A) A Reimbursement policy is one where the claimant or the person acting on their behalf submits the ‘facility’ or ‘home care’ expenses to the insuring company. They, in turn, pay the individual up to the limit of their insurance monthly benefit.
B) An Indemnity policy pays out the insured’s monthly benefit directly to the insured. They can then pay for a ‘facility’ or ‘home care’ as they choose.
To claim benefits, Long Term Care policies define medical impairment or loss of independence as follows:
1) The inability to perform two of the six normal activities of daily living (A.D.L’s) without substantial assistance. These include eating, bathing, dressing, continence, toileting and mobility.
2) Cognitive impairment which includes impaired memory or attention or loss of intellectual capacity that requires supervision.