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Glossary of long term insurance terms


Activities of Daily Living (ADLs): daily activities that people do independently, such as dressing, bathing, eating, moving about, and so forth.

Adult day care: services that provide temporary daytime care in a nonresidential program for frail or isolated individuals who do not live in a nursing home.

Assisted living facility: a facility that provides home services to residents in a comfortable environment.

Chronically ill: As defined under a qualified plan, chronically ill means that either you have a cognitive impairment requiring substantial supervision to protect your health and safety or you cannot do without substantial help from another person. Substantial help can mean that you need assistance to perform two of five (or six) ADLs for at least 90 days. Ambulation is often the ADL that is excluded. The states may determine which five (or all six) ADLs that must be used.

Custodial care: care that can be performed by persons with no medical training.

Free-look: a period of time in which you may look over the features of your policy and, if dissatisfied, return the policy for a full refund of the premium.

Intermediate nursing care: care for conditions that require periodic medical supervision, as ordered by a doctor.

Outline of coverage: a short description of your policy’s features and benefits.

Partnership programs: allow policyholders to go on Medicaid with a higher level of assets and/or income than would otherwise be allowed. These programs vary significantly from state to state.

Premium refund upon death: this provision refunds to your beneficiaries any excess of premiums that you paid over benefits that you may have received. In some policies, the provision is limited to deaths prior to a specified age, such as 65.

Skilled nursing care: care furnished on a physician’s order that requires professional personnel’s supervision or skill

Third-party notification: This is a benefit that allows a friend, relative or other person to be notified if the policy is about to lapse for non-payment of premium. This is particularly beneficial when the policyholder suffers from a cognitive impairment.

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