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Most LTC insurance plans will require you to have a need for assistance with activities of daily living such as bathing, dressing, transferring, eating, toileting or continence. Help is usually required to be hands on, and in the newer policies - 1996 and beyond - stand by assistance is ok. Before 1996, there was usually no need for your condition to last a certain time, so see if an older policy pays for the 6 weeks to heal from surgery. 1996 HIPAA approved plans require it must look to be a 3 month issue. With most serious injuries, Illness or aging issues, it will be. Cognitive impairment is its own trigger. Some older and post ’96 not Tax Qualified plans may include walking as an ADL, as well as “Medical Necessity.”
To make a claim, call your agent or the insurer. You will be given interviews and forms to fill in about your condition. Your doctor is usually asked for information. Once your claim is approved, a Benefit Analyst will contact you w/ info on how to submit receipts or other proof of expense. Most policies pay by reimbursement, tho others may pay indemnity--pure cash regardless of expenses. Some policies include Care Coordination to help you find services and equipment at a discount.
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To be able to use long term health insurance, you must meet the criteria set forth in the policy. See if you meet the criteria before contacting the insurance company.
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spearfish926,

Long term insurance is an important topic in many aging seniors and caregiver's lives. Carol is right, each policy is different and you need to find the policy that works best with you. I have included some long term care insurance articles to better familiarize your self with this type of insurance.

What is Long-Term Care Insurance?
https://www.agingcare.com/articles/Definition-of-long-term-care-insurance-143436.htm

7 Things to Consider Before Purchasing Long-term Care Insurance
https://www.agingcare.com/articles/tips-for-purchasing-long-term-care-insurance-143641.htm

Good Luck.
Karie
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Each policy is different. Contact your company and see what the policy covers. Some policies cover in-home care services, some assisted living and some just nursing homes (the older policies). The only way to know is to contact your company and look at the policy.
Good luck,
Carol
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