At BrightStarCare/North-Suburban, since we deal with seniors and their families, we know a lot about Long Term Care and Long Term Care Insurance . In this article, we're going to explore basic information and especially a caution about Long Term Care Insurance if you're filing a claim and want to actually use your policy.
Review of Long Term Care (LTC) Basics
Long Term Care, a.k.a., LTC, is actually a range of services and support that are available to us to meet personal-care needs and protect our assets in our golden, olden years. Most of LTC is not medical care, but rather assistance with the basic tasks of everyday living (ADL's).
- Age is not a determining factor in needing long-term care. About 70 percent of individuals over age 65 will require at least some type of long-term care services during their lifetime.
- About 40% of those receiving long-term care today are between 18 and 64.
Long Term Care also includes skilled nursing care and counseling people with regard to wise management of their financial assets."Wonderful," you say, "but how do I pay for these kinds of services and can I get financial assistance if I'm not in an assisted living facility and am aging in place in my own home, sweet home.
Long Term Care Insurance (to the Rescue?)
Long-term care insurance is designed to provide care not covered by health insurance, Medicare, or Medicaid. People who require long-term care are generally not sick in the traditional sense, but instead, are unable to perform two of the six activities of daily living (ADLs), referred to above, such as dressing, bathing, eating, toileting, continence, transferring (getting in and out of a bed or chair), and walking.
Okay, so let's say you thought ahead and were able to afford LTCI and you qualify to start receiving care at home. Are the claims steps easy, or can you run into a slippery slope suddenly raised by your insurance company?
The Big Beware About Long Term Care Insurance
After you file your claim to receive services, your insurance company is likely to require re-certification, that is assurance that you really do qualify for care. This includes a phone call and interview by an insurance representative. Here's the thing: the questions they ask are somewhat manipulative and designed to encourage the insured (you) to respond that you are able to function normally.
Instead of asking obvious questions like: "Are you unable to dress yourself or feed yourself or get in and out of the bed yourself?-- where you could provide a direct no-- they may ask manipulative questions designed to evoke a defensive response. For example, they may ask, "Do you consider yourself a self-sufficient person?"
That is quite a provocative question that almost invariably leads to a response of, "well of course I am!" It's in our nature to be proud of our ability to function independently. That's especially true of seniors who have made their way through all kinds of hurdles on their own their entire life and have been a virtual force of nature. Now, nature is a humbling fact of existence and admitting that you need help going to the bathroom requires its own kind of courage. So we fight for our honor and sometimes hold back the complete truth.
If the company representative is good enough, the results of the conversation can provide sufficient documentation that you've recovered to the point of not qualifying for a claim under your LTC policy.
At BrightStarCare/North-suburban, we're not saying make up things you can't do in the qualifying areas; we care for seniors and their loved ones dearly, but we're also HUGE on integrity in our organization and the services we provide. We're just saying, beware of tricky questions, tell the truth about your limited abilities in certain areas, and don't volunteer unnecessary information like the fact that you may be incontinent, but can still do 60 push-ups and a handstand.
If you need more information, want to talk about Long Term Care, as well as how to qualify (and pay) for our in-home services, call us today at 847-510-5750 and we can have an an open and non-misleading conversation. You'll get no tricky questions from us.
Check out our website at https://www.brightstarcare.com/locations/north-suburban-chicago/ We'd love to hear from you regarding any the following: