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Long Term Care Insurance - Qualifying for Benefits

How do you qualify for benefits under Long Term Care Insurance?
Benefits are payable under the policy when your physician diagnoses that you are unable to care for yourself due to cognitive impairment (problems with attention, memory, or other  loss of intellectual capacity that requires supervision to help protect the person impaired) or a condition that results in your inability to perform two or more activities of Daily Living. A Daily Benefit is paid directly to you once the waiting period (if any) has been satisfied.

What are activities of Daily Living?
Activities of Daily Living are used to measure your level of independence in terms of caring for yourself. These include bathing, dressing, eating, maintaining continence, toileting and transferring – as defined by the following guidelines:

  • Bathing – the ability to take a bath or shower or otherwise maintain adequate personal cleanliness, with or without the aid of special equipment.
  • Dressing – the ability to dress and undress, including putting on and taking off any medically necessary surgical appliance usually worn.
  • Eating – the ability to eat and drink, after food or drink has been prepared and made available.
  • Maintain continence – the ability to voluntarily control bowel and bladder functions, with or without the use of catheters, incontinence pads or other artificial aids.
  • Toileting – the ability to get to and from the toilet, get on and off the toilet and  maintain an adequate level of personal hygiene.
  • Transferring – the ability to move without assistance in and out of a chair or wheelchair or bed, with or without the aid of equipment.
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