You should also check with the LTC company to make sure the facility is on their list of facilities where they'd provide coverage. The same is true if you want the LTC insurance to pay for in-home care -- the agency needs to be on their list. If a particular facility like the one igloo ran into doesn't take LTC insurance it's worth checking to see if the facility would bill the resident who would pay out of pocket and then the bill would be submitted by the resident (or their POA)_ to the LTC company for reimbursement. We ran into this when my husband was using his LTC insurance to pay for home care. We'd pay the agency weekly then send copies of the bills monthly for reimbursement. The agency was on the LTC company's list but the LTC company for some reason didn't want to be billed directly.
Please reread what Alva wrote, the LTC insurance can be considered a resource for how LTC Medicaid program looks at an application.
Your imho going to have 3 interlocking aspects on this: - what LTC Policy will pay & when. This from the insurer. If you do not understand it, then you have to get someone to explain it to you. - how Medicaid views that payment for income (it’s a resource). You’ll have to make a copy of policy and it’s payout terms to accompany the LTC Medicaid filing. Imo you should expect to have time sensitive follow up from the caseworker on this and in detail AND - that the facility you are hoping to place your elder into accepts BOTH her LTC insurance as a payment source AND also has LTC Medicaid beds & take her as a Medicaid Pending starting the date she files the application.
Fwiw my mom’s 2nd and eons better NH did not take LTC insurance at all. Would not as just way too cumbersome paperwork & lots of foot dragging on payments. If my mom had had a LTC policy, she would not have been able to be there in a LTC Medicaid bed as she would have been turning down that LTC policy as an available resource.
I didn't realize that some facilities would refuse to take LTC insurance. We have been counting on ours to supplement our resources when the time comes (which could be in the not-too-distant future since my husband is 93 and I'm 86). So, if one or both of us must enter a facility, we need to find out if our LTC insurance would even apply, right?
Yes, and just occasionally it affects it negatively. In fact the LTC policy will provide some amount for monthly care. Add this to other assets such as monthly social security and the amount may be over the amount of monthly income required for medicaid eligibility while at the same time not providing enough income for a good ALF or MC.
Read the policy and see what is provided. Speak with medicaid advisors and with elder law attorney for specific advise about your Dad's case as these things are exceptionally complex and need reviewing for each individual person.
Your imho going to have 3 interlocking aspects on this:
- what LTC Policy will pay & when. This from the insurer. If you do not understand it, then you have to get someone to explain it to you.
- how Medicaid views that payment for income (it’s a resource). You’ll have to make a copy of policy and it’s payout terms to accompany the LTC Medicaid filing. Imo you should expect to have time sensitive follow up from the caseworker on this and in detail
AND
- that the facility you are hoping to place your elder into accepts BOTH her LTC insurance as a payment source AND also has LTC Medicaid beds & take her as a Medicaid Pending starting the date she files the application.
Fwiw my mom’s 2nd and eons better NH did not take LTC insurance at all. Would not as just way too cumbersome paperwork & lots of foot dragging on payments. If my mom had had a LTC policy, she would not have been able to be there in a LTC Medicaid bed as she would have been turning down that LTC policy as an available resource.
Read the policy and see what is provided. Speak with medicaid advisors and with elder law attorney for specific advise about your Dad's case as these things are exceptionally complex and need reviewing for each individual person.