The Maximum Lifetime Benefit is shown in the Schedule of Benefits. Return to the Index. Maximum Monthly Benefit Means the maximum benefit allowed during a given month for any combination of Home Care, Home Health Care, and Adult Day Care, as shown in the Schedule of Benefits. The Maximum Monthly Benefit will not exceed the actual charges for all covered services received during the month. Return to the Index.
Some policies also allow medical necessity as a qualifying criteria.
This usually means that your doctor has certified that your medical condition will deteriorate if you do not receive needed services in a setting such as a nursing home or your own home. In this instance needed services are identified by your doctor in a Plan of Care. Return to the Index. Return to the Index. It does not mean senility or Alzheimer's disease.