Find Senior Care (City or Zip)
Join Now Log In
S
Sunny5 Asked August 2014

Does long term medical insurance cover home care?

He thought medicare and his secondary insurance pays at home I keep telling him its not . My dad is in therapy to walk again has parkinson they won't let him go home if cannot do the things he used to do because he lives alone. He thinks i can do everything for him I have a family and my own home I"m his daughter I used to run back and forth everyday cleaning cooking paying his bills taking him to doctors but 24 hour care is much more I cannot do depends and bathing and stay 24 /7

karenlorenzo Sep 2014
@gladimhere, The asset protection program I believe is for long-term care insurance partnership program.

gladimhere Sep 2014
My mom bought a long term care policy for the sole purpose of being able to stay in her home. I am sure, however, that policies are very different in what and when they will pay.

As a side note make sure that someone other than the policy owner is responsible for verification that payments continue to be made. My Mom's long tern care policy lapsed for non payment. This was probably during early stages of Alzheimer's and she either forgot to make the payments of she made a very unwise financial decision.

And new rules this year on Medicaid. If someone has a long term care policy they will be permitted to keep personal assets up to the value of the policy. And also that amount will be doubled if the person has purchased long term care insurance. So, if the policy provides for $300,000.00 of care, then the insured has protected $600,000.00 of their assets to leave at their death.

ADVERTISEMENT


karenlorenzo Sep 2014
Medicare does not necessarily cover home care, it may pay for home services if you meet several conditions and the coverage is limited.
His long-term care insurance covers a wide variety of services including home care, review his contract and call the agent or insurance company where he bought his policy to check if home care is included in his policy. Some insurance providers offer alternative plan of care, this is an ltci feature which is only available in some states, not all insurance companies offer this type of feature.
If this is included in your dad's policy, then call the company so they can evaluate your dad's condition and see if he qualifies or to see what is best for him.

PrettyGood Sep 2014
Depends on the individual policy. Some written in the 1980's may not cover home care UNLESS there are several of the ADL's which require assistance. Your insurance company will for surely come out and evaluate the propsed recipient on their own, as well as requiring copies of medical records. They are not going to pay any claim without verifying it meets the qualifications.
Keep in mind, there is usually an elimination period of 60, 90, 180 days or something like that, during which, they must be reciving in-home care and you must be paying for it out-of-pocket. AFTER you have paid for all of that out of pocket, (not just waiting that many days......you must have the receipts to show you actually paid for it by yourselves), then they will start paying.
My folks' policy is one of those 1980's policies, and they only cover $20 a day (blushing) which is not much these days. They had an option to increase but they never thought they would need it. The option went bye-bye at age 80. Guess what at age 89 Dad gets dementia......so now he has only $20 a day, and a yearly max $1060 of care at home. Which is something, but hardly anyting (53 days???). And his lifetime max is only $90,000, but, (drum roll) there is a max of $10,200 per year. Again it's something but not much when memory care is about $7,000 per month.

Donna1944 Aug 2014
I have a policy with Mutual of Omaha. It is supposed to pay for home health care, then I believe when we can't manage at home anymore it pays up to $4000. A mo. for NH. It increases 3% each year, but premiums stay the same.
I am caring for my mom and wish she had enough money even for assisted living.


I am 70 this month, a time when I hoped to travel and enjoy my 6 grandkids, but as she has always been, everything has to be about HER. I can get up and leave, for which I'm thankful. I could not live with her 24/7 as was mentioned before. (she has started saying "I wish I could go home". I keep telling her that her friends and relatives are not in the county anymore, and no one to care for her needs that I am doing now. She refuses to make friends in the assisted living/retirement home. Doesn't want to leave her dog in the room, or sit on the front sidewalk and right now can't because of 90 degree temps.

If she doesn't walk, she will get to where she can't walk. I will suggest a nursing home if that gets worse, maybe that will get her up.
I'm taking a trip next week. Haven't told her yet. She has one friend who visits often and a niece who comes once a month. She needs to make the best of all the help she has, but would rather be pitiful. So many of us are in this boat.

BarbBrooklyn Aug 2014
Is he in rehab? Talk to the discharge folks at rehab about what is needs are going forward and how to pay for care.

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter