OmniFlex ™ Short-Term Care Frequently Asked Questions Benefits Continued Can an insured increase or decrease benefits? Yes. To increase benefits , a new application must be submitted referencing the current policy number, and approval is subject to underwriting. To decrease benefits , a written request (by email, mail, or fax) may be submitted, also referencing the current policy number. Can an insured add or remove a Rider from their policy? Yes. To add a Rider , a new application must be submitted referencing the current policy number, and approval is subject to underwriting. To remove a Rider , a written request (by email, mail, or fax) may be submitted, also referencing the current policy number. Would they get to keep the existing daily benefit amounts after they drop the inflation rider (if not, please clarify)? In addition, how would the new rate be calculated? No, if the inflation rider benefit was dropped and therefore no longer part of the benefit package. As an example, if the insured drops the simple inflation rider in the 8th year of the policy, their daily benefit amount would have matured as of the 5th policy anniversary date and then started growing with the inflation rider at that point. However, with the inflation rider no longer in place, the daily benefit amount would match the original amount selected at time of application. If a client personally pays $0 for their prescriptions and/or they are already receiving some other prescription benefit (i.e. some other Home Health Care or Short-Term Care plan, etc), do they still receive the OmniFlex™ Prescription Drug Benefit? Yes Is a prescription for Marijuana for treatment of anxiety or mild depression insurable? No, Marijuana cannot be prescribed like conventional medications because these products are not FDA- approved and are illegal under federal law. According to the policy language we would not cover this. Does ManhattanLife allow facilities (nursing home, assisted living, etc.) to file a claim on behalf of the policyholder, whereby ManhattanLIfe then pays the claim directly to the facility, per the terms of the policy? ManhattanLife can make claim payments to a facility or provider. Providers have the option to submit their own detailed invoice along with a an assignment of benefits signed by the policyholder. Alternatively, they can also submit a CMS 1500 claim form with the insured’s signature authorizing payment. Can the Fast-50 benefit from either the facility benefit or the Home Health Care Rider benefit be used for in home care from a family member or loved one? Yes. The policy allows for the Fast-50 benefit on the Facility Benefit and/or the Home Health Care Rider benefit to be used for in home care from a family member or loved one.
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