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Long Term Care Ins

July 31, 20233 min read

Information about Long Term Care Insurance

Hello everyone,

In honor of the desert, struggling like everyone in this heat, I'm posting this beautiful flower my cactus had a few weeks ago. This was the first year it bloomed and there were about a dozen blooms over 10 days. They bloom at night. I had to catch this before 8am.

Today I'm going to talk about Long Term Care Insurance Policies. They are beneficial, but they have many limitations. And, there is a lot of confusion about them.

Here's some things for you to know.

1. Most facilities will NOT take LTC Insurance as primary payor

Unfortunately, LTC insurance companies are notoriously hard to work with and sometimes the facility never does get paid. To complicate this, the contract is actually between the insurance company and the resident, NOT the facility. So the facility has no power.

For this reason, most/all facilities require that you pay the bill and they'll submit the claim information. The rest is up to you.

2. They don't usually cover Independent Living

In the eyes of most insurance companies and the people who work in Senior Living - Independent Living is "an apartment with extra services". This is the truth.

To almost everyone else, Independent Living is Senior Living and should be covered by LTC insurance. This is usually incorrect. Be sure you know the real designation of the living arrangements and assistance given before you assume that LTC insurance will be of any financial assistance.

3. These policies usually only cover a portion of costs

Check the policy details, especially if you bought it awhile ago. See how much it pays and compare it to the current prices out there. Call to be sure the company still exists! Be ahead of the curve whenever you can. If you're about to purchase a policy, ask about inflation protection.

4. They will require clinical information that a Business Office probably can't give you

Usually, the first claim submission needs clinical information as well as a first financial claim. This information needs to be completed by nurses, not the Business Office Staff. If the insurance company is asking repeatedly for this information - be sure to contact the right person at the facility for a status update.

5. Business Office will send monthly billing - and the insurance will claim they lost it. Repeatedly

Believe it or not, many of these insurance companies still rely on fax machines. And, it's in their interest to lose your paperwork. Sometimes they do - it's hard to know if it's on purpose or they're just unorganized. Get the fax confirmation from the facility and then.....

6. Be the contact to nag the insurance to pay, the nursing home will love you for it

This is your contract, as I mentioned before. If you're not getting you payment timely - call the insurance company and ask why. Ask for specific information. Make they prove things before they just blame the facility.

For more information and access to the Nursing Home 101 Guide

Nursing Homes 191

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Our senior citizens often live far from family and frequently have difficulty functioning on their own.  It only takes a moment for a medical event to send this situation spiraling out of control.   Even for someone in excellent health, navigating the important health care decisions, the paperwork, and the process can be overwhelming. My many years of experience as part of an administrative team in nursing homes have shown me where seniors and their families struggle with the complexities of a system that baffles everyone!  

After decades in this industry I know there's precious little guidance for the consumer - and mistakes can be costly and sad. I want to stop the suffering.  Let my experience guide you through this minefield with peace of mind and the security that your senior loved-one is being protected.    

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