Substantial Supervision
Continual attendance, cueing, or monitoring by another person required because of severe cognitive impairment - the standard paired with the cognitive trigger.
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Practice This Concept
An insured has been diagnosed with Alzheimer's disease and needs substantial supervision to protect his own safety, even though he can still physically perform most daily tasks. Which statement about this LTC benefit trigger is correct?
A severe cognitive impairment can trigger LTC benefits even if the insured has not lost the ability to perform ADLs — Long-term care policies provide two benefit triggers: loss of a specified number of activities of daily living (typically two) OR severe cognitive impairment. A person with Alzheimer's disease or another dementia may retain physical abilities yet need constant supervision because of memory loss, confusion, or unsafe behavior. For such a person, cognitive impairment alone is enough to trigger benefits — no ADL loss is required. The existence of the cognitive impairment is generally certified by a licensed health care practitioner. This dual-trigger structure is the core design of modern LTC insurance and addresses the reality that dementia, not only physical decline, drives much long-term care spending.
National insurance concept
An insured with early-stage Alzheimer's can still bathe and dress independently. Which statement about LTC benefit triggers is correct?
Severe cognitive impairment can trigger benefits even without ADL failure — Long-term care policies have two independent benefit triggers: failure of a specified number of ADLs or severe cognitive impairment, such as that caused by Alzheimer's disease. A person with cognitive impairment who still performs ADLs may qualify based on the cognitive trigger alone, often requiring substantial supervision for safety. AH-V.1d explicitly names ADL failure and cognitive impairment/Alzheimer's as the dual trigger framework.
National insurance concept
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