Long-Term Care Features: Glossary of Terms
As you research and learn more about this unique coverage solution, you may come across a number of terms and ideas which are unfamiliar. We have put together this term glossary as a resource to help you along the way, in hopes that it will enhance your visit to Long-Term-Care.org
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Activities of Daily Living: Basic self care like bathing, grooming, eating, toileting and ambulation Often, the number of ADLs you are able to perform independently helps determine when an insurance company will pay benefits to you.
Acute Care: Acute care is care for an illness or injury that is temporary and curable.
Adult Day Services: Daytime supervision that includes social and recreational activities, health and rehabilitation services. These generally operate during normal business hours and allow caregivers to work outside the home and care for loved ones at home in the evenings.
Alzheimer's Disease: A progressive, degenerative dementia.
Alzheimer's Units: Sections of assisted living or skilled nursing facilities specifically providing care and services for Alzheimer's disease.
Assisted Living Facility: A non-medical residential facility for seniors, offering room, board, recreational services and other services.
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Care Coordinator: A health care professional who manages and arranges for long term care services.
Care Management: The assessment, coordination and monitoring of medical ad social services an individual requiring LTC needs, generally supervised by a nurse or social worker, to assess, coordinate and monitor the overall medical, personal, and social services needed by an individual requiring long term care.
Caregiver, Primary: The main person who oversees or provides care for an incapacitated person. This is most often a loved one or custodial aide.
Caregiver(s), Secondary: Relatives and/or other aides who assist the primary caregiver in caring for an incapacitated person.
Caregiver(s), Custodial: The aides who care for the incapacitated person by performing the tasks that can safely be performed by a non-medical person.
Caregiver(s), Skilled: The physicians, RNs and other medical professionals who care for the incapacitated person.
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Caregivers, Formal: The people who assist the incapacitated person in a facility.
Caregivers, Informal: Family, friends, neighbors and other volunteers who assist the incapacitated person.
Chronic Care: Care for an illness continuing over a protracted period of time or recurring frequently.
Cognitive Impairment: A deficiency in a person’s short or long term memory; awareness of people, places and of time; safety awareness; problems with deductive or abstract reasoning
Continuing Care Retirement Community: A residential community that provides a wide range of services, from independent homes and apartments, to assisted living facilities and skilled nursing care
Custodial Care: Services that can be given safely and reasonably by a trained or capable non-medical person, designed mainly to assist with ADLs, such as bathing, eating, dressing, and other routine activities.
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Dementia: Deterioration of mental faculties due to a disorder of the brain.
Elimination Period: A type of deductible, this is the amount of time the insured pays out of pocket for long term care before the insurance policy makes payments.
Elder Abuse: When caregivers knowingly and intentionally neglect, harm and imperil an impaired person.
Home Health Care: In-home medical care, therapy, nursing care, social work and other home-oriented services.
Home Modification: Physical adaptations that often need to be made to a home to enable a person to perform usual tasks of daily living.
Home Telehealth: A new type of in-home care where skilled medical professionals interact with the patient daily, monitor vital signs, receive medical alerts and perform other aspects of care from a remote location.
Hospice Care: Care for the dying, at home or in a facility. Support for family members is also available.
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Inflation Protection: An optional policy feature of some policies that increases benefit levels over time in anticipation of the inflation of the cost of long term care.
Intermediate Nursing Care: Daily nursing care ordered by a physician and supervised by a RN. This is for individuals who do not need 24 hour care but do need daily nursing and personal care. It is generally administered for a longer period of time than skilled care.
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Lapse: The termination of a policy when the renewal premium is unpaid.
Means Test: The way income and assets are measured to determine eligibility for Medicaid and other government programs.
Medicaid: A federal, state and locally supported medical and health welfare program for eligible poverty level individuals.
Medicare: A federal program that provides hospital and medical insurance to the disabled, ill or persons aged 65 or older. Medicare offers limited coverage for nursing home and home health care services are limited.
Medigap Insurance: Private insurance that supplements Medicare benefits, covering co-payments and deductibles for medical and hospital costs. Coverage for personal and custodial care is not provided by Medigap.
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Nonforfeiture Benefit: An optional benefit that of a reduced, paid personal benefit account.
Nursing Home: A licensed facility that provides living assistance and a planned, ongoing medical treatment program. This can include 24-hour skilled nursing care, personal care, and custodial care. Medicaid only covers Medicaid-certified skilled nursing homes. The overwhelming majority of nursing homes do not meet their reqirements.
Organic Mental Illness: see, Alzheimer's Disease
Ongoing Care: Care for a severely injured, ill or otherwise incapacitated individual who either needs more than a few months to recover, or is not expected to recover.
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Permanent Impairment: A physical or mental disability that will not improve.
Personal Care Assistance: Assistance walking, bathing, grooming, dressing, eating and other routine daily tasks.
Plan of Care: A physicians’ written plan of type and frequency of care developed with other health care professionals tailored to suite the unique needs of the recipient of care.
Pre-existing Condition: An illness or disability that you contracted before the time of policy applications.
Preferred Health Discount: A discount on policy premiums given to applicants in good health.
Respite Care: Long term care services provided at home or in a facility to temporarily relieve the family or friends who normally provide care for an impaired individual.
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Skilled Nursing Care: Nursing and rehabilitative care that is performed by skilled medical personnel, usually available 24-hours-a-day and ordered by a physician under a treatment plan. It can be either in a facility setting or at home. (Note: Medicare and Medicaid both have their own definitions of "skilled nursing care" which do not necessarily match those in long term care insurance policies.)
Skilled Nursing Facility: A state-licensed institutional setting that provides skilled care by skilled medical personnel. This care is available 24-hours-a-day and is ordered by a physician under a treatment plan.
Spend-down: Using up all or most of your income or assets to meet Medicaid eligibility requirements. Even when this is done, what Medicaid will cover is changing, so research as many options as you can.
Survivorship Benefit Option: The waiver of premiums due on a surviving partner's policy when both partners have had policies for a certain period of time. Other criteria must also be met.
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Temporary Care: Care for a severely injured, ill or otherwise incapacitated person who is expected to recover within a few months time at most.
Third-party Notification: Someone who the insurance company can notify if your coverage is about to lapse due to a failure to pay premium if you are incapacitated. This can be a relative, friend or a lawyer or accountant.
Unintentional Lapse Protection: A provision that reinstates coverage that has lapsed, so long as back premiums are paid, when the lapse is due to cognitive or other impairment.
Waiver of Premium: Prevents the insured from having to pay premiums while receiving benefits.
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Long-Term-Care.org is not a long term care insurance broker or carrier, and we cannot issue insurance policies. We are not associated with the companies profiled on Long-Term-Care.org and we make no representation, express or implied, that you will receive a quote from a specific company profiled herein. This site provides free information on insurance providers and coverage options. Products and policies may not be available in all states, and product and policy information is subject to change without notice. Please direct all insurance questions to your insurance company or broker.
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