Glossary Terms D-G

Question 1

Daily Benefit Amount (DBA)

Answer 1

Maximum amount of money insured can be reimbursed per day for a covered service after waiting period is fulfilled.
Benefits are payable for actual cost of services up to daily benefit.

Question 2

Dementia

Answer 2

A condition of deteriorated mentality characterized by marked decline from individual’s former intellectual capacity and often by emotional apathy as well.

Question 3

Elimination Period or Waiting Period

Answer 3

• Also known as Elimination Period or Deductible.
• Period between becoming eligible for benefits and benefit payment.
• Waiting period begins day benefit eligibility criteria (trigger) is met.
• Can be measured in a variety of ways.
• Two most common waiting periods are service day and calendar day however, there are other types of waiting periods/
• Service day waiting periods require insured to receive and pay for services during waiting period.
• Calendar day waiting period does not require insured to receive or pay for services during period
• See Waiting Period (Universal) for more specific information

Question 4

Facility Care

Answer 4

Care received in a United States nursing home, assisted living facility, or hospice facility.

Question 5

Facility Only Plan

Answer 5

A Facility Only Plan includes services that you would receive while in a facility such as a nursing home or hospice facility. FOP is not available to residents of Pennsylvania (Situs Only) and Vermont.

Question 6

Free Look Period (FLP)

Answer 6

30 (plus 15 silent days) days from the date the copy of the policy is mailed to insured, during which insured can cancel coverage and receive a refund of any premiums paid.

Question 7

Functional Impairment

Answer 7

Limitations of physical or mental functioning that may affect an individual’s capacity for independent living.

Question 8

Grace Period

Answer 8

30 day period for payment of contributions after due date