How does one enforce a facility policy. We can't collect. My Mother has been paying $1,000 a month for 15 years. She now needs a Nurses Assistant 24 x 7. I am staying with her 12 hours a day. She is in Personal Care where Nurses Aids check on her during the night. There is an alert system but no room monitors. She has more than 2 qualifiers for 24 x 7 care. Where can I go to get enforcement of the policy she purchased for $150,000.00 over 15 years. I am being retaliated against for asking about this and other problems too numerous to list all here. This is a dangerous situation. Each night I leave her, she asks, will you be here in the morning. I answer yes and give her the time and we pray that God will keep her safe during the night. It is a big risk that she could fall. Some nights she is wobbly. When I get there in the morning her walker is left at the toilet. She is walking back and forth herself. Tonight she was delerious all evening. She is having blood tests tomorrow.
I appreciate knowing about the claim jockey. That would have been helpful. I can see there are still areas family or an advocate are needed, such as monitoring the caregiver hours, and making sure info is available to whomever needs it, but overall, it would have been helpful. Since I've not heard of it, I will pass info on. Thanks.
@Twinflower1: Good comments. There is now a company that will take care of all these pesky claim details. Contact Claim Jockey. The nurse from Genworth is there to help fill in the initial paperwork, too. Once the claim is approved, time sheets can be filled in by the worker, and the claimant or their family can just make sure they are accurate before sending them in for reimbursement.
This is a good article. I would add another dimension to the discussion in the arena of collecting the insurance. Who will be the person applying for the insurance when it is needed (often the purchaser is unable to master the complexities involved) and who will monitor payments, arrange visits from nurses that are required, and do the legwork regarding changing addresses, following up on changes when a client has to move from assisted living to memory care of any other situation regarding a change of living status for the client. I have been told that by the time a person needs and is qualified for long term care insurance, they often are not able to handle the application process. Having gone through that process, with an Aunt who was unable to do it, I am firmly going to advocate that anyone purchasing long term care insurance know that a third party will be needed to handle the application and monitoring.. Genworth sends nurses to meet to the client and observe their condition. They make appointments and spend an hour to an hour and a half asking questions and asking patients to perform tasks so their level of function can be quantified. My Aunt was upset at the length of the interview and felt someone was trying to do something to her. She was in a mild form of dementia at the time, but I needed to calm her. I personally would have been exhausted after the lengthy evaluation. They need providers names, addresses and numbers, and often they need information that only family or a close caregiver can give. During the initial interview, the facility nurse was present and unable to answer all the questions. They either didn't know my Aunt well enough, or they didn't have a complete history. The insurance company also needs legal documentation before they can talk to you. Throughout the process of collecting long term care insurance (five years), my experience is that "glitches" occur regularly. The facility bills, the insurance company deposits into the bank a reimbursement payment. Only it doesn't happen like that all the time. The facility can send the paperwork, but the insurance company doesn't get it. There can be as many as five attempts to get the billing through. It usually requires a phone call to resolve the issue. I used to be notified by mail when a claim was not received by the insurance company. I could alert the facility who would also receive a notice a claim was not received. Now I receive a notice that my Aunt's premiums are being reinstated. If you're wondering, the insurance company didn't receive a claim, assumes my Aunt is no longer in the facility and ends her benefits. I keep a very close watch on the deposits to her account, If nothing appears when there should be a deposit, I prompt the facility that their billing didn't go through. If no one was watching, all payments would stop. If you rely on the reimbursement payment for current bills, things get out of hand quickly if the deposit doesn't arrive. While saying this, there are also stretches where all goes well. If the facility changes bookkeepers, be prepared to instruct them on how your insurance company works and whom to call to put eyes on your billing. I have found that the insurance company is very willing to correct mistakes. But they make it very easy to have benefits stopped. I would also recommend coverage to the full extent allowed per day. My Aunt purchased insurance that was adequate for the time period she was in at the time of purchase. Daily expenses have doubled since that time for assisted living and nursing home care. She also had a dollar limit on her policy. I would get one for the duration if you can afford it. If you are expecting to take care of all the application paperwork yourself, or think the facility will take care of the paperwork, you are probably not going to be able to claim your benefits. Your POA or trustee needs to be on the ball.
The person who told you that you could only buy 2 to 5 years of LTCi benefits is mistaken.
In 49 states (including KY) there is a policy offering long-term care coverage that is unlimited. There's no cap on how much it can pay in benefits over your lifetime.
In 50 states a couple can share two policies that combined can pay benefits for at least 16 years.
In 48 states a couple can share two policies with $1.5 million dollars of long-term care benefits.
If the person who told you that you could only buy 5 years of benefits is an insurance agent, it might be that he/she does not represent the companies that offer these larger benefits.
I'm sorry to hear about your mother. It's important that anyone who purchases a long-term care policy let their close relatives or friends know about the policy so that a claim is made on the policy.
Also, with all policies today that meet the federal guidelines, the insurance company has to send notices to those you designate if a premium is not paid on time. This is to prevent your policy from lapsing. The people you designate to receive these notices will know about your policy and they can also be there to make sure that a claim is filed when you need care.
ScottAOlsonLTC, I would like to know where you got your info from. Every policy I looked into offered only from 2 - 5 yrs stating that that is the most they expected someone to survive in a NH. Maybe it differs in different states. That is the way it is in KY. Also, when the subscriber stops payment, or has no more sense to continue, if they have up to a year to get partial reimbursement back, regardless of mental state. She was paying $7000.00 a year for her. Mother lost $130,000.00 because she did not understand to submit a request. It was too late before I found out. The insurance co basically said to bad so sad, get lost. Go ahead, they said, and get an lawyer, it won't do you any good. It didn't. She could have used that money. Dad lasted a year & got his benefit, but be careful, Mom's premiums more than tripled after he died in 99. Mom had to pay up front monthly, out of their stocks and then was reimbursed by the insurance sometime afterward, rather than the insurance co paying direct. Read the small print, please.
Long-term care insurance, as described in infolongtermcare.org is a product that may not fit everyone, but if you have the funds, then you should buy it. The guides provided herein are helpful so that you can tailor a policy that best suits your needs and preference, the key to having a good long-term care insurance coverage is to avoid over-insuring. No individuals are the same in as much as no long-term care insurance policies are ever the same so plan carefully and do not forget to consider the tips listed here, make sure to talk to an expert before shopping for long-term care insurance.
Long-term care insurance, as described in infolongtermcare.og is a product that may not fit everyone, but if you have the funds, then you should buy it. The guides provided herein are helpful so that you can tailor a policy that best suits your needs and preference, the key to having a good long-term care insurance coverage is to avoid over-insuring. No individuals are the same in as much as no long-term care insurance policies are ever the same so plan carefully and do not forget to consider the tips listed here, make sure to talk to an expert before shopping for long-term care insurance.
I would just like to add that considering the financial rating of long term care insurance companies is important since freeltcquotes claims that it can help consumers find a company that can meet the claims of policyholders, provide high quality services and very stable. Most people forget this, which often leads to a problem especially when it's time for them to file for claim.
By following these tips, I'm pretty sure consumers will find the appropriate carrier and policy type for them.
Considering these things before buying long term care insurance can actually save you money. Long term care insurance cost can go around $1,000 to $7,000 annually which is a bit pricey for people who have other financial responsibilities. These tips are beneficial to those who have a limited budget but keen in having a policy. I just hope consumers will use these guidelines before purchasing coverage.
If a person has assets, there is a product for those already experiencing loss of 2 activities of daily living. Normal annuities would base their payout on the life charts, but this one will base it on a person's health condition. The benefit for the person already needing care is that they can design coverage to augment their income, say by $3000 a month, again, based on their expected lifespan. The payout will be higher and initial amount funding it will be lower than a normal annuity. Now, let's say this person lives longer than their expected life--the policy continues to pay as long as they live. This can put a stop-loss on their estate by paying their LTC costs for the rest of their life.
Actually, that is not correct. When someone purchases LTC insurance they can choose how long of a "Benefit Period" they want their policy to have. The "Benefit Period" is the amount of days, months, or years, the policy is designed to pay benefits once you qualify for benefits. The size of the Benefit Period is chosen by the person purchasing the policy (not the insurance company).
You can choose a Benefit Period as short as two years, if you want to. Most insurers offer the choice of: 2 years, 3 years, 4 years, 5 years, and 6 years. Many insurers offer 8 years or 10 years. Most insurers allow married couples to "share benefits" so a married couple could share as many as 20 years of benefits between them (if they each had a 10 year Benefit Period).
Those interested should also know most policies are only good for 2 years. A select few will last for up to 5. Read the fine print carefully. Been there and burned.
The Affordable Care Act, which forbids denying coverage because of pre-existing conditions, applies only to medical insurance. That requirement does not take effect until 2014.
For all other insurance products (e.g. life insurance, disability insurance, long-term care insurance, critical illness insurance, "cancer insurance", etc...) people still need to "health qualify".
Hillary, If you purchased your policy just a year ago, you will probably NOT be getting any premium increase. The insurer that recently announced a 40% increase is only requesting that exact increase in one state. Most of their policyholders who will get a premium increase will get an 18% to 22% increase. And most of those have had their policies for over 5 years. Most of the people who purchased a policy in the last 5 years will not be getting any increase at all. Additionally, that insurer has announced that for those policyholders who could get a premium increase, they can elect to modify their benefits (e.g. reduce a 5% compound inflation benefit to a 4% compound inflation benefit) and thereby avoid any premium increase. Scott
Asset-based LTC is incorporated in a life insurance policy. Can't ever increase premiums & pays the death benefit if LTC not used, cash value if policy surrendered. So no worries about losing the premiums if no LTC. Also, easier to qualify for. A great new product.
We purchased LTC last year. We are 52 and after living through the pain of dealing with a parent with dementia and the final stages being in a nursing home we thought it was time. However now we are aware that premiums will be going up as much as 40%. Since we probably have 30 years of paying into it, do we keep it or let it go and take the $2500 lose as a lesson. Since the crystal balls are out of stock we are open to suggestions.
In our case we purchased long term for my mother in 2000 and have been paying for it all this time. She's gone into assisted living and it won't pay a cent!! When we took out the policy there was only nursing homes around here and that's the policy we have. Therefore, if and until she goes into a nursing home we have no coverage at all.
It is very unlikely that any company will provide long term care insurance for someone who has Alzheimer's or is in a nursing home. You need to buy this type of insurance before the need, just like you buy homeowner's insurance before the fire and car insurance before the wreck.
Also, you need to buy it young while it is still affordable. The older you are the more expensive it is. So even if a company will provide the insurance when you are older you may not be able to afford it. One solution to this problem is for the children in a family to help pay for long term care insurance for parents or grandparents. This insurance benefits everyone in a family, the caregivers as well as the person getting care.
I have the same question and would like to know the answer on behalf of our clients. We own and operate an Adult Day Care Center in Sparks Nevada and provide care for those with most forms of Dementia, including Alzheimer's, at the cost of $55 per day, which is about 1/4 the cost of in-home care or assisted living. It also allows the families to stay together longer and gives the caregiver a welcome break while playing an active role in ensuring their loved one receives proper care. So if you don't qualify for LTC ins. please consider contacting an Adult Day Care near-by to maximize your limited resources.
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8 Factors to Consider Before Buying Long-Term Care Insurance
I have been told that by the time a person needs and is qualified for long term care insurance, they often are not able to handle the application process. Having gone through that process, with an Aunt who was unable to do it, I am firmly going to advocate that anyone purchasing long term care insurance know that a third party will be needed to handle the application and monitoring..
Genworth sends nurses to meet to the client and observe their condition. They make appointments and spend an hour to an hour and a half asking questions and asking patients to perform tasks so their level of function can be quantified.
My Aunt was upset at the length of the interview and felt someone was trying to do something to her. She was in a mild form of dementia at the time, but I needed to calm her. I personally would have been exhausted after the lengthy evaluation.
They need providers names, addresses and numbers, and often they need information that only family or a close caregiver can give. During the initial interview, the facility nurse was present and unable to answer all the questions. They either didn't know my Aunt well enough, or they didn't have a complete history. The insurance company also needs legal documentation before they can talk to you.
Throughout the process of collecting long term care insurance (five years), my experience is that "glitches" occur regularly. The facility bills, the insurance company deposits into the bank a reimbursement payment. Only it doesn't happen like that all the time. The facility can send the paperwork, but the insurance company doesn't get it. There can be as many as five attempts to get the billing through. It usually requires a phone call to resolve the issue. I used to be notified by mail when a claim was not received by the insurance company. I could alert the facility who would also receive a notice a claim was not received. Now I receive a notice that my Aunt's premiums are being reinstated. If you're wondering, the insurance company didn't receive a claim, assumes my Aunt is no longer in the facility and ends her benefits. I keep a very close watch on the deposits to her account, If nothing appears when there should be a deposit, I prompt the facility that their billing didn't go through. If no one was watching, all payments would stop. If you rely on the reimbursement payment for current bills, things get out of hand quickly if the deposit doesn't arrive. While saying this, there are also stretches where all goes well. If the facility changes bookkeepers, be prepared to instruct them on how your insurance company works and whom to call to put eyes on your billing.
I have found that the insurance company is very willing to correct mistakes. But they make it very easy to have benefits stopped. I would also recommend coverage to the full extent allowed per day. My Aunt purchased insurance that was adequate for the time period she was in at the time of purchase. Daily expenses have doubled since that time for assisted living and nursing home care. She also had a dollar limit on her policy. I would get one for the duration if you can afford it.
If you are expecting to take care of all the application paperwork yourself, or think the facility will take care of the paperwork, you are probably not going to be able to claim your benefits. Your POA or trustee needs to be on the ball.
The person who told you that you could only buy 2 to 5 years of LTCi benefits is mistaken.
In 49 states (including KY) there is a policy offering long-term care coverage that is unlimited. There's no cap on how much it can pay in benefits over your lifetime.
In 50 states a couple can share two policies that combined can pay benefits for at least 16 years.
In 48 states a couple can share two policies with $1.5 million dollars of long-term care benefits.
If the person who told you that you could only buy 5 years of benefits is an insurance agent, it might be that he/she does not represent the companies that offer these larger benefits.
I'm sorry to hear about your mother. It's important that anyone who purchases a long-term care policy let their close relatives or friends know about the policy so that a claim is made on the policy.
Also, with all policies today that meet the federal guidelines, the insurance company has to send notices to those you designate if a premium is not paid on time. This is to prevent your policy from lapsing. The people you designate to receive these notices will know about your policy and they can also be there to make sure that a claim is filed when you need care.
Scott A. Olson
LTCShop
By following these tips, I'm pretty sure consumers will find the appropriate carrier and policy type for them.
You can choose a Benefit Period as short as two years, if you want to. Most insurers offer the choice of: 2 years, 3 years, 4 years, 5 years, and 6 years. Many insurers offer 8 years or 10 years. Most insurers allow married couples to "share benefits" so a married couple could share as many as 20 years of benefits between them (if they each had a 10 year Benefit Period).
Scott
LTCShop
For all other insurance products (e.g. life insurance, disability insurance, long-term care insurance, critical illness insurance, "cancer insurance", etc...) people still need to "health qualify".
Scott
If you purchased your policy just a year ago, you will probably NOT be getting any premium increase.
The insurer that recently announced a 40% increase is only requesting that exact increase in one state.
Most of their policyholders who will get a premium increase will get an 18% to 22% increase. And most of those have had their policies for over 5 years.
Most of the people who purchased a policy in the last 5 years will not be getting any increase at all.
Additionally, that insurer has announced that for those policyholders who could get a premium increase, they can elect to modify their benefits (e.g. reduce a 5% compound inflation benefit to a 4% compound inflation benefit) and thereby avoid any premium increase.
Scott
Thanks!
Also, you need to buy it young while it is still affordable. The older you are the more expensive it is. So even if a company will provide the insurance when you are older you may not be able to afford it. One solution to this problem is for the children in a family to help pay for long term care insurance for parents or grandparents. This insurance benefits everyone in a family, the caregivers as well as the person getting care.
Jan