Depending on the specific long term care policy, the contract may be triggered if 2 out of the 6 ADLs, activities of daily living, can’t be accomplished: Eating, bathing, dressing, toileting, transferring and continence. There may be other assisted living options that can also be triggered; the language per policy is an important issue to know how your benefits are engaged.
There are triggers that indicate when Long Term Care benefits can be used. If non tax qualified policies, the triggers are when skilled or rehabilitative care is needed for medical necessity, when there is an inability to two or more activities of daily living, or when there is cognitive impairment.
With tax qualified plans, the triggers for benefits are unable to do or more ADL's without substantial assistance, cognitive impairment requiring substantial supervision, and the condition must be expect to last for at least 90 days. Medical necessity is not a trigger in this type of plan.
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With tax qualified plans, the triggers for benefits are unable to do or more ADL's without substantial assistance, cognitive impairment requiring substantial supervision, and the condition must be expect to last for at least 90 days. Medical necessity is not a trigger in this type of plan.