|
Frequently Used Long Term
Care Terms
To help in
understanding long-term care and long-term care insurance,
below are general explanations of some frequently used terms. 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).
Adult
Day Care: Care provided during the
day for adults, usually outside of the home in a group setting.
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.
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.
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.
Cognitive Impairment: A deficiency in a
person's memory; orientation as to person, place or time; deductive
or abstract reasoning; or judgment as it relates to safety
awareness.
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.
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.
Exclusions: The types of expenses
that are not covered by a policy.
Functional Incapacity: A person's inability to
perform a number of those Activities of Daily Living specified in a
Long-Term Care insurance policy.
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
the carrier on a class basis.
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.
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.
Home
Health Care Provider: A person or organization
licensed or certified to provide Home Health Care services.
Homemaker Services: Includes domestic, laundry and
cleaning services; food shopping and errands; meal preparation and
cleanup and transportation assistance to and from medical
appointments.
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.
Intermediate Care: Occasional nursing and
rehabilitative care performed by, or under the supervision of,
skilled medical personnel.
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.
Married Couple or Married Person Discount: A reduction in the
insurance policy premium when both spouses have Long-Term Care
coverage.
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.
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.
Respite Care: Professional care
provided on a short-term basis for the purpose of temporarily
relieving unpaid caregivers, such as family members or friends.
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.
Skilled Nursing Care: Daily nursing and
rehabilitative care that can be performed only by, or under the
supervision of, skilled medical personnel.
Tax-Qualified
Long-Term Care Insurance Policy: A policy that conforms to
certain standards in federal law offering federal income tax
advantages.
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.
Waiver
of Premium: An insurance policy
feature that suspends the premium payment requirement while policy
benefits are being paid.
Back to Top |
