Long Term Care Insurance Policy Schedule of Benefits
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UPDATED: Jul 14, 2023
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We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.
Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.
UPDATED: Jul 14, 2023
It’s all about you. We want to help you make the right legal decisions.
We strive to help you make confident insurance and legal decisions. Finding trusted and reliable insurance quotes and legal advice should be easy. This doesn’t influence our content. Our opinions are our own.
COMMENT: The following is a typical Schedule of Benefits page for a long term care insurance policy. |
Sample Life Insurance Company
P.O. Box 123456
Anytown, NY 22212-7890
Toll Free Number: 1-800-987-6543
SCHEDULE OF BENEFITS
INSURED
Robert W. Brown
CURRENT COVERAGE: EFFECTIVE DATE – June 11, 2007
(REPLACES ANY PREVIOUS SCHEDULE OF BENEFITS)
Original Coverage Effective Date Original Issue Age Policy Number Plan Number Elimination Period TOTAL LIFETIME BENEFIT (does not reflect claims paid or payable) |
June 11, 2007 46 06758-493210 6758 100 days $500,000 |
COMMENT: The Elimination Period is the total number of days after the Original Coverage Effective Date during which the Insured must be Chronically Ill and receiving Primary Services before certain Benefits become payable. No Elimination Period is required in order to receive Benefits for Respite Care, Needs Assessment or Informal Caregiver Training. The Insured only has to satisfy the Elimination Period once during the lifetime of the Policy. |
PRIMARY SERVICES Nursing Home Assisted Living Facility Respite Care – 21 days/Policy Year
Home Care and Community Care ADDITIONAL SERVICES |
MAX DAILY BENEFIT AMOUNT $120.00 $120.00 $100
$100
MAXIMUM BENEFIT AMOUNT |
Health Rating: Preferred
Discounts: Spousal Discount
Spousal Discount applies as long as associated policies remain in force.
COMMENT: The Spousal Discount applies when, and only when each spouse has an individual long term care insurance policy with Sample Life. |
PREMIUM SCHEDULE
Gross Annual Premium (includes Riders and Health Rating; does not include Discounts, if any)
COVERAGE Base Coverage |
$1,277.86
ANNUAL PREMIUM* $ 365.04 |
* If You pay premiums more frequently than annually, an additional charge has been included.
Case Studies: Long-Term Care Insurance Policy Benefits
Case Study 1: Robert W. Brown
Robert W. Brown, the insured individual, had a long-term care insurance policy with Sample Life Insurance Company. His coverage, effective since June 11, 2007, included primary services such as nursing home care, assisted living facility care, and respite care for up to 21 days per policy year.
Additionally, the policy covered home care and community care services. The maximum daily benefit amount for nursing home or facility care and at-home or assisted living facility care was $120. The policy also provided additional services like needs assessment and informal caregiver training. With a preferred health rating, Robert enjoyed discounts, including a spousal discount.
Case Study 2: Jane and Michael Thompson
Jane and Michael Thompson, a married couple, both had long-term care insurance policies. Jane’s policy covered nursing home and assisted living facility care, respite care, and home care services. Michael’s policy offered similar coverage.
Their policies had a base coverage amount with a 5% automatic compound inflation protection rider, contingent benefits upon lapse rider, and paid-up premiums rider. The Thompsons enjoyed discounts due to their preferred health ratings. The spousal discount applied as long as both policies remained in force.
Case Study 3: Susan Reynolds
Susan Reynolds, a single individual, had a long-term care insurance policy with comprehensive coverage. Her policy included nursing home care, assisted living facility care, and home care services. Susan opted for a policy with a base coverage amount and additional riders.
The policy had a gross annual premium, including health rating and applicable discounts. She paid her premiums monthly, with an additional charge for more frequent payments.
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Mary Martin
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Mary Martin has been a legal writer and editor for over 20 years, responsible for ensuring that content is straightforward, correct, and helpful for the consumer. In addition, she worked on writing monthly newsletter columns for media, lawyers, and consumers. Ms. Martin also has experience with internal staff and HR operations. Mary was employed for almost 30 years by the nationwide legal publi...
Published Legal Expert
Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.