How Do I Qualify for Benefits? WI

Most long-term care policies will pay a preset amount of an insured’s long-term care costs when the insured requires substantial supervision to protect himself/herself from threats to health and safety due to severe cognitive impairment and/or the insured is unable to perform without substantial assistance from another individual at least two out of six of the activities of daily living (ADLs), although benefit triggers can vary by company and policy. The activities of daily living are: transferring (moving from a chair to another room without assistance, for example), bathing, toileting, dressing, eating and continence. Once a long-term care insurance policy’s benefits are triggered, the policy will continue to pay a preset maximum daily benefit for a pre-set time period, until the insured no longer needs long-term care, or until the insured has exhausted his/her benefits.

Before collecting any policy benefits an insured must also fulfill the waiting period/ elimination period. The “waiting period”/”elimination period” works like a deductible. Waiting periods vary in length, and most long-term care insurance companies offer numerous options, but 60 to 90 day waiting periods are quite common. During the waiting period, an insured is liable for all costs related to their long-term care services. Once the insured has met the requirements for a claim and fulfilled the waiting period, the long-term care insurance provider will begin paying benefits.

Click here for important policy form information.
Click here for important legal information.

Please note: This resource center is for informational purposes only. You should contact your professional advisors for legal, tax or accounting advice.

256952HO

Rate This
Rating: 0/0 (0 votes cast)

  Be the first to Comment