Choice and control when you become dependent on others for care
Sun Long Term Care Insurance helps you manage the risk of losing your independence due to an unexpected illness, chronic condition or dementia by transferring the risk to long term care insurance. It provides a comprehensive income-style benefit when you’re dependent. It’s designed to help cover the cost of care services you need in any environment, including:
- Your personal residence
- A retirement home
- A long term care facility
You should consider this coverage if:
- You are worried that your personal finances might be impacted if you were to develop a chronic health condition that would require someone to care for you
- You are concerned that government healthcare programs won’t offer the choice and support you and your family will want when you require care
- You want a solution that meets both immediate unexpected needs as well as needs you may have in the future as you age
How to qualify for benefits
There are 3 ways to qualify to receive the long term care insurance benefit. Benefits are paid if you reside in Canada or the United States. You may travel outside these countries for a maximum of 8 weeks at a time and continue to receive benefits.
In order to qualify for benefits, you must require:
You’re considered to have deteriorated mental ability if you need continual supervision by another person for protection from threats to your physical health and safety as the result of deterioration in or a loss of:
- Short- or long-term memory
- Orientation as it relates to people, place and time
- Reasoning, or
- Judgement, as it relates to safety awareness
Deteriorated mental ability must result from an organic brain disorder such as Alzheimer’s disease, irreversible dementia, or brain injury.
The activities of daily living are defined as follows:
- Bathing means washing yourself with or without the aid of assistive devices in a bathtub or shower, including getting in and out of the bathtub or shower, or by sponge bath. Bathing doesn’t include the ability to reach and wash the back or feet.
- Dressing means putting on, taking off, fastening and unfastening, with or without the aid of assistive devices: clothing, and medically necessary braces or artificial limbs. You’re not dependent for dressing if reasonable alterations to or changes in the clothing you usually wear would let you dress yourself without substantial physical assistance.
- Toileting means getting to and from and on and off the toilet, with or without the aid of assistive devices, and performing associated personal hygiene.
- Transferring means moving into or out of a bed, chair or wheelchair, with or without the aid of assistive devices.
- Continence means the ability to control both bladder and bowel functions, or maintain a reasonable level of personal hygiene (including caring for catheter or colostomy bag) when not able to control bowel or bladder functions.
- Feeding means the ability to get food into your body, with or without the aid of assistive devices, through your mouth, or by feeding tube. Feeding does not include cooking or preparing a meal.
What is an assistive device?
Assistive devices are aids that can be used to improve your functioning. If using an assistive device allows you to perform an activity of daily living safely and completely, you’re not dependent for that activity. Assistive devices include: adjustable beds, buttonhooks, canes, crutches, grab bars, handheld showerheads, bath brushes, seat lifts, transfer benches, walkers and wheelchairs.
Stand-by assistance means another person must always be within arm’s reach so you can safely and completely perform the activities of bathing and transferring.
If you require stand-by assistance for only one of bathing or transferring, we consider you dependent when you also require substantial physical assistance to perform one of the other activities of daily living.
You must be between the age of 21 and 80 years old to consider this plan.
- Minimum weekly benefit: $150
- Maximum weekly benefit: $2,300
The benefit period is the maximum number of weeks you can receive benefits. Choose among:
- 100 weeks (1.9 years)
- 150 weeks (2.8 years)
- 250 weeks (4.8 years)
The waiting period is the length of time you must be continuously dependent before a claim is submitted. It starts on the date you are first considered dependent. Choose between:
- 90 days
- 180 days
The following features are included at no extra cost:
Regardless of the waiting period selected, a claim may be submitted 30 days after you:
- Require substantial physical assistance for at least 4 activities of daily living
- Have been diagnosed with a terminal disease, or illness by a qualified physician or another healthcare professional acceptable to us, and
- Are receiving palliative care that’s supportive and provides comfort
- When we approve a new claim, the first payment includes a bonus amount. It’s equal to 12 times the weekly amount.
- The first payment bonus doesn’t affect the number of weeks remaining in the policy’s benefit period.
- If you’re receiving palliative care and qualify for benefits after a 30-day waiting period, the bonus is equal to 4 times the weekly amount.
- If the policy includes inflation protection, the bonus includes any accumulated increases to the weekly amount.
When we approve a claim for benefits, we waive premiums for the policy.
If both spouses are covered under policies that include Spousal waiver, premiums will be waived if one spouse dies or if we’re paying benefits on either spouse’s policy (even after we’ve paid benefits for the entire benefit period on the spouse’s policy).
To qualify for the benefit, each spouse must have a policy that has been continuously in effect with no approved claim, from the dates they came into effect until:
- Both policies have reached their 10th policy anniversaries, or
- Both spouses have had their 86th birthdays
If a premium payment is missed, this protection may automatically continue coverage for a fixed period. The length of time the coverage continues is set out in the extended term insurance schedule in the policy. The weekly amount, waiting period and benefit period will not change. While the policy continues as extended term insurance:
- Money can’t be put into the withdrawable premium fund
- We won’t pay a first-payment bonus
- Return of premium on death, if included in the policy, and
- Inflation protection ends, if included in the policy
The following service is included at no extra cost:
With a long term care insurance policy from Sun Life Financial, you can make use of the valuable resources provided through LifestageCare.™ This national, bilingual service available 24 hours a day, 7 days a week, provides you with access to unbiased information about local, qualified healthcare and personal care providers that meets your individual and family care needs, at every stage of life.1
1LifestageCare is currently available to new and existing long term care insurance policy owners of Sun Life Financial. It’s not a guaranteed feature of the product and may be withdrawn at any time.
™ LifestageCare is a trademark of Sykes Assistance Services Corporation.
These benefits can be added to enhance your plan at an additional cost:
There are 2 options to protect the weekly benefit against inflation:
- Option A. The weekly benefit increases by 3% on each policy anniversary while the weekly benefit is payable.
- Option B. The weekly benefit increases by 2% on each policy anniversary if the weekly benefit is not payable, and it increases by 3% on each policy anniversary while the weekly benefit is payable.
If you die while the policy is in effect, we’ll pay the returnable premium amount to the beneficiary named in writing. If no beneficiary is named, the returnable premium amount will be paid to the policy owner, or to their estate. This option is available for issue ages 21-65.
Paying your premiums
Choose one of the following payment periods:
- Pay for the lifetime of the policy (until the policy anniversary following your 100th birthday)
- Pay to the later of 25 years or to the policy anniversary after age 65
Premiums won’t change for the first 5 years from the policy issue date. After that, we may increase or decrease the premium on a policy anniversary. If we do make a change, we’ll give advance notice of the change. The new premium will be guaranteed for at least another 5 policy years.
As you read through these sample policies, please keep in mind that not all sections you see will apply to every policy. Your policy can have sections that are somewhat different from those that you've read here, depending on the options you choose. When we issue your policy, it governs the legal relationship between you and Sun Life Financial.