Questions About Long-Term Care Insurance
We answer the most common questions about long-term care insurance.
Q: How do I qualify for benefits?
A: (1) You meet plan requirements such as the policy being in force and the elimination period satisfied; and
(2) A physician provides certification that you require extended care in a facility or at home because of:
- Inability to perform two or more specified activities of daily living — bathing, dressing, eating, maintaining continence, toileting, transferring:
or
- Cognitive impairment, which involves memory loss or difficulties with problem-solving due to illnesses such as Alzheimer's or Parkinson's.
Q: What is the difference between Home Care and Facility Care?
A: The Home Care benefit is designed to reimburse you for the cost of a medically necessary long-term program in the home, as recommended by a physician and provided by a licensed nurse, an authorized employee of a home care agency, or a private caregiver.
The Facility Care benefit is typically payable when health or personal care services are required on a long-term basis in a long-term care facility, as recommended by a physician.
Q: Can Home Care be provided by a family member?
A: No. Home Care can only be administered by a licensed vocational nurse, a licensed practical nurse, an authorized employee of a home care agency, or private caregiver.
Q: What is an elimination period?
A: The elimination period — sometimes also known as the waiting period - is the number of calendar days which must pass while under care before the benefits are payable. There are two options for this elimination period, depending on the plan you select: 0 days for Facility Care and 60 days for Home Care; or 90 days for Facility Care and 90 days for Home Care.
Q: How do I satisfy the elimination period?
A: The elimination period is the number of calendar days which must expire once you begin living in a long-term care facility, or begin receiving home care services. Elimination periods do not include any time on a waiting list for services or placement in a facility.
Q: Will I have to pay premiums throughout my life?
A: No. The premium payment period ends after 20 years or when you reach 65, whichever is the longer.
Q: Are the rates guaranteed?
A: Yes. Premium rates are fully guaranteed for the first 5 years of the policy, from the time of issue. After 5 years, RBC Insurance guarantees that the policy can be renewed annually, however we reserve the right to increase the renewal premium up to a lifetime maximum of 50% of the original annual premium, excluding the policy fee.
Q: Do I have to pay premiums while I'm receiving benefits?
A: No. A waiver of premium benefit is included in the policy at no extra cost and it takes effect as soon as benefit payments begin. Any premiums paid during the elimination period are refunded back to you.
Q: Can I purchase Home Care coverage on its own?
A: No. All policies must contain Facility Care.
Q: Can I purchase Facility Care coverage on its own?
A: Yes.
Q: What does the Return of Premium benefit (ROP) do?
A: If you die 5 years or later after purchasing a long-term care insurance policy, we will reimburse to your beneficiary all annual premiums paid for the Facility Care benefit (including the policy fee and the Return of Premium rider), if we have never paid Facility Care benefits to you. You can receive Home Care benefits and still be eligible for the Return of Premium benefit.
Q: Can I receive payments from the government and RBC Insurance at the same time?
A: Yes.
Q: Can I receive Facility Care and Home Care benefits from RBC Insurance at the same time?
A: No. Benefits for Facility Care and Home Care cannot be paid at the same time. If you are collecting Home Care benefits and then need Facility Care, RBC Insurance will begin to pay Facility Care benefits.
Q: Will I have to pay additional premiums after the policy is paid up?
A: No. For example: If the plan was for a 20 year premium payment period and the plan has been paid for the entire 20 years, no additional premiums will be required and no premium adjustments can be made, but you are still eligible for benefits until the maximum benefit period you selected has expired.
Q: Are there any exclusions under which I won't receive benefits, even though I need long-term care?
A: Yes, they include:
- self inflicted injury
- military service
- results from war
- results or losses due to alcoholism or chemical dependency
- nervous or mental disorders without organic cause
- losses resulting from engaging in illegal activities
Please refer to the policy for a full listing of all limitations and exclusions.
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