Long-term care insurance policies use “benefit triggers” to determine if you’re eligible to start receiving benefits. Activities of daily living, or ADLs, are the most common trigger used by insurance companies.
The National Association of Insurance Commissioners publication, A Shopper’s Guide to Long-Term Care Insurance, lists and defines six ADLs:
• Bathing: The ability to sponge bathe or get in and out of bath tub or shower.
• Eating: The ability to feed oneself by getting food into the body or by a feeding tube.
• Continence: The ability to maintain control of bladder and bowel functions.
• Toileting: The ability to get to and from the toilet and perform associated personal hygiene.
• Dressing: The ability to put on and remove all items of clothing and any braces or artificial limbs.
• Transferring: The ability to get in and out of bed, chair, or wheelchair. A person qualifies for benefits when they are unable to perform two or three ADLs, depending on the long-term care insurance policy.
Make sure bathing and dressing are included on the list of ADL benefit triggers because these are usually the two that a person can’t do. The more ADLs you must be unable to perform under your policy, the harder it will be to qualify for benefits.
However, policies that require more ADLs may cost less than those that require fewer ADLs. Still, you want to have coverage when you need it. Look for long-term care insurance policies that only require two ADLs to be met to qualify for benefits.
We would like your feedback on this Personal Finance Frequently Asked Question.