Benefits Choices and Features

There is no one-size-fits-all when it comes to long term benefits. Review the key features below of Kehilla Care, the Lifeline Alliance LTCBP, to better understand how they affect your coverage :

Kehilla Care offers multiple daily benefit amounts (DBAs) from $100 to $300. This is the maximum amount your insurance will pay in any single day.

  • If you want your DBA to approximately match the 2016 national average daily cost of nursing home care, you may want to choose a $280 DBA.
  • If you are able to pay a portion of the cost of care out of your own pocket, (for example, from your savings) or if you live in an area where the cost of care is lower than the national average, you may want to choose a lower DBA.
  • On the other hand, you may want to choose a higher DBA if you live in an area where the cost of care is higher than the national average. It is important to keep in mind that services can be more costly in metropolitan areas.
  • This is the length of time benefits will be paid if you receive benefits each and every day equal to your daily benefit amount (DBA). You can choose from a two-year, three-year, or five-year benefit period.
  • If you receive services that cost less than your DBA or you do not receive services every day, your benefits will last longer than your benefit period.
  • When deciding which benefit period is right for you, it is important to think about your budget, as well as your potential needs. If you want to keep your premium costs low and are willing to pay out of pocket for some of your care, the two-year benefit period will provide you with a basic level of protection. If you have considered that future advances in medical care could mean longer life expectancy, and the possibility of needing care for many years, you may prefer a longer benefit period, if it is something you can comfortably afford.
  • It is important to note that future advances in medical care could mean longer life expectancy and a greater chance of outliving your benefits. For this reason, you may wish to consider the five-year benefit period or the unlimited benefit period.
  • The maximum lifetime benefit (MLB) is the maximum amount your coverage can pay. To calculate your MLB, multiply your DBA by your benefit period (in days).
  • Kehilla CAre benefit periods: two years (730 days), three years (1,095 days), or five years (1,825 days).

Example: The following is the MLB calculation for an enrollee with a DBA of $150 and a three-year benefit period:

$150 x 1,095 days = $164,250 maximum lifetime benefit

The waiting period under the Kehilla Care is 90 days. The waiting period is the number of calendar days during which you must be eligible for benefits before we will pay benefits.

You only have to satisfy the waiting period once in your lifetime. Days applied toward satisfying the waiting period need not be consecutive, nor associated with the same episode of care.

  • To help your benefits keep pace with inflation and the rising costs of care, Kehilla Care offers an Automatic Compound Inflation Option (ACIO) and a Future Purchase Option (FPO).
  • Kehilla Care offers a 2% and a 4% ACIO . With these options, your DBA and remaining portion of your maximum lifetime benefit (as well as other remaining benefit amounts listed in your schedule of benefits) will automatically increase by either 2% or 4% (depending on the percentage shown on your schedule of benefits) compounded every year. The increases occur on each anniversary of your original effective date of coverage (or the date you switch to one of these options). Increases under this option are made without regard to your age, claim history, or the length of time your coverage has been in effect. The increases cease during periods of eligibility for benefits when continued Sharing
  • With the FPO, every two years we will increase your daily benefit amount and the remaining portion of your maximum lifetime benefit (as well as other remaining benefit amounts listed in the schedule of benefits), except as described below. We will send notice of the increase to enrollees with this option with the next fall FPO offering for an increase that will apply the following January 1. Increases will occur every two years on January 1 thereafter. Your LTCBP must be in effect for at least 12 months in order for you to receive your first increase under this provision.
  • If you do not want the increase, we must receive your rejection before the date specified in the increase notice. If you want the increase, you do not have to take any action other than paying the additional premium. The increase will automatically take effect. Increases under this option will be made regardless of your age, but we will not increase your benefits under this option if you are eligible for benefits. Increases under this option do not require you to provide evidence of your good health.
  • Please note: Suggested Sharing Contributions are not guaranteed. Your Suggested Sharing Contributions will not change because you get older or your health changes or for any other reason related solely to you. However, your Contributions may increase if you are among a group of enrollees whose premium is determined to be inadequate.
  • If you select the ACIO, your Sharing Contribution is designed to include all future inflation increases you will receive each year while you are insured. Your Sharing contribution will not increase with each inflation increase under this option.