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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

  1. 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.
  2. 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.
  3. Activities of daily living (ADLs): the basic personal tasks of everyday living: bathing, dressing, toileting, transferring, continence and eating.

Policy Specifics

  1. Benefit period: how long the policy will pay benefits once a claim begins.
  2. 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.
  3. Inflation protection: an optional feature that increases the benefit amount each year to keep pace with rising care costs. See inflation protection for more.
  4. Daily/monthly benefit: the most a policy will pay for covered long-term care services per day or per month.
  5. Maximum lifetime benefit: the total a policy will pay for covered long-term care services over the policyholder's lifetime.

General Lingo

  1. Premium: what the policyholder pays to keep a hybrid long-term care insurance policy in force, often paid annually, semi-annually or monthly.
  2. Underwriting: the process of evaluating an applicant's health, medical history and other factors to decide eligibility and premium rates.
  3. Guaranteed renewable: a feature that keeps the insurance company from canceling the policy as long as premiums are paid on time.
  4. Nonforfeiture benefit: an optional feature that lets a policyholder keep some benefits if they cancel the policy or let it lapse.
  5. 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.
  6. 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.
  7. Waiver of premium: a provision that suspends premium payments while the policyholder is receiving long-term care benefits.

Common Settings Covered in LTC Policies

  1. Respite care: temporary care that gives a primary caregiver a break from caregiving.
  2. Home health care: medical or non-medical care provided in the policyholder's home.
  3. Adult day care: community-based daytime programs offering social and health services for adults who need supervised care.
  4. Assisted living facility (ALF): a residential community that helps with activities of daily living and provides basic health care services.
  5. Nursing home: a facility providing round-the-clock skilled nursing care and rehabilitation for people with chronic illnesses or disabilities.

Typical Additional Benefits

  1. Hospice care: supportive care for people with a terminal illness and a life expectancy of six months or less.
  2. 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.
  3. 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.
  4. Shared care: an optional feature that lets a couple share their combined long-term care benefits, for more flexibility and coverage options.
  5. 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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