Monthly benefits reimburse long term care expenses. There are caps on both the monthly benefits and lifetime benefits.
There may be different caps based on the levels of care
Home health care
Adult day care
Assisted living
Nursing home
Eligibility Triggers
Older policies may have paid for services in a nursing home only and there may have been restrictions about being ‘medically necessary’. There may be a requirement that there be a prior hospitalization.
Current plans require that the certified as being chronically ill. To qualify as ‘chronically ill’ the insured will need either:
to need assistance with at least two of the ‘Activities of Daily Living’ (eating, bathing, dressing, toileting, transferring, continence), or
require substantial supervision due to severe cognitive impairment
