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Long-Term-Care Glossary

Long-term-care:

Long-term medical, physical and lifestyle assistance, often for someone with a prolonged physical illness, cognitive impairment (such as Alzheimer’s disease) or a disability. Long-term-care also includes personal care, assistance with one or more activities of daily living (ADLs), such as bathing, eating, dressing or transportation.

Medicare:

The largest health insurance program in the U.S., created and administered by the federal government. Medicare is available to U.S. citizens 65 years of age or older, and certain qualifying individuals with disabilities under 65. Medicare is made up of three parts: hospital insurance (Part A), medical insurance (Part B) and prescription drug benefits (Part D). Medicare does not cover nursing-home and other long-term-care needs.

Medicare Supplemental Insurance:

Private insurance that helps pay for the some of the gaps in Medicare coverage (such as hospital deductibles and excess physician charges). Medicare supplemental policies do not cover long-term-care costs.

Medicaid:

A joint program between the federal and state governments for low-income U.S. citizens. Medicaid covers basic healthcare and long-term-care for those eligible, including nursing-home care and home and community-based services care, after they’ve exhausted their assets.

Long-term-care insurance:

Type of insurance that specifically pays for long-term-care. It was introduced in the 1980s as nursing-home insurance but has since expanded to cover long-term home and community care.

Elimination period:

The length of time an individual must pay out of pocket for care before the insurance company provides coverage benefits. The shorter the elimination period, the higher the policy premium.

Benefit triggers:

Term used by insurance companies to describe the criteria and methods they use to determine when you are eligible to receive benefits.

Activities of daily living (ADLs):

Everyday functions and activities individuals do themselves, such as bathing, dressing, eating, toileting and transferring. Most insurance companies kick in long-term-care benefits when the individual needs assistance with at least two ADLs.

Community-Based Services:

Services designed to help individuals remain independent and within their homes.

 

 

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