Example 1: For example, if a member has a Daily Benefit Amount of $100/day and the cost of the nursing care facility is $80/day, then Aetna will reimburse $80/day and reserve the $20 difference in the member’s Lifetime Maximum (pool of money).

Example 2: In another example, if the member has a Daily Benefit Amount of $100/day and the cost of the nursing care facility is $125/day, then Aetna will reimburse $100 toward the nursing care and the member will be responsible to pay the difference.