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chapter 5 (long term care insurance (LTC) (categories of long term care…
chapter 5
long term care insurance (LTC)
to qualify for benefits, must not be able to do two ADLs
benefit period if length of time claims will be paid
usually is for care that is over 90 days
typically provides a minimum benefit period of 1 year
typically doesn't cover acute conditions
most times, a preexisting condition is one that is there within 6 months of starting the policy
benefits are usually excluded or limited for limited behavior like alcoholism or drug addiction
categories of long term care
skilled nursing care
is continuous, around-the-clock care by licensed professionals under the supervision of a physician
intermediate nursing care
provided by nurses under supervision of a physician on an intermittent basis
custodial care
provides assistance in meeting ADLs
taxation
qualified are treated the same as accident and health insurance
amounts received for the plan are excluded from income because they are not taxable
there are limits on the amounts and they increase because of inflation
qualified premiums paid by employer are usually not counted as gross income for employee
long term care partnership programs
allows those who purchase qualified long term care policy or coverage to protect a portion of assets that they would usually need to spend down prior to qualifying for medicare coverage
medicare supplement policies
cover medical care costs not covered by medicare part a and b
designed for people on medicare
no age restriction
sometimes provide preventative medical care benefits like annual physical exams
hospice care is included in most
part b expenses not covered by medicare must be covered by them
must include 30 day free look
core benefits
cover coinsurance on hospital costs
covers part of
medicare part A and B hospice coinsurance or copayment
first 3 pints of blood received as hospital inpatient
home and community-based services
adult day care
for people who require adl assistance when primary caregivers are gone
respite care
designed to provide a rest for a family caregiver
continuing care
provides benefits for elders who live in a continuing care retirement community
assisted living
needs supervision but not fulltime care
medicare select
you choose providers that belong to a network
aka medicare advantage/medicare part C
does not cover long term care
you stick with providers, you pay a lower premium
medicare part D
a prescription drug plan