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Frequently Used Long Term Care Terms
To help you understand long term care and long term care insurance, we have
provided below a general explanation of some frequently used terms. Note that
the exact definitions of these terms can vary from company to company, from
state to state, and from policy form to policy form, even between forms of the
same company. Always consult the actual policy for the meaning of the terms
applicable to your situation.
Activities of Daily Living (ADLs)
Everyday functions and activities people usually are able to do without help.
Includes bathing, continence, dressing, eating, toileting and transferring
(moving in or out of a bed, chair or wheelchair).
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Adult Day Care
Care provided during the day for adults, usually outside of the home in a group setting.
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Assisted Living Facility
A residential living arrangement that can provide individualized care and
health services for residents who need assistance with Activities of Daily
Living. May also be called Custodial Care, Domiciliary Care, Intermediate
Care, Personal Care, Residential Health Care, Sheltered Care or Supported
Care Facilities.
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At-Home Care
Services and supplies provided when living in one's home, such as Home
Health Care, Adult Day Care, Hospice Care and Respite Care.
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Caregiver Training
An instructional program for the training of an informal caregiver
(Husband, wife, adult child or other relative or friend) whose caregiving
will allow a patient to remain at home instead of entering a long term care
facility. This type of training is typically provided by home health care
agencies or other Qualified Home Health Care Providers, nursing homes,
hospitals or other health care agencies or professionals.
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Cognitive Impairment
A deficiency in a person's memory; orientation as to person, place or time;
deductive or abstract reasoning; or judgement as it relates to safety awareness.
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Custodial Care (Also called Personal Care)
Care to help people perform Activities of Daily Living that can be provided
by someone without professional medical training.
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Elimination Period
The length of time for which a long term care insurance policy will not
pay benefits for services covered by a policy. The longer the elimination
period, the lower the premium.
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Exclusions
The types of expenses that are not covered by a policy.
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Functional Incapacity
A person's inability to perform a number of those Activities of Daily
Living specified in a Long Term Care insurance policy.
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Guaranteed Renewable
Means that an insurance policy cannot be cancelled, terminated, changed
or reduced if all renewal premiums are paid on time, except rates may be
revised by Bankers on a class basis.
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Home Health Aide
A licensed or certified home care worker, other than a doctor, nurse or
therapist, who assists patients in performing the Activities of Daily Living.
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Home Health Care
A variety of services and supplies provided in the home, such as visits by
nurses, Home Health Aides and physical, occupational, speech and inhalation
therapists, Homemaker Services, drugs, medicines, medical supplies and lab
services as well as durable portable therapeutic equipment.
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Home Health Care Provider
A person or organization licensed or certified to provide Home Health Care services.
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Homemaker Services
Includes domestic, laundry and cleaning services; food shopping and errands;
meal preparation and cleanup and transportation assistance to and from medical
appointments.
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Hospice Care
Care provided for pain and symptom management associated with a terminal
illness and any related conditions. Normally provided by an agency that
specializes in providing pain relief, symptom management and support services
to dying persons and their families.
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Intermediate Care
Occasional nursing and rehabilitative care performed by, or under the
supervision of, skilled medical personnel.
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Inflation Protection
An insurance policy option that calls for regular increases in benefit
limits to help offset the future increases in long term care expenses.
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Married Couple or Married Person Discount
A reduction in the insurance policy premium when both spouses have Long Term Care coverage.
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Medically Necessary Care
Services and supplies which are provided in accordance with accepted
medical practice; and as are required by the patient's condition. It doesn't
include care that exceeds the scope, duration or intensity needed to provide
safe, adequate and appropriate care; nor does it include treatment provided
solely for someone's convenience.
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Paid-up Survivorship
An insurance policy option that will waive the surviving spouse's future
premiums upon the death of the other spouse. A minimum duration of continuous
coverage under the policy by both spouses may be required in order for the
benefit to be applicable.
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Respite Care
Professional care provided on a short-term basis for the purpose of temporarily
relieving unpaid caregivers, such as family members or friends.
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Restoration of Benefits
An insurance policy feature that will bring a policy's maximum benefit
amounts back to the level that would apply if policy benefits hadn't been paid.
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Skilled Nursing Care
Daily nursing and rehabilitative care that can be performed only by, or
under the supervision of, skilled medical personnel.
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Tax-Qualified Long Term Care Insurance Policy
A policy that conforms to certain standards in federal law offering federal
income tax advantages.
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Third Party Notice (Authorized Designee)
An insurance policy feature that lets the policyholder name someone who the
insurance company would notify if the policy is about to lapse because the
premium hasn't been paid on time.
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Waiver of Premium
An insurance policy feature that suspends the premium payment requirement
while policy benefits are being paid.
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