Send to Printer

Close

[ Back to the Contents Page ]

Benefits Provided by the Federal Program

Payment of Benefits

We pay all benefits in United States currency.  

Eligibility for Benefits

You must be eligible for benefits and satisfy any required Waiting Period in order for benefits to be payable for covered services. You are eligible for benefits if you meet all of the following requirements after your coverage becomes effective:

• a licensed health care practitioner has certified within the last 12 months that:
  • you are unable to perform, without substantial assistance from another person, at least two Activities of Daily Living (see definition on next page) for an expected period of at least 90 days due to a loss of functional capacity; or
  • you need substantial supervision due to your severe cognitive impairment;
• we agree with that certification; and
• we approve a written plan of care established for you by a licensed health care practitioner or our Care Coordinator.

[ Back to the Contents Page ]

Call: 1-800-LTC-FEDS (1-800-582-3337) (TTY: 1-800-843-3557)

Close