So, you planned ahead. You purchased long term care insurance (LTCI). You paid the premiums religiously. You think that, when the time comes, you’ll just file a claim and receive a check.
The process seems simple enough. Think again.
Most LTCI policies require that the insured demonstrate either cognitive decline, as determined by the insurer, or show an inability to complete three activities of daily living (e.g., eating, dressing, personal hygiene, maintaining continence, and mobility).
Here are the problems:
1. You may not be able to recognize that it’s time to apply for eligibility.
2. By the time you meet the LTCI criteria, you are often not capable of submitting a claim by yourself.
Who will determine that you are demonstrating the decline warranting LTCI and complete the LTCI claim? The answers to these questions are another important component of your aging plan. Your conversations with your support team must include:
- identification of your long term care insurer, policy number, and location of your paper policy.
- individual(s) who decide it is time for you to begin the eligibility process.
- individual(s) who will complete your LTCI claim.
- setting funds aside to pay your expenses while initial claims are being submitted and there are gaps in coverage
Eligibility for LTCI doesn’t instantly translate into a check. Typically, policy terms include a 90-day waiting period. The ongoing claim submission and payment process can leave you paying out of pocket for long periods of time. This is because you are often required to pre-pay for services, but you cannot submit a claim until after services have been received. Furthermore, if there is a mistake in the claim submission, then you may be paying out of pocket longer.
Don’t assume that every facility accepts your long term care insurance. Before you select a facility, be sure you check the facilities’ policies on acceptable LTCI. All policies should be carefully reviewed so that the insured clearly understands all the terms and conditions.
Life Managers & Associates can assist you with long term care insurance by:
- reviewing policy terms and conditions.
- submitting applications for eligibility.
- managing monthly claims once you qualify for benefits.
Let Life Managers & Associates help you maximize the investment you have made in their LTCI. Visit www.life-managers.com