Explanations of the words and phrases used by Medicare are in the Medicare Glossary.
Daily Benefit — The insurance benefit amount (in dollars) that a person selects as the basis for their long-term care insurance. However, the daily benefit may not be the actual amount paid for each day an insured person is eligible for a benefit. There are three different methods of computing benefits; but, each insurance policy will use only one of them.
1. Expense-Incurred Method — After you qualify for benefits, the insurance will pay the lower of: (1) the expenses you incurred for eligible long-term care services, or (2) the dollar limit of your policy. Most policies bought today pay benefits using the expense-incurred method.
Some expense-incurred policies protect a covered person from the situation where expenses exceed the daily limit on some days and are less than the daily limit on other days, by setting up a weekly pool of benefits. That is, the daily benefit is multiplied by 7 to establish a weekly pool of money that can be used to pay all eligible expenses until the pool is exhausted for that week. Under the pool of money approach, any unspent money is often added to the end of the policy to extent the period of coverage. (A few policies use a monthly pool of money.)
2. Indemnity Method — This method is not based on the specific service received or on the actual expenses incurred. After you qualify for benefits and receive eligible long-term care services, the insurance company will pay a fixed amount directly to you, up to the limit of the policy. The fixed amount is pre-determined by your insurance policy.
3. Disability Method — After you qualify for benefits, you will receive your full daily benefit even if you don’t receive any specific long-term care services. These benefits are yours to spend as you wish.
Deductible — The amount you must pay, usually every year, before your health insurance or Medicare begins to pay benefits.
Dementia — Deterioration of intellectual abilities (e.g., vocabulary, abstract thinking, judgment, memory loss, physical coordination), the loss of which interferes with daily activities. Dementia can be caused by degenerative diseases (e.g., Alzheimer’s, Huntington’s and Parkinson’s diseases), vascular diseases or stroke, metabolic disorders (thyroid, liver or kidney dysfunction and certain vitamin deficiencies), AIDS, drugs and alcohol, and psychiatric disorders. Some dementias may respond to treatments, others do not. For more information, click on Alzheimer’s and Other Dementias.
Depression — This is one of the most undiagnosed conditions among seniors. But, with proper medical care, depression is a reversible psychiatric condition. Symptoms include a persistent sad, anxious or “empty” mood, loss of interest or pleasure in activities once enjoyed, and difficulty sleeping. For more information, click on Signs and Symptoms of Depression.
Dermatologist — A physician who specializes in disorders of the skin such as skin cancer, moles, birthmarks, scars, acne, aging skin and skin allergies.
Discharge Planner — A social worker or other health care professional who assists hospital patients and their families in transitioning from the hospital to another level of care such as rehabilitation in a skilled nursing facility, home health care in the patient’s home, or long-term care in a nursing home.
DNR — DNR stands for Do Not Resuscitate. A DNR is a written request to not have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing.
Domicile — A person’s permanent legal residence for tax purposes; typically, this is also the address where the person maintains his or her voter’s registration.
Donee — A person or organization who receives a gift.
Donor — A person or organization who gives a gift.
Dressing — The third activity of daily living — Putting on and taking off all items of clothing and any necessary braces, fasteners or artificial limbs.
Durable Medical Equipment — Medical equipment that is ordered by a doctor for use in the home. These items, such as walkers, wheelchairs, and hospital beds, must be reusable. Durable medical equipment is paid for under Medicare, subject to a 20% coinsurance of the Medicare-approved amount.
Durable Power of Attorney for Finances — A Power of Attorney (POA) for Finances is a legal document that is used to delegate legal authority to another person. The person who signs (executes) a POA is called the Principal. The POA gives legal authority to another person (called an Agent or Attorney-in-Fact) to make property, financial and other legal decisions for the Principal. A Principal can give an Agent broad legal authority or very limited authority. The POA is frequently used to help in the event of a Principal’s illness or disability. Unless otherwise specified, the POA applies only to assets owned directly by the Principal, not to any assets transferred into a trust by the Principal.
A simple Durable Power of Attorney enables the Agent to act for the Principal even after the Principal is not mentally competent or physically able to make decisions. A simple Durable POA may be used immediately by the Agent, and is effective until it is revoked by the Principal, or until the Principal’s death.
A Springing Durable Power of Attorney becomes effective at a future time. That is, it becomes effective upon the happening of a specific event chosen by the Principal, and spelled out in the POA. The springing event is usually the determination that the Principal is no longer competent to handle his or her affairs. The Springing POA will frequently provide that the determination of non-competency will be made by the Principal’s physician (or by the Principal’s physician and another qualified physician). A Springing POA remains in effect until the Principal’s death, or until revoked by a court.
Durable Power of Attorney for Health Care — A Power of Attorney for Health Care is a written legal document in which one person (the Principal) appoints another person (called an Agent or Attorney-in-Fact) to make health care decisions on behalf of the Principal in the event the Principal becomes incapacitated (the document defines incapacitation). The Durable POA for Health Care can contain instructions about specific medical treatment that should be applied or withheld. While its purpose remains essentially the same from state-to-state, the name of this document can vary; for example, in Florida it is called an Appointment of Health Care Surrogate.