 for care through a home care agency,
the policy will pay you the full $100 benefit. The balance may be used at your discretion. (See Reimbursement Policy for comparison)
Top |
|
| Long-Term Care |
Care provided for chronic conditions that include long-term physical illness, a disability or a cognitive
impairment such as Alzheimer's disease or senile dementia.
Top |
|
| Medicaid |
A government program to pay for acute medical care and long-term care for the indigent. You must meet
state and federal eligibility requirements to receive benefits that first require a spend-down of assets and income.
Top |
|
| Medicare |
The federal program providing hospital and medical benefits to people age 65 or older (a person with
a disability may receive benefits before age 65). Benefits for nursing home and home health services are limited.
Top |
|
| Medigap |
Privately paid insurance that supplements coverage under Medicare.
Top |
|
| Monthly Benefit Amount |
The maximum dollar amount that will be paid to you monthly when receiving benefits.
Top |
|
| Non-Forfeiture Benefit |
Your coverage is Guaranteed Renewable and can be canceled only if you stop paying premiums. You may
also choose an optional feature called the Non-Forfeiture benefit. With this option, offered at an additional premium, you may stop paying premiums
after three years. The policy will remain in effect with a credit equal to 100% of the sum of all premiums paid but not less than 30 times the
daily nursing home benefit at the time of lapse after the rider has been in force no longer than three years.
Top |
|
| Nursing Home |
A Nursing Facility completely separate from a hospital that provides skilled or intermediate nursing
care and custodial care and operates under state licensing law and any other laws that apply.
Top |
|
| Preferred Risk Discount |
A reduction of your insurance premium because you fall within specific health criteria established
by the insurance company.
Top |
|
| Partner |
An individual:
* who is currently married, OR
* is in a committed relationship
with an individual with whom he/she has been living together for a period of at least 5 years OR
* who has been living together with
a Family Member of the same generation for a period of at least 5 years.
Top
|
|
| Reimbursement Policy |
A policy which reimburses you up to the daily benefit amount for the cost of "covered services"
received. For example, if you have $100 available for home care in a day and you pay $35 for care through a home health care agency, the policy
will pay you $35 as a reimbursement for costs incurred. (See Indemnity Policy for comparison).
Top |
|
| Respite Care |
Replacement care while your primary caregiver takes a short-term rest, business trip or vacation. The
policy's elimination/waiting period does not have to be satisfied to receive this benefit.
Top |
|
| Simple Inflation Protection |
For an additional initial premium, your daily/monthly benefit(s) will increase by an amount equal to
5% of the daily/monthly benefit amount in effect in the original policy year. The annual increase in automatic and will occur on each policy
anniversay. In addition, your lifetime benefit will increase proportionately.(See Compound Inflation Protection for comparison). (Note: In Texas,
an applicant must reject Compound Inflation before electing Simple Inflation)
Top
|
|
| Skilled Nursing Services |
Care prescribed by your Physician and provided by a skilled professional such as a Registered or Licensed
Practical Nurse or provided under the supervision of a Registered or Licensed Practical Nurse.
Top |
|
| Spend Down |
The Medicaid requirement that you use up most of your income and assets before Medicaid will
pay for care.
Top |
|
| Stand-by Assistance |
The presence, but not the hands on assistance, of another human being to ensure that all or part of
an Activity of Daily Living is completed or to ensure your safety. It may also mean that you need verbal cuing in order to complete an Activity
of Daily Living.
Top |
|
| Toileting |
Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.
Top |
|
| Transferring |
The ability to move into or out of a bed, chair or wheelchair.
Top |
|
| Underwriting |
The process an insurance company uses to examine, accept, or reject insurance risks, and to classify
those selected for coverage.
Top |
|
| Waiting Period |
This is the deductible for long-term care insurance policies. It's the period during which you pay
for your care on your own before the insurance benefits begin. This is also called the elimination period.
Top |
|
| Waiver of Premium |
A standard policy feature that eliminates your premium payments while you are collecting benefits under
your policy.
Top |