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Benefits Provided by the Federal Program
Benefit Amounts
You may select a Daily Benefit Amount from $50-$300, in $25 increments. Your Daily Benefit Amount determines the most we will pay per day for covered services. It also determines your Maximum Lifetime Benefit — see the Maximum Lifetime Benefit subsection.
The Federal Program provides reimbursement for actual charges you incur for covered services up to the following percentages:
| Covered Services Under Both Options | Daily Reimbursement Up To |
|---|---|
| Nursing home, assisted living facility, or hospice facility | 100% of your Daily Benefit Amount |
| Bed reservations | 100% of your Daily Benefit Amount — benefits limited to 30 days per calendar year |
| Caregiver training | 100% of your Daily Benefit Amount — benefits limited to 7 times your Daily Benefit Amount in your lifetime |
| Respite services | 100% of your Daily Benefit Amount — benefits limited to 30 times your Daily Benefit Amount per calendar year |
| Additional Covered Services Under the Comprehensive Option | Daily Reimbursement Up To |
|---|---|
| Formal caregiver services | 75% of your Daily Benefit Amount |
| Informal caregiver services | 75% of your Daily Benefit Amount — benefits for informal caregiver services are limited to those who did not normally live in your home at the time you became eligible for benefits and are limited to a total of 365 days in your lifetime |
| Hospice care at home | 100% of your Daily Benefit Amount |
| Adult day care center | 75% of your Daily Benefit Amount |
If you select the Comprehensive Option, you may choose to have benefits for covered services calculated on a weekly basis. The Weekly Benefit Amount is equal to seven times your Daily Benefit Amount. If you choose the Weekly Benefit Amount, the Federal Program provides reimbursement for actual charges you incur for covered services up to the following percentages:
| Additional Covered Services Under the Comprehensive Option (Weekly Benefit Amount) | Weekly Reimbursement Up To |
|---|---|
| Nursing home, assisted living facility or hospice facility | 100% of your Weekly Benefit Amount |
| Formal caregiver services | 75% of your Weekly Benefit Amount |
| Informal caregiver services | 75% of your Weekly Benefit Amount — benefits for informal caregiver services are limited to those who did not normally live in your home at the time you became eligible for benefits and are limited to a total of 365 days in your lifetime |
| Hospice care at home | 100% of your Weekly Benefit Amount |
| Adult day care center | 75% of your Weekly Benefit Amount |
| Bed reservations | 100% of your Weekly Benefit Amount — benefits limited to 30 days per calendar year |
| Caregiver training | 100% of your Weekly
Benefit Amount — benefits limited to 7 times your Daily Benefit Amount
in your lifetime |
| Respite services | 100% of your Weekly Benefit Amount — benefits limited to 30 times your Daily Benefit Amount per calendar year |
| Call: 1-800-LTC-FEDS (1-800-582-3337) (TTY: 1-800-843-3557) |
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