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In this chapter, you learned about the important terms, definitions, and policy components of long-term care insurance policies. Let's look over some of the key points:
| Topic | Key Points |
|---|---|
| Policies | Available as individual policies, group policies, or as riders to life insurance policies. Coverage for individuals who require living assistance at home or in a nursing home facility. Must provide at least 12 months of consecutive coverage in a setting other than an acute care unit of a hospital. Guaranteed renewable, but insurers may increase premiums. |
| Levels of Care | Skilled care — daily nursing and rehabilitative care provided by medical personnel. Intermediate care — occasional nursing or rehabilitative care provided for stable conditions that require daily medical assistance on a less frequent basis than skilled nursing care. Custodial care — care for a person's activities of daily living provided in an institutional setting or in the patient's home. Home health care — provided by registered nurses, licensed practical nurses, licensed vocational nurses, or community-based organizations like hospice in one's home. Residential care — provided while the insured resides in a retirement community. Hospice — short term for terminally ill people with a life expectancy of 6 months or less. Adult day care — provides for functionally impaired adults on less than a 24-hour basis. Respite care — provides relief to the family caregiver; adult day care centers may also provide this type of relief. Assisted living — provides help with nonmedical daily activities. |
| Coverage and Benefits | 12 consecutive months. Elimination period between 0–365 days. Longer benefit periods result in higher premium. Trigger: inability to perform 2 ADLs. |
| Required Provisions | Must be guaranteed renewable. Must offer inflation protection. Must cover Alzheimer's disease. Disclosure requirements — outline of coverage and policy summary. |