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Period of Care: A Period of Care usually
begins on the first day you are eligible for benefits, and ends after
a treatment-free interval during which you do not need any benefits.
If you need care later, you may have to meet another Elimination Period.
Example: If your policy uses a 180-day
treatment-free interval to measure the end of the Period of Care, and
you leave the nursing home on June 1 and require no further care for
180 days, the Period of Care will end in 180 days on November 30. If
you return to the nursing home before November 30, you will be in the
same Period of Care and there will be no new Elimination Period. If
you return to the nursing home again after November 30, you will have
to pay your own expenses during a new Elimination Period.
Selecting the Elimination Period:
Multiply the current cost of one day of care by the number of elimination
days you plan to use. (Example: $141 X 30 = $4,230)². Then estimate
the number of days you could afford to pay for your own care without
liquidating any assets. That is the maximum number of days you should
select as an Elimination Period. Although choosing a short Elimination
Period increases your premium, the amount you will pay for your own
care during an Elimination Period is likely to be much more expensive.
Another factor to take into account is that the daily cost of care doubles
about every 14 years. Your out of pocket cost for the Elimination Period
you choose will increase as well. Remember that short nursing home stays
are more common than long stays and many people may need long-term care services more than once during their lifetime.
Plan of Care: This is a plan written
by your doctor or a medical team (such as a home health Agency's health
care team) that establishes your need for care, and describes the kind
of care you need, and the frequency of the required services. The Plan
of Care is a familiar document to your doctor, hospital discharge planners,
home health agencies and other health care providers who know about
long-term care services. Many policies also require that the Plan of
care be updated periodically to reflect any change in your need for
care.
Care Management: Some policies include
Care Management features. A Care Manager may assess your condition,
consult with your doctor, establish a Plan of Care, follow your progress,
and recommend care providers.
² The average daily cost in California in 2002.
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