Glossary of Terms (continued)

Pre-existing Condition - A disability or illness an individual has been treated for within a certain time period before applyiing  for a insurance policy.

Reduced Pay-up Benefits - A nonforfeiture option that reduces the daily benefit but keeps the full benefit period on a policy until death. The exact amount of the reduction depends on how much premium has been paid on the policy.

Rescind - Where the insurance company cancels a policy.

Respite Care - Usually provided by a third party. Care that relieves family caregivers for a few hours or days to allow a break from daily caregiving responsiblities.

Rest Home - A general term for a facility that cares for elderly people. It is often not covered under a long term care insurance policy.

Rider - An addition to an insurance poilcy that changes the provisions of the policy.

Shortened Benefit Period - A nonforfeiture option that reduces the benfit period but keeps the daily maximums applicable until death. The exact amount of the reduction depends on how much premium has been paid on the policy.

Skilled Care - Daily nursing and rehabilitative care that can only be performed by, or under the supervision of skilled medical personnel. It must be ordered by a physician and must follow a plan of care. It is usually needed 24 hours a day. Skilled care is usually performed in a nursing home but may be received elsewhere.

Spend Down - A Medicaid requirement that an individual must use up most of their income and assets to meet eligibility requirements.

Stand-by Assistance - Where a caregiver stays close to an individual to provide physical assistance if necessary.

State Health Insurance Program - Federally funded program to train volunteers to provide counselling on the insurance needs of senior citizens.
List of State Health Insurance Programs.

Substantial Assistance - Hands-on or standby help needed to do ADLs.

Substantial Supervision - An individual watching over another who has a cognitive impairment.

Tax Qualified Long-Term Care insurance Policy - A policy that conforms to standards in federal law and offers certain federal tax advantages.

Third Party Notice - A benefit that allows the policy holder to name someone that the insurance company can notify if the premium has not been paid and coverage was about to end. This can be a friend, relative, lawyer, accountant for example.

Transferring - The act of moving into and out of a wheelchair, bed or chair.

Triggers (Benefit Triggers) - Used by insurance companies to describe when to pay benefits.

Underwriting - The process of examining, accepting, or rejecting insurance risks, and classifying those selected to charge the proper premium for each.

Waiver of Premium - A provision in an insurance policy that relieves the insured of paying the premiums while receiving benefits.

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