What are the requirements to receive benefit payments?
To qualify for and begin receiving monthly LTC benefits, the following things must happen:
If you eventually need LTC, we offer personalized support in filing your claim and finding the care that’s appropriate for you.
Even if you don’t have all the information that you think you might need, a Claims Coordinator will help you with the process.
Be unable to perform, without substantial stand-by or hands-on assistance from another individual, at least 2 activities of daily living (ADLs) due to a loss of functional capacity for a period of at least 90 days (ADLs are bathing, continence, dressing, eating, toileting and transferring).
Have a severe cognitive impairment that requires them to receive substantial supervision from another individual to protect them from threats to health and safety due to their impairment.
2. The insured must complete a 90-calendar-day elimination period. Upon meeting the elimination period, it is satisfied for life of the policy in the event you have more than one LTC claim.
The LTC claim must be recertified at least every 12 months, but may be sooner based on the insured’s recoverability or condition.
How our long-term care benefits are paid
All our products pay a cash indemnity benefit. This means that once the claim has been approved, we don’t require monthly bills and receipts to be submitted. The full monthly amount is available without any restrictions from Nationwide on how it is spent.
Benefits are tax free up to the greater of the HIPAA daily limit in year of claim or the actual qualifying long-term care cost incurred. Benefits may be taxable under certain circumstances. Consult your tax advisor.