Glossary of Nursing Care Insurance Terms

Activities of daily Living (ADL’s)Routines that relate to a persons ability to live independently. These include bathing, eating, dressing, continence, toileting, transferring.

Adult Day CareLicensed day care program providing care, supervision, and assistance for an individual’s activities of daily living.

Accelerated Payment OptionAbility to pay premiums for a set amount of years and the coverage will automatically be renewed for the rest of your life without any further premium payments.

Assisted Living FacilityIndependent living facilities that provide on-site services, supervision, and assistance with an individuals activities of daily living.

Benefit PeriodThe amount of time benefits will be paid under a LTCI policy.

Benefit Eligibility TriggersDefined requirements that must be satisfied for the LTCI policy to pay claims. Most likely it is the inability to perform a set number of ADL’s and/or suffer from a cognitive impairment i.e. Alzheimer’s.

Care CoordinatorLicensed care manager that asses your condition, creates a plan of care with your physician, coordinates and monitors ongoing care. Person is usually a Registered Nurse.

Cognitive ImpairmentMental deterioration due to Alzheimer’s or other forms of Dementia.

Comprehensive PolicyThis policy pays benefits for all levels of care. i.e. Nursing Home, Assisted Living Facilities, and Home Health Care.

Daily BenefitThe maximum daily benefit paid by the policy towards your care.

Elimination PeriodThe number of days you must wait when you become eligible for benefits before the policy pays the daily benefit.

Home Health CareAssistance with activities of daily living in your residence.

Inflation ProtectionOption to increase original daily benefit by 5% per year credited on a simple or compound basis.

Long Term Care InsuranceA specific type of insurance policy designed to offer financial support in paying for necessary long term care service in a variety of settings.

MedicaidJoint federal and state welfare program administered by the state to provide payment for health care services for those meeting minimum asset and income requirements.

MedicareFederal program that provides hospital and medical expense benefits for individuals over age 65 or those meeting specific disability standards.

Non-forfeiture BenefitsOption on a long term care insurance policy that allows the insured to continue receiving long term care coverage if the insured stops paying the premium.

Nursing Home Only PolicyType of policy that pays for care in a nursing home or similar facility.

Pre-existing conditionMedical condition which you sought treatment for in the previous six months before you purchase the policy.

Skilled CareProfessional type of nursing assistance performed by trained medical personnel under the supervision of a physician of a physician or other qualified medical personnel.

Respite CareTemporary relief for caregivers.

Waiver of Premium Provision that allows you to stop paying premium after a specified time while you are receiving benefits.