Citi Benefits Handbook
Choosing a Level of Coverage
When you enrolled, you chose a daily maximum benefit (DMB) of a range of $115 to $405 a day from the table below. The DMB is the most the LTC Plan may pay for all covered services received on any day. Each DMB has a corresponding lifetime maximum benefit (LMB), which is the total amount payable for covered LTC services while you are insured for other than the stay-at-home benefit. Informal care is also subject to a calendar-year maximum.
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Nursing home DMB
Alternate-care facility DMB1
Community-based professional care DMB2
Informal care DMB
Informal care calendar-year maximum3
Lifetime maximum benefit (excluding stay-at-home benefit)
Stay-at-home lifetime maximum
1 If you are a Kansas resident, the alternate-care facility DMB benefit varies slightly. Call John Hancock at 1 (800) 222-6814 for details.
2 Community-based professional care includes adult day care (Washington state refers to this as adult day health care) and the following services provided in your home: home health care, hospice care and homemaker services provided by a person certified or employed through a licensed home health care agency.
3 The total benefits payable for all informal care received in any calendar year is 30 times the informal care DMB.
Stay-at-Home Benefit
The stay-at-home benefit can be used to pay for expenses for a care-planning visit, home modifications, an emergency medical response system, durable medical equipment, caregiver training, a home safety check and a provider-care check.
The stay-at-home benefit amount is the most the LTC Plan will pay for the cost of all covered services received while you are insured and will not exceed 30 times the DMB. This lifetime maximum for the stay-at-home benefit is separate and in addition to the lifetime maximum for your other LTC benefits.
It is available during the qualification period; it is not available if coverage is in reduced paid-up status and cannot be restored under the restoration-of-benefits provision. The stay-at-home benefit amount will be recalculated whenever your DMB changes as a result of inflation or benefit increases or decreases, provided you have not exhausted this benefit.
Any benefits paid will be subtracted from the recalculated amount. Except for the care-planning visit, you must be residing in your home to be eligible. The maximum amount payable for caregiver training will not exceed five times your DMB.