Guide
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Here are the 25 terms worth knowing when you're considering a hybrid long-term care insurance policy. For more definitions, the federal government keeps a long-term care glossary.
General Terms
- Hybrid long-term care insurance: a combined policy that offers both long-term care benefits and a life insurance or annuity component, providing coverage for care expenses plus a death benefit or cash value.
- Long-term care (LTC): a range of services and support for personal care needs, including help with activities of daily living such as bathing, dressing and eating.
- Activities of daily living (ADLs): the basic personal tasks of everyday living: bathing, dressing, toileting, transferring, continence and eating.
Policy Specifics
- Benefit period: how long the policy will pay benefits once a claim begins.
- Elimination period: the waiting period before benefits begin, often 30 to 90 days after the policyholder qualifies for long-term care. See elimination periods for more.
- Inflation protection: an optional feature that increases the benefit amount each year to keep pace with rising care costs. See inflation protection for more.
- Daily/monthly benefit: the most a policy will pay for covered long-term care services per day or per month.
- Maximum lifetime benefit: the total a policy will pay for covered long-term care services over the policyholder's lifetime.
General Lingo
- Premium: what the policyholder pays to keep a hybrid long-term care insurance policy in force, often paid annually, semi-annually or monthly.
- Underwriting: the process of evaluating an applicant's health, medical history and other factors to decide eligibility and premium rates.
- Guaranteed renewable: a feature that keeps the insurance company from canceling the policy as long as premiums are paid on time.
- Nonforfeiture benefit: an optional feature that lets a policyholder keep some benefits if they cancel the policy or let it lapse.
- Cash surrender value: the cash a policyholder can receive if they cancel a policy with a cash value component, such as a hybrid policy with a life insurance or annuity component.
- Return of premium: an optional feature that refunds part of the premiums paid if the policyholder cancels the policy or passes away without using the long-term care benefits.
- Waiver of premium: a provision that suspends premium payments while the policyholder is receiving long-term care benefits.
Common Settings Covered in LTC Policies
- Respite care: temporary care that gives a primary caregiver a break from caregiving.
- Home health care: medical or non-medical care provided in the policyholder's home.
- Adult day care: community-based daytime programs offering social and health services for adults who need supervised care.
- Assisted living facility (ALF): a residential community that helps with activities of daily living and provides basic health care services.
- Nursing home: a facility providing round-the-clock skilled nursing care and rehabilitation for people with chronic illnesses or disabilities.
Typical Additional Benefits
- Hospice care: supportive care for people with a terminal illness and a life expectancy of six months or less.
- Care coordination: help from a care coordinator or case manager so the policyholder and their family can navigate the long-term care system and reach the right services.
- Facility-only policy: a long-term care policy that covers care only in a licensed facility, such as a nursing home or assisted living facility. These are exceedingly rare today.
- Shared care: an optional feature that lets a couple share their combined long-term care benefits, for more flexibility and coverage options.
- Tax-qualified policy: a long-term care policy that follows specific IRS rules, so the policyholder can potentially deduct part of the premium as a medical expense on their income tax return and receive tax-free benefits. The IRS explains the premium deduction in Publication 502.
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