Reimbursement:
Reimbursement means the policyholder is paid after services are received. The amount paid back to the policyholder is based on the either a daily or monthly amount (up to a pre-selected limit) for qualified services provided. The policyholder must maintain and submit receipts to their insurance company to receive payment. Daily reimbursement plans are common among Traditional long-term care plans and may require more planning to manage care costs. For example, if a client has a policy that reimburses up to $200 per day, any amount spent for care over $200 in a single day will be the responsibility of the client. If they spend less than the $200 daily limit, the difference will remain in their pool of benefits for future use and will extend their policy. There is no averaging on daily limit plans so you cannot spend more than your daily limit one day because you spent less on another day. Services are looked at separately for each day and the total for the month is reimbursed the following month. Monthly reimbursement policies are common on Hybrid and Asset Based plans and give more flexibility. For example, if the client has a $6000 monthly limit, they may spend up to that amount in any number of days and be reimbursed up to the full monthly amount of their plan. This eliminates having to juggle services to avoid going over a daily limit and provides more options for scheduling care especially when receiving care at home.
Indemnity (Cash Benefit):