What you need to know

IntroductionOverviewThe ProblemThe SolutionTax SavingsPremium CostsQuestions & AnswersGlossary
Accelerated Premium OptionsDressingMonthly Benefit Amount
Activities of Daily Living (ADLs)EatingNon-Forfeiture Benefit
Acute CareElimination PeriodNursing Home
Assisted Living FacilityFacility Care OnlyPartner
Attending Physician StatementFixed Benefit PolicyPreferred Risk Discount
Automatic Inflation Coverage (CPI)Future Purchase Rider (FPO)Reimbursement Policy
BathingGuaranteed Increase Option (GIO)Respite Care
Bed Reservation ProvisionGuaranteed Purchase Inflation Option (GPO)Simple Inflation Protection
Care Referral AssistanceGuaranteed RenewableSkilled Nursing Services
Chronic CareHome CareSpend Down
Cognitive ImpairmentHospiceStand-by Assistance
Compound Inflation ProtectionIndemnity PolicyToileting
Consumer Price Index (CPI)Long-Term CareTransferring
ContinenceMedicaidUnderwriting
Custodial CareMedicareWaiting Period
Daily Benefit AmountMedigapWaiver of Premium
Accelerated Premium Options
  • You may limit your premium payments to ten years or to age 65 with this option. You will pay a higher premium during the limited payment period to cover the cost of coverage after your premiums stop.
  • Top
Activities of Daily Living (ADLs)
Acute Care
  • The care you receive directly relating to a short-term medical condition. Acute care services are covered by health insurance, Medicare and Medigap policies.
  • Top
Assisted Living Facility
  • If you do not need constant care, the more home-like atmosphere of an assisted living facility is an excellent and usually less expensive alternative to a nursing home.
  • Top
Attending Physician Statement
  • A statement from your personal physician or another medical specialist concerning your health history and current health status.
  • Top
Automatic Inflation Coverage (CPI)
  • Every year, on the policy anniversary the Benefit Amount and remaining Total Pool of Benefits will be automatically adjusted according to the change in the Consumer Price Index (CPI). The rate used to determine the actual increase in benefits is the annual change in the CPI over the one-year period ending three months prior to the policy anniversary. This percentage is then applied to the latest benefits and becomes effective as of the policy anniversary.
  • Top
Bathing
  • Washing oneself by sponge bath, taking a bath in the tub or taking a shower, or the task of getting into or out of a tub or shower.
  • Top
Bed Reservation Provision
  • If your stay in a nursing or assisted living facility is interrupted because you are hospitalized and you are receiving benefits under your policy, the policy will continue to pay you benefits if a charge is made to reserve your accommodations. These benefits will count towards the maximum lifetime benefit of the policy.
  • Top
Care Referral Assistance
  • Assistance with finding the best type of long-term care providers for you or your family.
  • Top
Chronic Care
Cognitive Impairment
  • A condition that results in the deterioration or loss in your intellectual capacity. Diagnosis is made by clinical evidence and standardized tests that measure your impairment.
  • Top
Compound Inflation Protection
  • For an additional initial premium, your daily/monthly benefit(s) will increase by an amount equal to 5% of the daily/monthly benefit amount in effect during the prior policy year. The annual increase in automatic and will occur on each policy anniversay. In addition, your lifetime benefit will increase proportionately. (See Simple Inflation for comparison)
  • Top
Consumer Price Index (CPI)
  • The Consumer Price Index which has been on the rise for over 50 years tracks the price of a basket of goods and services and includes such items as medical care and housing. The CPI is often used to provide cost-of-living wage adjustments to millions of American workers. The CPI has a strong association with housing and labor costs, two of the key drivers of long-term care costs today and in the future. U.S. Social Security benefits and many U.S. pension plan benefits are also linked to the CPI, the most widely used measure of inflation.
  • Top
Continence
  • The ability to voluntarily control bowel and bladder function, or, in the event of incontinence, the ability to maintain a reasonable level of personal hygiene.
  • Top
Custodial Care
  • Personal care that is not covered by medical insurance or Medicare to help you meet personal needs such as bathing, and dressing as a result of a disability, illness, or simply advancing age.
  • Top
Daily Benefit Amount
  • The maximum dollar amount that will be paid to you daily when recieving benefits.

  • Top
Dressing
  • The ability to put on or take off all items of clothing and any braces, fasteners or artificial limbs.
  • Top
Eating
  • The ability to feed yourself by getting food into the body from a receptacle like a plate, cup or table or by feeding tube or intravenously.
  • Top
Elimination Period
  • This is the deductible for long-term care insurance policies. It's the period during which you pay for your care on your own before the insurance benefits begin. This is also called the waiting period.
  • Top
Facility Care Only
  • Coverage restricted to care in a facility such as a nursing facility, an assisted living facility, a hospice facility, a rehabilitation facility, an Alzheimer's facility or a residential care facility.
  • Top
Fixed Benefit Policy
Future Purchase Rider (FPO)
  • If this option is selected, you will automatically receive a 5% increase in your Daily Benefit Amount and the balance of your Total Lifetime Benefit each year, unless you decline the adjustment in writing. Your premiums will be adjusted to reflect the increased coverage, and will be based on your attained age as well as the premium rates in effect, at the time each increase takes effect. Increases will be made automatically on the policy anniversary date, until you have declined such increases in writing for two consecutive years.
  • Top
Guaranteed Increase Option (GIO)
  • If you select Automatic Inflation Coverage, you will also receive a Guaranteed Increase Option (GIO). This feature gives the opportunity every three years to increase your existing Daily/Monthly Benefit amount and Total Pool of Money by 10% - with no health questions or exams. If you wish to increase benefits for any reason, you have the option to do so, regardless of how many times you decline the offer.
  • Top
Guaranteed Purchase Inflation Option (GPO)
  • This inflation option provides the option to increase benefits (daily or monthly) and the Total Pool of Money by 5% compounded annually without additional health questions or exams. This option will be offered every three years. When selected, the Total Pool of Money will be increased by the same percentage as the Benefit Amount and rounded to the nearest dollar.
  • Top
Guaranteed Renewable
  • Your policy is Guaranteed for life. The only way the policy can be canceled is if you fail to pay the premiums that are due. (The insurer reserves a limited right to increase premiums by class or state).
  • Top
Home Care
  • Home care benefits may include home care aides and homemaker aides who work through a licensed home health care agency. They can provide assistance with personal care needs, such as bathing and dressing, and with other needs like housekeeping, shopping and meal preparation. Care may also be provided by a nurse, a therapist, or other service provided by and through the licensed agency.
  • Top
Hospice
  • A facility that provides a formal program of care for the terminally ill whose life expectancy is less than 6 months provided on an inpatient basis as directed by a physician. It must be licensed or registered in the state of operation.
  • Top
Indemnity Policy
  • A policy where full benefits are paid for each day "covered services" are received, regardless of the cost of the services. For example, if you have $100 available for home care benefits in a day and you pay $35 for care through a home care agency, the policy will pay you the full $100 benefit. The balance may be used at your discretion. (See Reimbursement Policy for comparison)
  • Top
Long-Term Care
  • Care provided for chronic conditions that include long-term physical illness, a disability or a cognitive impairment such as Alzheimer's disease or senile dementia.
  • Top
Medicaid
  • A government program to pay for acute medical care and long-term care for the indigent. You must meet state and federal eligibility requirements to receive benefits that first require a spend-down of assets and income.
  • Top
Medicare
  • The federal program providing hospital and medical benefits to people age 65 or older (a person with a disability may receive benefits before age 65). Benefits for nursing home and home health services are limited.
  • Top
Medigap
  • Privately paid insurance that supplements coverage under Medicare.
  • Top
Monthly Benefit Amount
  • The maximum dollar amount that will be paid to you monthly when receiving benefits.
  • Top
Non-Forfeiture Benefit
  • Your coverage is Guaranteed Renewable and can be canceled only if you s paying premiums. You may also choose an optional feature called the Non-Forfeiture benefit. With this option, offered at an additional premium, you may stop paying premiums after three years. The policy will remain in effect with a credit equal to 100% of the sum of all premiums paid but not less than 30 times the daily nursing home benefit at the time of lapse after the rider has been in force no longer than three years.
  • Top
Nursing Home
  • A Nursing Facility completely separate from a hospital that provides skilled or intermediate nursing care and custodial care and operates under state licensing law and any other laws that apply.
  • Top
Partner
  • An individual:
    * who is currently married, OR
    * is in a committed relationship with an individual with whom he/she has been living together for a period of at least 5 years OR
    * who has been living together with a Family Member of the same generation for a period of at least 5 years.
  • Top
Preferred Risk Discount
  • A reduction of your insurance premium because you fall within specific health criteria established by the insurance company.
  • Top
Reimbursement Policy
  • A policy which reimburses you up to the daily benefit amount for the cost of "covered services" received. For example, if you have $100 available for home care in a day and you pay $35 for care through a home health care agency, the policy will pay you $35 as a reimbursement for costs incurred. (See Indemnity Policy for comparison).
  • Top
Respite Care
  • Replacement care while your primary caregiver takes a short-term rest, business trip or vacation. The policy's elimination/waiting period does not have to be satisfied to receive this benefit.
  • Top
Simple Inflation Protection
  • For an additional initial premium, your daily/monthly benefit(s) will increase by an amount equal to 5% of the daily/monthly benefit amount in effect in the original policy year. The annual increase in automatic and will occur on each policy anniversay. In addition, your lifetime benefit will increase proportionately.(See Compound Inflation Protection for comparison). (Note: In Texas, an applicant must reject Compound Inflation before electing Simple Inflation)
  • Top
Skilled Nursing Services
  • Care prescribed by your Physician and provided by a skilled professional such as a Registered or Licensed Practical Nurse or provided under the supervision of a Registered or Licensed Practical Nurse.
  • Top
Spend Down
  • The Medicaid requirement that you use up most of your income and assets before Medicaid will pay for care.
  • Top
Stand-by Assistance
  • The presence, but not the hands on assistance, of another human being to ensure that all or part of an Activity of Daily Living is completed or to ensure your safety. It may also mean that you need verbal cuing in order to complete an Activity of Daily Living.
  • Top
Toileting
  • Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene.
  • Top
Transferring
  • The ability to move into or out of a bed, chair or wheelchair.
  • Top
Underwriting
  • The process an insurance company uses to examine, accept, or reject insurance risks, and to classify those selected for coverage.
  • Top
Waiting Period
  • This is the deductible for long-term care insurance policies. It's the period during which you pay for your care on your own before the insurance benefits begin. This is also called the elimination period.
  • Top
Waiver of Premium
  • A standard policy feature that eliminates your premium payments while you are collecting benefits under your policy.
  • Top
(888) 310-8633
Office hours: 9 a.m. to 5 p.m. Eastern Time, Monday through Friday
The Todd Benefits Group Inc.
P.O. Box 230
Saco, Maine 04072

Processing...

Messages