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Tips for Unlocking Long-Term Care Insurance Benefits

Home Care San Diego Long Term Care Insurance LTC

Life expectancy rates have risen dramatically in the United States over the last century, largely due to better living standards and access to high-quality healthcare.  This increased life expectancy has given seniors much more time to enjoy their retirement years.  Unfortunately, it also means seniors have to find a way to fund the costs of their medical care and lifestyle.

Long-term care insurance (LTCi) is a useful financial product that can help seniors cover the costs of long-term care support.  This article will help you understand this form of insurance and offer four useful tips for unlocking long-term care insurance.

Understanding long-term care insurance

A long-term care insurance policy will reimburse a policy holder a daily amount for any services which assist them with their activities of daily living.  Those activities include bathing, getting dressed, ambulating, preparing meals, etc.

When you purchase the policy, you can select which care options and benefits you require.  For example, you may only require minimal assistance.  Typically, the cost of an LTCi policy is based on:

  • The maximum amount that the policy will pay you each day
  • The maximum number of days that are covered each year
  • What age you are when you buy the policy
  • The maximum total payout over your lifetime
  • Optional benefits that you choose

Seniors who are in poor health and already require a great deal of assistance may not be eligible for this kind of policy.  However, some insurance companies may still allow you to purchase one of these policies with a limited number of options.

Some policies will only pay benefits for a certain number of years, while others continue to pay benefits while the policy holder is alive.

Tips for unlocking long-term care insurance benefits

Unfortunately, these kinds of policies can sometimes be quite complex.  It can be difficult to understand when a person is eligible for a specific service and how often they are allowed to make a claim.  These tips will help you understand when a policyholder is eligible and how to obtain the maximum number of benefits from the policy.

Ask the right questions

Insurance providers are sometimes not clear about the specifics of their LTCi policies.  Don’t be afraid to ask your insurance company questions about your policy and what it covers.  If you are interested in receiving a specific type of benefit, ask plenty of questions about it.  For example, if you want to receive home care, ask your provider the following questions:

  • Does my long-term care insurance policy cover home care?
  • Are all home care services covered or only specific ones?
  • What percentage is the coverage? Is it 100% covered?
  • What is the maximum daily claim for home care?
  • How many days can I claim payments for home care each year?
  • What is the deductible period also known as an elimination period?

Make sure you record the answers to these questions.  Either write them down or record the customer service representative (if you have their permission).  This will help you remember the answers to your questions and notice any discrepancies from the insurance provider’s responses.

If the customer service representative seems a bit unsure about the answers to your questions, ask to be connected to a specialist insurance consultant.

Read the fine print in the insurance policy

Most long-term care insurance policies have certain rules regarding how and when claims can be made.  It is important to understand these rules before purchasing.

For example, most policies will have an “elimination period” — a rule saying that benefits will not be paid to a policy holder until a certain amount of time has passed and documentation has been provided.  That means you might not receive a benefit for a service you paid for until 30, 60 or 90 days later.

Some policies have a “start of care” rule stating that a service must commence within a few weeks of a claim being lodged or they will only partially pay the benefits you are owed.  That means you need to organize a service quickly after you lodge a claim.

Other policies have rules regarding the kinds of qualifications that caregivers must have.  They might only pay you for services received if they are provided by a certified nurse’s aide or a licensed home care agency.  If your policy has these kinds of restrictions, it is important to let your home care service provider know in advance.

The best way to process claims

Process all of your claims as soon as possible and make sure the insurance company has all of the information they need.  When submitting a claim form you may have to mark off the specific services that you received from the home care provider.  It often helps to make your home care agency aware of the services that are covered by your insurance company and those you are expected to receive.

Some forms also require multiple signatures, including your signature and a signature from your home care agency.  You may also have to sign activity logs that record which services you have received.  It is always a good idea to submit claim forms regularly — try for a weekly submission.

Document all communications with the insurance company

It is important to record your interactions with the insurance company, including any letters, phone calls, and emails.  This information may be of use if an insurance company ever denies one of your claims.  You can present them with evidence that shows your claim should be honored.

How Adult Home Health Care Can Help

Our consultants can help you wade through the intricacies of your long-term care insurance policy and find out what services you are eligible for.  Adult Home Health Care professionals can assist with processing new claims as well as ongoing claims.  We can then supply highly experienced caregivers to help you in the comfort of your own home.  Some of the services that they provide include:

  • Meal preparation
  • Assistance with personal hygiene tasks and getting dressed
  • Assistance with medication reminders
  • Performing Laundry
  • Light house cleaning duties
  • Much more!

If you are interested in learning more about Adult Home Health Care, contact us today at 619-940-6561 for a free in-home consultation.  We will discuss your parent’s capabilities and determine which services they may require.