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Long Term Care Terms for Insurance Agents and Professionals

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Here are a few common terms found in long term care insurance policies that long term care insurance agents and long term care insurance brokers need to understand and be able to interpret to your clients.

Accredited services and facilities:
Services and facilities that are licensed by the state's department of health.

Activities of Daily Living (ADLs):
The inablitiy to independently perform a specific number of certain tasks is used to qualify for start of insurance payment. These tasks include:

  • Eating
  • Toileting
  • Dressing
  • Bathing
  • Transferring
  • Continence

A long term care insurance policy can explain that benefits trigger when the insured person needs "substantial assistance" (which can be further defined as "hands on" or "stand by" help) with 2 or more "ADLS".

Acute vs. Chronic Care
Acute care is refers to care provided after a health crisis such as a stroke, heart attack, or surgery. Chronic care refers to care provided due to the normal course of aging and illnesses associated with aging.

Respite care:
Having a health professional come into the home to give the family member caregiver a break or rest.

Community Based Care
Can include Adult Day Care, outpatient rehab and therapies, Meals on Wheels, etc. Community based services are designed to help seniors stay independent and in their own homes may be reimbursable.

Custodial Care
Care provided by an untrained person to assistance with bathing, dressing & eating.

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