Frequently Asked Questions

Benefits

Maximum Lifetime Benefit

1. What is the maximum lifetime benefit?
    
2. When can I access my maximum lifetime benefit? Do I have to pay premiums for a minimum length of time first?
    
3. If I claim benefits, but don't use all of my maximum lifetime benefit, can I receive it in cash or can my survivors have the money?
    
4. If my maximum lifetime benefit runs out, couldn't I just increase my premiums before that point so it won’t run out?

1. What is the maximum lifetime benefit?

The maximum lifetime benefit (MLB) is the total amount of money that we may pay for charges you incur for covered services. Your maximum lifetime benefit is equal to your benefit period (in days) multiplied by the daily benefit amount (DBA) that you choose. It may increase or decrease, as described in your Benefit Booklet, and is reduced as benefits are paid. If you have an unlimited benefit period, your maximum lifetime benefit is also unlimited.

Example: The following is the MLB calculation for an enrollee with a DBA of $150 and a 3 year (1,095 days) benefit period:

$150 x 1,095 days = $164,250 maximum lifetime benefit

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2. When can I access my maximum lifetime benefit? Do I have to pay premiums for a minimum length of time first?

If you are eligible to receive benefits and have met your waiting period, you can begin to access your maximum lifetime benefit. It does not matter how long you have paid premiums. That's one of the advantages of long term care insurance — it is available when you need it. You don't have to wait for it to "build up" like you would if you were saving your own money to cover the probable costs of long term care.

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3. If I claim benefits, but don't use all of my maximum lifetime benefit, can I receive it in cash or can my survivors have the money?

No. The maximum lifetime benefit is not "yours" per se. It's a pool of financial resources that you have access to. You and your survivors do not have any right to unspent dollars. The funds are available to you if benefits are payable. The possibility of unspent monies is taken into account to keep everyone's premiums as low as possible.

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4. If my maximum lifetime benefit runs out, couldn't I just increase my premiums before that point so it won’t run out?

No. Actually, such an idea would be quite contrary to insurance principles. It would be analogous to allowing people to increase the amount of their homeowners policy while their house was on fire. The insurance company would be taking on a guaranteed claim. The time to buy insurance is when you are in good health, not when you are in a claim status.

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