facility? yes/no yes/no If not, what doesn’t it pay for? 7. Does the policy provide home care benefits for: Skilled nursing care? Personal care given by home health aides? yes/no yes/no Homemaker services? yes/no yes/no Other ________________________? yes/no yes/no yes/no yes/no 8. Does the policy pay for care received in: Adult day care centers? Assisted living facilities? yes/no yes/no yes/no yes/no Unable to do activities of daily living (ADLs) • 9. How much will the policy pay each day for: Cognitive impairment • Nursing home care? Doctor certification of medical necessity • Assisted living facility care? Prior hospital stay • Home care? 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? 10. Are there limits on the number of days or visits • Waiting period—Covered service days or calendar each year for which benefits will be paid? If yes, what • days? are the limits for: Nursing home care? Assisted living facility care? 15. Are the waiting periods for home care consecutive? Home care? (days or visits) Policy 1 Policy 2 11. How long is the benefit period? yes/no yes/no 12. Are there limits on how much the policy will pay days days during your lifetime? If yes, what are the limits for: Nursing home care? Assisted living facility care? Home care? (days or visits) Total lifetime limit yrs yrs yes/no yes/no How does the policy decide when you’re eligible for benefits? (Refer to page 18) 13. benefit triggers does the policy use to decide if you’re eligible for (It may have more than benefits? one.)
facility? If not, what doesn’t it pay for? 7. Does the policy provide home care benefits for: Skilled nursing care? Personal care given by home health aides? Homemaker services? Other ________________________? 8. Does the policy pay for care received in: Adult day care centers? Assisted living facilities? yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no yes/no 9. How much will the policy pay each day for: Nursing home care? Assisted living facility care? Home care? $ $ $ $ $ $ 10. Are there limits on the number of days or visits each year for which benefits will be paid? If yes, what are the limits for: Nursing home care? Assisted living facility care? Home care? (days or visits) 11. How long is the benefit period? 12. Are there limits on how much the policy will pay during your lifetime? If yes, what are the limits for: Nursing home care? Assisted living facility care? Home care? (days or visits) Total lifetime limit How does the policy decide when you’re eligible for benefits? (Refer to page 18) 13. 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
cmte_b_ltc_shop_wg_180416_guide_redline_180402.docx