We all know that dealing with your insurance company can be tough. Policies are often unclear and difficult to understand. At Extended Family Inc., we can help take some of the guesswork out of dealing with your insurance company.
An Overview
Traditional insurance covers prescriptions, preventative and emergency care, and doctor’s visits. Long term care insurance is a specific type of insurance covering the long term care of recipients either in an institutionalized setting, or in-home, with regards to their daily needs. There are many types of long term care coverage, and benefits differ from policy to policy, so always contact your insurer to be clear on exactly what your specific policy does and does not cover.
What Does Long Term Care Insurance Cover?
Long term care insurance traditionally covers in-home care from a licensed caregiver, nursing home care, hospice care and Alzheimer’s facilities. Long term insurance can help with the cost of an in-home caregiver. Policies vary, some are unlimited, with no maximum payable benefit, and some have a daily maximum amount. Policies also differ in length, with some policies covering the patient indefinitely, while others have a limit to the amount of time that coverage will be provided.
What Costs Might I Incur Out Of Pocket?
Out of pocket costs are a huge consideration for the family of a loved one requiring long term care. Most insurers take between two to four weeks to start disbursement. Some insurers also require proof of between 20 to 120 service days of paid care before they will begin disbursement. It is also important to check with both your insurance carrier and your care provider to ensure that your coverage is sufficient to cover the needs of your loved one without ongoing out of pocket expenses.
What about Medicare and Medicaid?
Medicare generally does not cover long term care. Medicare only covers medically necessary nursing home or at home care. You must meet certain requirements for medicare to cover these services. Medicare does not cover in home help for activities of daily living, such as bathing, dressing, etc. Medicare defines this as ‘custodial care’ and it is not currently covered without the purchase of supplemental insurance.
Medicaid recipients (as Medicaid is an income based program) are NOT encouraged to purchase long term care insurance, as the premiums are generally not feasible for recipients. Medicaid covers the same medically necessary care as Medicare. There are programs available to those on Medicaid through Long Term Care Options.
Helping Long-Term Care Insurance Work for You
Navigating the ins and outs of insurance policies is never easy, especially when you’re already working through the complications of finding the best care possible for your elderly loved one. As long-term care insurance becomes a more popular option for the aging population in the U.S., it’s increasingly important that the family members of those needing care be able to understand what long-term care insurance is and how it can be used to ensure quality in-home care for their loved ones.
The National Clearinghouse for Long Term Care Information (a website developed by the U.S. Department of Health and Human Services) is a great resource for those looking for more information on the particulars of long-term care insurance. On this site, you’ll find information about:
- Coverage and benefits choices
- Buying long-term care insurance
- State partnership programs, which help link private long-term care policies with Medicaid
Long-term care insurance policies vary a great deal in terms of how much care is covered, the length of the policy, and when one can begin receiving benefits. Because of all these variables, understanding an existing policy can be complicated.
Extended Family is ready to help make the process as seamless as possible so that our clients can get the care they need, quickly and easily. We have many years of experience working with long-term care insurance companies. From the start, we’re there to:
- Help families review their long-term care insurance policies and answer any questions they might have during the process of setting up insurance reimbursement.
- Facilitate communication between families and their insurance agencies to help move the process forward most efficiently.
- Deal directly with our clients’ insurance agencies in order to streamline the reimbursement process. Because we’re a licensed home care agency, we can bill your long-term care insurance company directly and submit all care notes and other required paperwork.
Extended Family Inc. can help you navigate your insurance company more effectively. While we are unable to speak directly with your insurer, (with the exception of billing) we can prepare you with pertinent information about our services, and give you guidance in asking effective questions of your insurer. We can help you understand your coverage and how it will affect you with regards to out of pocket costs and options for the care of your loved one. Because Extended Family Inc. is a licensed home care provider, we can bill your insurance directly, saving you time and frustration. It’s our priority to provide the best care possible for our clients, and simplifying the insurance reimbursement process is one of the ways we do this. If you have any questions about long-term care insurance, feel free to give us a call and we’ll be happy to talk to you about it!
