How Much Coverage Will I Have?


Remember, you control the amount of coverage you have by the benefit choices you make.

Before you choose your Daily Benefit, please determine the following:

  • Check the "Cost of Care" in your area.

  • Do You Want To Fully or Partially Insure for Long Term Care Services? Can you afford to pay for a portion of your care at the time of claim?

How Do I Choose My Lifetime Benefit?:

Maximum Benefit Limit: Most policies limit the total benefit they will pay over the life of the policy, but there are still a few offering a "lifetime benefit period". The Lifetime Benefit Period means if you go on claim, you will receive the Daily Benefit chosen as long as you qualify for benefits. You will have an endless pool of money. These are very expensive contracts and are becoming harder and harder to find.

At the time of application, you choose a benefit period (one, two, three, or more years, or even lifetime), the choices available depend on product chosen. Then you choose a daily benefit ($80 - $400), which also depends on product chosen.
To Calculate:

Benefit Period   x   Daily Benefit   =   "Total Lifetime Benefit"
"Maximum Lifetime Benefit"
"Total Plan Benefit"
"Total Pool of Money"

Example:

3 Years Benefit Period (3 x 365 days = 1095 days):   1095 days x $150.00 Daily Benefit

=   $164,250... Your "Total Lifetime Benefit"

Daily or Monthly Benefit Limit: Policies normally pay benefits by the day or month. Once you choose your daily benefit amount, you may have the option of choosing whether you want it paid out on a "daily" or "monthly" calculation. Some daily benefit plans offer monthly options, others do not. Other plans offer only monthly payout without a choice of a daily payout.

Daily Benefit Limit: If the Daily Benefit chosen is $150.00 per day, you can only be reimbursed up to $150.00 for any one day even if you spent more than $150.00. Example: During the month, you spend $200 (10 days), $300 (4 days), $100 (10 days) and no money some days, your total expenses for the month will be $4,200. You received care 24 days of care during this month. See calculation

$2,100.00

($150 DB x 14 days of care for the days $150 or more was spent.)

 + $1,000.00

($100 x 10 days)

$3,100.00

(Reimbursement of Daily Expenses)

Monthly Benefit Limit means if you choose a Daily Benefit of $150.00 with a Monthly Benefit Calculation... you can be reimbursed up to $4500.00 per month. Example: Using the same scenario, during the month you spend $200 (10 days), $300 (4 days), $100 (10 days) and no money some days, your total expenses for the month will be $4,200. Your benefit limit for the month was $4,500, therefore you would receive $4,200 as a reimbursement.

$2,000.00

($200 DB x 10 days of care)

$1,200.00

($300 DB x 4 days of care)

 + $1,000.00

($100 x 10 days)

$4,200.00

(Reimbursement of Monthly Expenses)

Monthly calculation plans usually cost more than daily benefit plans, but they offer more flexibility and opportunity to receive benefits at full reimbursement if daily expenses are greater than the daily benefit chosen.

Please Note: Whether you choose a daily or monthly benefit, the pool of money (Total Lifetime Benefit) you created will remain available as long as you are eligible for benefits and there is money remaining in the pool. If you choose a 3 year benefit and you are only using half of what's available per day or month, your benefit period will extend and continue until benefits are exhausted.

Once You Have Your Contract Verify You Received What You Applied For!
Most contracts will have a "Schedule of Benefits" page providing a detailed list of the benefits chosen during the application process. This page is usually found in the front of your contract.


Disclaimer: Insurance products are offered through insurance companies with which we have sales arrangements. Not all products/features may be available in your state. Check with your Accountant or Tax professional on the tax issues associated with Long-Term Care insurance purchase and benefits. Associates of Clifton Park are not a part of Raymond James & Associates. Securities offered through Raymond James & Associates, Inc. Member FINRA/SIPC

Raymond James financial advisors may only conduct business with residents of states and/or jurisdictions for which they are properly registered. Therefore, a response to a request for information may be delayed. Please note that not all of the investments and services mentioned are available in every state. Investors outside of the United States are subject to securities and tax regulations within their applicable jurisdictions that are addressed on this site. Contact your local Raymond James office for information and availability.