Claims Denials or Delays With Long Term Care Insurance.
According to a recent article in The Wall Street Journal (The Latest Long-Term Care Snafu), however, some families are encountering claims-denials that can prevent or delay the collection of benefits.
If you have purchased a long-term care insurance policy, there are steps you can take to help avoid this problem. Most importantly, be sure to re-read your policy’s fine print before hiring a caregiver or entering a facility. We have found, it may make sense for you to hire, Senior Life Care Planning, to help in preparing and advocating for your claims.
Be particularly vigilant if the policy was purchased before 1997. Older policies often include requirements such as a three-day hospital stay before they will pay for nursing home care. These types of stipulations can exclude many people for receiving care, especially those who are physically healthy, but still require care, such as Alzheimer’s patients.
Federal law requires tax-qualified long-term care contracts issued since 1997 to pay benefits under two conditions: when policyholders are unable to perform two out of six basic “activities of daily living,” such as dressing or bathing, or when they have a cognitive impairment requiring “substantial supervision.” For virtually all policies sold today, a health-care professional, such as a doctor or nurse, must certify that the disability is expected to last at least 90 days.
If you are currently evaluating a long-term care insurance policy and would like an objective evaluation of your policy terms, please call our office for a consultation.
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