Accessing the Benefits of Long-Term Care Insurance

Accessing the Benefits of Long-Term Care Insurance
family caregiver helping senior with paperwork

These tips will help families access the benefits of long-term care insurance.

Long-term care insurance can provide extraordinary peace of mind, but accessing those benefits can end up being a confusing experience for seniors and their family members. To help guide families through the process, Hired Hands Homecare, the leader in home care in Rohnert Park and the surrounding area, provides this helpful overview.

What services are covered?

Prior to filing a claim, it’s important to thoroughly read through a copy of the long-term care insurance policy in order to gain an understanding of the types of services the policy covers. If you don’t have a copy of the policy, reach out to the carrier to request one.

While all policies differ in what they cover, long-term care insurance usually covers non-medical services at home, provided assistance is required with a minimum of two or more activities of daily living, or the policyholder has been diagnosed with some form of cognitive impairment, such as Alzheimer’s. Examples of the type of care that long-term care policies may cover include:

  • Personal care needs, such as bathing/showering and getting dressed
  • Ambulation and transfers
  • Toileting and incontinence care
  • Meal preparation and feeding
  • Household chores
  • And others

If you or a senior loved one needs help understanding the details of the policy, an insurance agent, elder care attorney or financial planner may be helpful.

Are all of the costs of care covered?

While individual plans vary, each plan outlines the allowable monthly coverage, which is identified as the “present daily allowance,” and often has a lifetime maximum cap. Policies also typically identify a specific length of time for which the benefits are available, such as five years, or if the coverage is in effect for the remainder of the policyholder’s lifetime.

It’s also important to check the long-term care plan’s elimination period. The elimination period is the time during which the cost of care is paid out-of-pocket initially, until a set amount of time has passed. While some plans specify a zero-day elimination, meaning cost of care and coverage begin immediately, other policies may require up to 120 days of care first.

Choose your care provider carefully.

If you plan on filing a claim with long-term care insurance, it’s important to partner with a home care company that has experience in billing long-term care insurance providers; otherwise, there is the potential that the claim may not be fully reimbursed. Hired Hands Homecare is experienced in helping families access the benefits of long-term care insurance and can provide the documentation needed to help clients file efficient claims.

How are claims filed?

To file a long-term care insurance claim, the following documents are typically required:

  • A claimant’s statement (or policyholder statement) detailing the reasons for the claim
  • A physician statement completed by the doctor, verifying that care is needed
  • A prescribed plan of care and nursing assessment
  • A provider statement, completed by the home care agency
  • An authorization form

Once completed and submitted, a phone interview is scheduled with the insurance company’s claims department, and from there the claim is either approved or denied.

If you are looking to access home care services through a long-term care policy, reach out to Hired Hands Homecare  today at (866) 940-4343. You can feel confident in knowing that we have years of experience in not only providing expert care in the comfort of home, but also in assisting families with long-term care insurance claims and getting the most out of their benefits. To learn more about our top-rated home care in Rohnert Park  and the other communities we serve, please visit our Service Area page.

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