Keiber Retirement Solutions, Inc.

What Are The Benefit Triggers?



The term usually used to describe the way insurance companies decide when to pay benefits is "Benefit Triggers". Criteria used to evaluate when you are eligible for benefits, and the conditions you must meet to receive benefits. This is an important part of a long term care insurance policy.

Types of Benefit Triggers

Activities of Daily Living (ADLs): The inability to do activities of daily living is the most common way insurance companies decide when you are eligible for benefits. They are:

  • Bathing
  • Continence
  • Dressing
  • Eating
  • Toileting
  • Transferring

Typically, a policy pays benefits when you can't do a certain number of the ADLs, such as two of six or three of six. The greater the number of ADLs required, the harder it will be to become eligible. Tax-Qualified policies are required to use the inability to perform two of the six ADLs as a benefit trigger.

Cognitive Impairment: Most long-term care policies also pay benefits for "cognitive impairment". Coverage of cognitive impairment is especially important if you develop Alzheimer's disease or other dementia. If your policy only uses ADLs as a trigger, it may not pay benefits if you have Alzheimer's disease because you may still be able perform your ADLs on your own.

Disclaimer: This site is for informational purposes only and does not constitute an offer to sell or a solicitation of an offer to buy any security which may be referenced herein. These are the views of Associates of Clifton Parks, Long-Term Care specialists, and not necessarily those of the named representative, Broker-Dealer or Investment Advisor, and should not be construed as investment advice.

Insurance products are offered through insurance companies with whom KRS associates have sales arrangements. Not all products/features may be available in your state. Check with your Accountant or Tax professional on the tax issues associated with Long-Term Care insurance.

Securities and advisory services are offered through Level Four Financial, LLC, Member FINRA/SIPC. Keiber Retirement Solutions, Inc. is not owned or operated by Level Four Financial, LLC. Nor is Associates of Clifton Parks affiliated with Level Four Financial, LLC.

Level Four Financial, LLC advisors may only conduct business with residents of states and/or jurisdictions for which they are properly registered. Therefore, a response to a request for information may be delayed. Please note that not all of the investments and services mentioned are available in every state.