yes/no yes/no How does the policy decide when you’re eligible for yes/no yes/no (Refer to page 18) benefits? yes/no yes/no yes/no yes/no 13. Which benefit triggers does the policy use to decide if you’re eligible for benefits? (It may have more than one.) Unable to do activities of daily living (ADLs) • Cognitive impairment • Doctor certification of medical necessity • days days Prior hospital stay • days days Bathing is one of the ADLs • days days service days service days When do benefits start? (Refer to page 19) 14. How long is the waiting period before benefits begin for: yes/no yes/no Nursing home care? • Assisted living facility care? • Home health care? • Waiting period—Covered service days or calendar • 16. How long will it be before you’re covered for a days? (usually 6 months) pre-existing condition? 17. How far back will the company look at your 15. Are the waiting periods for home care consecutive? medical history to determine a pre-existing condition? (usually 6 months) Policy 1 Policy 2 Does the policy have inflation protection? to page 20) yes/no yes/no days days 18. Are the benefits adjusted for inflation? 19. Are you allowed to buy more coverage? If yes, When can you buy more coverage? • How much can you buy? • yrs yrs When can you no longer buy more coverage? • 20. Do the benefits increase automatically? If yes, yes/no yes/no What is the rate of increase? • Is it a simple or compound increase? • When do automatic increases stop? • 21. If you buy inflation coverage, what daily benefit would you receive for Nursing home care: 5 years from now? • 10 years from now? • Assisted living facility care: 5 years from now? • 10 years from now? • Home health care: 5 from now? • 10 years from now? • yes/no yes/no
How does the policy decide when you’re eligible for benefits? (Refer to page 18) 13. Which benefit triggers does the policy use to decide if you’re eligible for benefits? (It may have more than one.) • Unable to do activities of daily living (ADLs) • Cognitive impairment • Doctor certification of medical necessity • Prior hospital stay • Bathing is one of the ADLs When do benefits start? (Refer to page 19) 14. How long is the waiting period before benefits begin for: • Nursing home care? • Assisted living facility care? • Home health care? • Waiting period—Covered service days or calendar days? 15. Are the waiting periods for home care consecutive? Policy 1 Policy 2 yes/no yes/no days days yrs yrs yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no days days days days days days service days service days yes/no yes/no 16. How long will it be before you’re covered for a pre-existing condition? (usually 6 months) 17. How far back will the company look at your medical history to determine a pre-existing condition? (usually 6 months) Does the policy have inflation protection? to page 20) 18. Are the benefits adjusted for inflation? 19. Are you allowed to buy more coverage? If yes, • When can you buy more coverage? • How much can you buy? • When can you no longer buy more coverage? 20. Do the benefits increase automatically? If yes, • What is the rate of increase? • Is it a simple or compound increase? • When do automatic increases stop? 21. If you buy inflation coverage, what daily benefit would you receive for Nursing home care: • 5 years from now? • 10 years from now? Assisted living facility care: • 5 years from now? • 10 years from now? Home health care: • 5 from now? • 10 years from now?
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