Long Term Care Insurance Policy, Page 11

SAMPLE LONG TERM CARE INSURANCE POLICY

Plan of Care means a written plan for long-term care services designed especially for You. This Plan of Care must specify the type, cost, frequency and providers of all the services You require; and be in accordance with accepted medical and nursing standards of practice. A Licensed Health Care Practitioner must approve Your Plan of Care. Your Plan of Care must be updated as Your condition and needs change. We must be provided with a revised Plan of Care each time it is updated. We reserve the right to request periodic updates regarding Your Plan of Care, but not more frequently than once every 30 days. No more than one Plan of Care may be in effect at a time.

Policy Limit means the total amount, as shown on the Policy Schedule, from which You will be paid benefits for all covered care and services. All benefits, except for the Stay at Home Benefit and Care Advisory Services Benefit, will be deducted from the Policy Limit. We will not pay benefits, except for the Stay at Home Benefit and Care Advisory Services Benefit, in excess of the Policy Limit as shown in the Policy Schedule.

Respite Care is the short-term care designed to provide temporary relief to Your primary
uncompensated caregiver from his or her caregiving duties and provided in: a Nursing Home; an Assisted Living Facility; an Adult Day Care Center; Your Home; or a community-based program. Respite Care includes: confinement in a Nursing Home or Assisted Living Facility; Home Health Care; Adult Day Care; and Hospice Services.

Substantial Assistance means You need hands-on or standby assistance while You are performing an Activity of Daily Living.

• Hands-on assistance means the physical assistance of another person without which You
would be unable to perform the Activity of Daily Living.

• Standby assistance means the presence of another person within arm’s reach of You that is necessary to prevent, by physical intervention, injury to You while You are performing the Activity of Daily Living.

Substantial Supervision means You need continual supervision due to Your Cognitive Impairment (which may include cueing by verbal prompting, gestures, or other demonstration) by another person that is necessary to protect You from threats to Your health or safety (such as may result from wandering).

We, Our and Us means the John Hancock Life Insurance Company.

You, Your and Yourself means the person listed in the Policy Schedule as the Insured.

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