MMC Benefits Handbook
About Your Benefits
What services are covered by this Plan?
Once you are certified as eligible for Long Term Care Insurance, the Plan covers:
- adult day care—75% of the monthly benefit selected
- Alzheimer's facility—100% of the monthly benefit selected
- assisted living facility—100% of the monthly benefit selected
- at-home hospice care—75% of the monthly benefit selected
- home care—75% of the monthly benefit selected
- in-patient hospice—100% of the monthly benefit selected
- nursing home services—100% of the monthly benefit selected
- respite care—up to the Facility Care Maximum in a calendar year
- bed reservation—up to the Facility Care Maximum for up to 60 days per calendar year
- home assistance expenses—up to 2X the Facility Care Maximum per lifetime
- informal care—up to 1% of the Facility Care Maximum up to 30 days per calendar year
- care coordination services at no cost.
There is a lifetime maximum benefit of:
For example, the lifetime maximum benefit for a $6,000 monthly benefit option for five years would be $360,000 ($6,000 X 60).
Some services have specific limits or restrictions.
Some services are not covered (these are called exclusions).
Does the Plan cover organic and inorganic brain diseases?
The Plan covers disabilities resulting from organic brain diseases, including Alzheimer's disease and similar disorders. The Plan also covers dependencies resulting from brain diseases which are organically based, as long as the insured person meets the benefit eligibility criteria. Genworth does not attempt to identify the cause of disability or mental disorder.
Are benefits provided outside the United States?
International coverage is available for care and support services including room and board provided by a nursing facility located outside of the United States, limited to 75% of the Facility Care Maximum, for up to 48 months.
Is there an automatic inflation protection feature?
The types of inflation protection available under the Group Program are:
- Future Purchase Options: This benefit will apply if neither of the automatic options are selected. Every three years the insured is offered the opportunity to increase his or her benefit amounts by 5% compounded annually. The offer is guaranteed as long as the option has not been declined two consecutive times. The premium for the additional coverage is based on the insured's attained age as of the effective date of the increase. The offer is not made if the insured is in claim, is benefit eligible, is receiving benefits, or is satisfying the Elimination Period.
- Automatic 3% Compound Benefit Increases for Life: Under this optional rider, the benefit amounts increase automatically each year by 3% compounded annually while the insurance is in effect and premiums are paid. There is an additional premium for this rider.
- Automatic 5% Compound Benefit Increases for Life: Under this optional rider, the benefit amounts increase automatically each year by 5% compounded annually while the insurance is in effect and premiums are paid. There is an additional premium for this rider.
Do I have a Nonforfeiture option?
The Nonforfeiture benefit is included. It allows the insured to retain partial coverage if he or she decides to cancel his or her long term care coverage after it has been in force for more than three years.
What is Home and Community Care?
Home and Community Care benefits are payable for expenses incurred for home and community care which includes adult day care, and nurse or therapist services, home health or personal care services and incidental homemaker and chore care provided in the insured's home, up to the Home and Community Care Maximum, based on the option selected.
What is the Home Assistance Benefit?
The Home Assistance Benefit covers home assistance expenses that are stated and furnished in accordance with the insured's Plan of Care which are intended to enable the insured to remain in his or her home, including home modifications, emergency medical response systems and caregiver training, up to the lifetime maximum of two times the Facility Care Maximum.