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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.
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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.
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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.
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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.
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Attending Physician Statement |
A statement from you personal
physician or another medical specialist concerning your
health history and current health status.
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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.
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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.
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Care Referral Assistance |
Assistance with finding the best
type of long-term care providers for you or your family.
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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.
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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.
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Compound Inflation Protection |
A feature which automatically
increase your monthly and maximum lifetime benefits
annually by 5% of the previous year's benefits with no
increase in premium. (See Simple Inflation Protection for
comparison)
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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.
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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.
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Daily Benefit Amount |
The maximum dollar amount that will
be paid to you daily when receiving benefits.
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Dressing |
The ability to put on or take off
all items of clothing and any braces, fasteners or
artificial limbs.
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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.
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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.
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Facility Care Only |
Coverage for nursing homes and
assisted living facilities only.
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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.
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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.
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Home Care |
Home
care benefits 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.
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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.
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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)
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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.
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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.
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Medicare |
The federal program providing
hospital and medical benefits to people age 65 or older.
Benefits for nursing home and home health services are
limited.
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Medigap |
Privately paid insurance that
supplements coverage under Medicare.
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Monthly Benefit Amount |
The maximum dollar amount that will
be paid to you monthly when receiving benefits.
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Non-Forfeiture Benefit |
An optional policy feature available
for an additional premium. If you choose this option, pay
premiums for at least three years, and then stop paying
premiums, the policy remains in effect with a reduced
maximum lifetime benefit. The reduced maximum lifetime
benefit is equal to the greater of your monthly benefit or
the total premiums you have paid.
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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.
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Preferred Risk Discount |
A reduction of your insurance
premium because you fall within specific health criteria
established by the insurance company.
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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).
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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.
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Simple Inflation Protection |
This feature will automatically
increase your monthly and maximum lifetime benefits
annually by 5% of the original policy benefit with no
increase in premiums. (See Compound Inflation Protection
for comparison)
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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.
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Spend Down |
The Medicaid requirement that you
use up most of your income and assets before Medicaid
will pay for care.
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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.
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Toileting |
The ability to get to and from and
on and off the toilet, to maintain a reasonable level of
personal hygiene, and to care for clothing.
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Transferring |
The ability to move into or out of a
bed, chair or wheelchair.
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Underwriting |
The process an insurance company
uses to examine, accept, or reject insurance risks, and to
classify those selected for coverage.
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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.
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Waiver of Premium |
A standard policy feature that
eliminates your premium payments while you are collecting
benefits under your policy.
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