What services are covered by this Plan?

Once you are certified as eligible for Long Term Care Insurance, the Plan covers:

There is a lifetime maximum benefit of:

For example, the lifetime maximum benefit for a $200 daily benefit option for five years would be $365,000 ($200 X 1,825).

Some services have specific limits or restrictions.

Some services are not covered (these are called exclusions).

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 meets the benefit eligibility criteria. MetLife does not attempt to identify the cause of disability or mental disorder.

International coverage is available through the International Coverage Certificate Rider to U.S. salaried employees who are living or working outside the United States.

The daily benefit amount will be referred to as a "per diem benefit." The per diem benefit amount will be equal to 50% of the home care benefit and will be paid whether or not services are received once the insured has been deemed eligible for benefits and the "waiting period" as defined under "How the Plan Works" has been fulfilled. The per diem benefit will be paid in United States dollars.

For New York residents, the following applies: you will never receive less than $25 per day. If you provide evidence of confinement in a licensed nursing home, the minimum amount paid will be $50. The per diem benefit will be paid up to a maximum of six years while you are outside of the United States.

For non-New York residents: This benefit will be paid to a maximum of 10 years while the insured is outside of the United States.

No, there is no automatic inflation protection feature. Rather, an optional inflation protection feature is offered in connection with this coverage.

To keep up with inflation, the Long Term Care Insurance Plan offers the opportunity to upgrade your daily benefit amount to protect against future increases in the cost of long-term care. This option is offered every three plan years.

When your daily benefit increases, your lifetime benefit will also increase. The amount of daily benefit increase will be approximately 5% compounded annually.

Your premium for the increase will be based on your age as of the effective date of the increase.

The offering is guaranteed as long as the option has been selected once every two offerings. If you don't choose this option for two consecutive offerings, it will continue to be offered; however you must provide Evidence of Insurability.

The offer is made regardless of age, claim status, claim history, or length of participation in the Plan.

The Nonforfeiture feature is only available, as an option, if you design a custom plan.

With this feature, if you stop paying premiums after three years, you keep a reduced level of benefits. The amount will be based on the greater of the total premiums you have paid, or 30 times your daily benefit amount.

There is no discount program. However, case managers often negotiate lower fees from physicians, facilities, equipment suppliers, etc. on behalf of a patient.

The Plan's transition expense benefit provides a one-time payment up to five times the daily benefit amount to be used for long-term care purposes, such as a personal emergency response system, caregiver training, durable medical equipment, or offsetting costs of qualified services received during the "waiting period" in which you or a covered family member were being qualified for benefits as described under "How the Plan Works".

It is payable after completion of the waiting period. To access this benefit, proof of payment for a covered expense must be submitted to MetLife. It does not reduce the total lifetime benefit.