So Use It When You Need It
In 2014 Long Term Care Insurance carriers paid over $7.8 billion in claims. Seventy Percent of seniors over 65 will need assistance with Activities of Daily Living (ADL’s). Unfortunately only 10% of seniors have Long Term Care Insurance (LTCI). Sadly over 90% of seniors never file a claim on their policy. Those that do often have problems getting their claims approved.
Benefits of Utilizing Your LTCI Policy:
Stay at home with a higher degree of independence, improves quality of life, safety and fall prevention, and monthly premium may stop.
Care may need to be certified by a health care professional:
- Registered Nurse
- Licensed Clinical Social Worker
- Medical Doctor
Key Terms in Your Policy:
- STAND BY ASSISTANCE: Another person needs to be in arms reach to intervene in the event the policy holder is going to injure oneself.
You don’t have to be 100% dependent on another person to help assist you with ADL’s. You simply need to have somebody close by to help if you are about to fall.
- HANDS-ON ASSISTANCE: Another Person must physically help you perform 2 or more ADL’s. Without someone physically helping you perform these ADL’s you would not be able to perform them.
- This is what most seniors believe is required to use their policy. However it’s not the case.
To use your policy you must need either hands-on assistance or stand-by assistance to perform two or ADL’s.
- CONSTANT SUPERVISION: Policy holder is a safety risk to self or others if left unattended due to a cognitive impairment.
A cognitive impairment is enough to activate a claim. No assistance with ADL’s are required.
Must need assistance with at least 2 of the following ADL’s: bathing, dressing, toileting, continence care, transferring, or feeding.
Policies will pay for homemaker services secondary to needing assistance with 2 ADL’s: housekeeping, laundry, meal prep, and transportation services.
All policies are different. It’s critical to understand what is in your specific policy prior to activating a claim. The policy may pay for care:
- Only in your home
- Only in a nursing home
- Only in a facility or nursing home
- Comprehensive (Both in the home or facility.
Hiring a home care company with experience, expertise and understands the claims process is essential in getting your claims approved to pay for care.
Article Provided by:
Amada Senior Care
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