LTC terminology surfaced on demand throughout the app via dotted-underlined terms.
A deductible-like waiting period measured in days of care that must be satisfied before the policy begins paying benefits. Care during this period is paid out-of-pocket. How days are counted, and when they begin accruing, is defined by the policy.
Conditions that must be met to begin receiving benefits, as defined by the policy. The inability to perform two or more activities of daily living without substantial assistance, or a severe cognitive impairment, is classified as a benefit trigger when certified by a licensed health care practitioner.
Six core self-care tasks used to determine benefit eligibility: bathing, dressing, toileting, transferring, continence, and eating.
The maximum amount the policy will reimburse per day of qualifying care, across home care, assisted living, or nursing facility settings.
The maximum amount the policy will reimburse per month of qualifying care. Under a monthly maximum, spending may vary day to day within the month's limit.
The total dollars the policy will pay over the insured's lifetime, calculated from the daily/monthly benefit and the benefit period. Elections that reduce benefits reduce this pool; whether an election can be reversed depends on its terms.
The stated length of time benefits would last at the maximum rate (for example, 3 years, 5 years, or lifetime). Actual duration depends on the rate of spend against the benefit pool.
Rider that grows the daily/monthly benefit over time (commonly 3% or 5%, simple or compound) to offset rising cost of care.
An option offered in connection with a rate increase that reduces future benefits (for example, a reduced BIO rider, a shorter benefit period, or a lower daily benefit) in exchange for a premium lower than the full increase.
State Partnership Program designation that allows policyholders to protect a corresponding amount of assets from Medicaid spend-down. May be lost if benefits are reduced below the state's qualifying thresholds.
Provision that suspends premium payments while the insured is receiving qualifying benefits. Terms vary by policy form.
An increase to in-force policy premiums, filed with and permitted by state insurance departments. Generally driven by experience across a group of policies: how many people keep their policies, how many use their benefits, how long claims last, and interest rates.
Option to stop paying premiums and retain a reduced, paid-up benefit based on premiums paid, as determined by the contract. Structures vary (NFO rider, Contingent Nonforfeiture, Optional Limited Benefit), and prior claims may reduce the amount. A future qualifying claim draws on that fixed pool.
The modeled ratio of total benefits paid to total premiums paid over the illustration period, under the selected scenario's assumptions. An illustration metric, not a guarantee and not a basis for recommending an option.
Continuing Care Retirement Community. A community offering a spectrum of housing and care (independent living, assisted living, skilled nursing) on one campus under one contract.
Modeled sequence and duration of care settings used to project total cost (e.g. months of home care, then assisted living, then nursing facility).
Age at which modeled qualifying care begins. Drives the duration of inflation growth applied to the daily benefit before benefits begin.