Long-Term Care Glossary

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Accelerated Death Benefit: A feature of a life insurance policy that lets you use some fo the policy's death benefit prior to death.
Activities of Daily Living (ADLs): Everyday functions and activities individuals usually do without help. ADL functions include bathing, continence, dressing, eating, toileting, and transferring.
Adult Day Care: Care during the day for adults, usually at senior or community centers.
Alzheimer's Disease: A progressive, degenerative form of dementia that causes severe intellectual deterioration.
Assisted Living Facility: A residential living arrangement that provides individualized personal care and health services for people who require assistance with activites of daily living.
Benefit Triggers: Term used by insurance companies to describe when to pay benefits
Care Management Services: A service in which a professional, typically a nurse or social worker, may arrange, monitor, or coordinate long-term care services
Cash Surrender Value: The amount of money you may be entitled to receive from the insurance company when you terminate a life insurance or annuity policy. The amount of cash value will be determined as stated in the policy
Chronic Illness: An illness with one or more of the following characteristics: permanency, residual disability, requires rehabilitation training, or requires a long period of supervision, observation, or care
Cognitive Impairment: A defenciency in a person's short-or-long term memory; orientation as to person, place and time; deductive or abstract reasoning; or judgment as it relates to safety awareness.
Community-Based Services: Services designed to help older people stay independent and in their own homes
Custodial Care (Personal Care): Care to help individuals meet personal needs such as bathing, dressing, and eating. Care may be provided by someone without professional training
Daily Benefit: The amount of insurance benefit in dollars a person chooses to buy for long-term care expenses.
Dementia: Deterioration of intellectual faculties due to a disorder of the brain.
Elimination Period: A type of deductible; the length of time the individual must pay for covered services before the insurance company will begin to make payments. The longer the elimination period in a policy, the lower the premium.
Guaranteed Renewable: When a policy cannot be cancelled and must be renewed when it expires unless benefits have been exhausted. The company cannot change the coverage or refuse to renew the coverage for other than nonpayment of premiums (including health conditions and/or marital or employment status).
Health Insurance Portability and Accountability Act (HIPAA): Federal health insurance legislation passed in 1996 that allows, under specified condition, long-term care insurance policies to be qualified for certain tax benefits.
Home Health Care: Services for occupational, physical, respiratory, speech therapy, or nursing care. Also included are medical, social worker, home health aide, and homemaker services.
Homemaker Services: Household services done by someone other than yourself because you're unable to do them.
Inflation Protection: A policy option that provides for increases in benefit levels to help pay for expected increases in the costs of long-term care services
Lapse: Termination of a policy when a renewal premium is not paid
Medicaid: A joint federal/state program that pays for health care services for those with low incomes or very high medical bills relative to income and assets.
Medicare: The federal program providing hospital and medical insurance to people aged 65 or older and to certain ill or disabled persons. Benefits for nursing home and home health services are limited.
Medical Supplement Insurance: A private insurance policy that covers many of the gaps in Medicare coverage.
National Association of Insurance Commissioners (NAIC): Membership organization of insurance commissioners. One of its goals is to promote uniformity of state regulation and legislation related to insurance.
Noncancellable Policies: Insurance contract that cannot be cancelled and the rates cannot be changed by the insurance company.
Nonforfeiture Benefits: A guarantee that companies must offer you which says that you will receive some of the benefits you paid for even if you later cancel or lose coverage. In most cases, the longer you pay premiums on the policy, the larger the nonforfeiture benefit will be. Generally, a nonforfeiture benefit will either pay up to the total amount of all premiums paid or 30 times the daily nursing home benefit at the time the policy lapsed, whichever is greater. The benefit options for long term care policies are generally limited to reduced paid-up, extended term or shortened benefit period or other benefit options approved by the Secretary of the U.S. Department of Health and Human Services, if the policy is intended to be tax qualified.
Pre-existing Condition: Illnesses or disability for which you were treated or advised within a time period before applying for a life or health insurance policy.
Reduced Paid-Up Benefit: A type of nonforfeiture benefit that a policy holder may purchase which provides that, if you lapse your policy after a specified number of years, the policy will continue with reduced daily benefit amounts. (Some insurers apply this nonforfeiture benefit only to nursing home benefits).
Rescind: When the insurance company voids (cancels) a policy.
Respite Care: Offers a few hours to several days of help to relieve family caregivers.
Rider: Addition to an insurance policy that changes the provisions of the policy, usually available at an additional cost.
Shortened Benefit Period: A type of nonforfeiture benefit that, if purchased, will provide that if you lapse your policy after a specified number of years, the policy will continue to cover the same benefits (amounts and frequency in effect at the time of lapse) that would have been covered under your policy until the nonforfeiture benefit amount is exhausted.
Spend Down: A requirement that an individual use up most of his or her income and assets to meet Medicaid eligibility requirements.
State Health Insurance Assistance Program: Federally funded program to train volunteers to provide counseling on the insurance needs of senior citizens.
Substantial Assistance: Means hands-on or stand-by help required to do ADLs.
Substantial Supervision: The presence of a person directing and watching over another who has a cognitive impairment.
Tax-Qualified Long-Term Care Insurance Policy: A policy that conforms to certain standards in federal law and offers certain federal tax advantages
Term Life Insurance: Covers a person for a period of one or more years. It pays a death benefit only if you die during that term. It generally does not build a cash value.
Third-Party Notice: A benefit that lets you name someone who the insurance company would notify if your coverage is about to end due to lack of premium payment. This can be a relative, friend, or professional such as a lawyer or accountant, for example.
Underwriting: The process of examining, accepting, or rejecting insurance risks, and classifying those selected, in order to charge the proper premium for each.
Waiver of Premium: A provision in an insurance policy that relieves the insured of paying the premiums while receiving benefits.
Whole Life Insurance: Policies that build a cash value and cover a person for as long as he or she lives if premiums continue to be paid.