Long-Term Care Options at a Glance
| Bronze Option* | Silver Option | Gold Option | Platinum Option | |
|---|---|---|---|---|
| Deductible | 90 days of covered long-term care | 90 days of covered long-term care | 90 days of covered long-term care | 90 days of covered long-term care |
| Benefit Eligibility | Inability to perform 2 of 5 activities of daily living | Inability to perform 2 of 6 activities of daily living or cognitive impairment | Inability to perform 2 of 6 activities of daily living or cognitive impairment | Inability to perform 2 of 6 activities of daily living or cognitive impairment |
| Lifetime maximum benefit | $200,000 all services $50,000 home health care |
$400,000 all services | $300,000 all services | $300,000 all services |
| Nursing home daily benefit | $125 in Alaska $75 outside Alaska |
$200 in and out of Alaska | $200 in and out of Alaska | $200 in and out of Alaska |
| Assisted living facility daily benefit | Covered in lieu of other services if approved | $150 in and out of Alaska | $150 in and out of Alaska | $150 in and out of Alaska |
| Home health care daily benefit | $75 in Alaska $40 outside Alaska |
$125 in and out of Alaska | $125 in and out of Alaska | $125 in and out of Alaska |
| Hospice daily benefit | Not Covered | $125 in and out of Alaska | $125 in and out of Alaska | $125 in and out of Alaska |
| Respite care daily benefit amount | Not Covered | Up to $200 in and out of Alaska, maximum of 14 days | Up to $200 in and out of Alaska, maximum of 14 days | Up to $200 in and out of Alaska, maximum of 14 days |
| Inflation protection | None | None | Simple at 5% of original benefit each year. Applies to lifetime and daily benefit amounts. | Compound at 5% of the prior year’s benefit each year. Applies to lifetime and daily benefit amounts. |
*existing option closed to new entrants after 1/31/2000
Definitions
- Cognitive Impairment
- A measurable deterioration or loss in intellectual capacity requiring substantial supervision or verbal cueing by another individual in order to protect the impaired and others from serious threats to health and safety.
- Deductible
- the amount you must pay before the plan pays benefits.
- Activities of Daily Living
- The Silver/Gold/Platinum options include bathing, continence, dressing, eating, toileting, and transferring. The Bronze Option includes dressing, toileting, transferring, eating, and walking.