Texas General Lines — Life, Accident, Health and HMOHealth InsuranceMedium

A client has a long-term care insurance policy that offers a 'daily benefit' of $150 and an 'elimination period' of 90 days. If the client requires covered long-term care for 120 days, how much will the policy pay?

  1. A$4,500
  2. B$22,500
  3. C$13,500
  4. D$18,000
Show answer & explanation

Correct answer: A. $4,500

The elimination period is a waiting period before benefits begin. For a 120-day care period with a 90-day elimination period, benefits will be paid for 30 days (120 - 90 = 30). The total payout is then 30 days * $150/day = $4,500.

Why the other options are wrong

  • B. This calculation likely uses an incorrect number of payable days or a misapplied daily benefit.
  • C. This calculation incorrectly subtracts the elimination period from the daily benefit or miscalculates the number of payable days.
  • D. This calculation incorrectly pays for the entire 120 days without applying the elimination period.

Long-Term Care Elimination Period

A waiting period in a long-term care insurance policy, starting from the day care is first received, during which the policy will not pay benefits. It's similar to a deductible.

  • Must be satisfied before benefits begin.
  • Common periods are 30, 60, 90, or 180 days.
  • Insured is responsible for care costs during this period.
  • Longer periods result in lower premiums.

Memory trick: Eliminate the wait, then multiply by the daily benefit.

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