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Long Term Care (LTC)
What is Long Term Care?
A system of health and custodial services to support people who
have chronic or long-term physical or mental conditions.
LTC is not just for the older generations. Government statistics show
that 40 percent of people receiving health care at home are working-age
adults or children.
Eligibility
Regular full-time and part-time faculty and staff who are budgeted to work at least 1,000 hours per year. Retirees, spouses, domestic partners (as defined by the WFU policy), parents, parents-in-law, grandparents and grandparents-in-law. You must enroll within 31 days of your hire date.
Covered Services - Coverage for Nursing Home Care, Alternate Care Facilities, Home Health Care, Adult Day Care and Informal Care
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Benefit Dollar Amounts
Daily Maximum Benefit (DMB)
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Nursing Home (100%)
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Alternate Care Facility (75%)
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Home Health Care/Adult Day Care (50%)
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Informal Care (25%)
Note: Calendar year maximum of 30 x informal care DMB. Informal care can be delivered by unskilled person, including family members who reside in the insured's home.
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Lifetime Maximum Benefit (LMB) 5 years (Nursing Home DMB x number of days in 5 years)
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Other Plan Design Features
Qualification Period - 90 days
Inflation Adjustments - you may purchase additional amounts without providing evidence of insurability, every three years
Bed Reservation Benefit - continues to pay nursing home for 14 days if hospitalized
Return of Premium at Death - provides a refund of a portion of premiums paid according to the following scale, less benefits paid
Waiver of Premium
Portability
Premium Rate Guarantee - rates guaranteed for 5 years from original effective date
Biweekly Long Term Care Rates
Monthly Long Term Care Rates
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