Archive for May, 2011

I Have An LTC Policy…Now What?


You have purchased your own Long Term Care Policy!

I hope that you truly understand how to use your benefits in the future should you ever need help. Suppose you have a medical incident that requires Long Term care:

• So how does it work?
• What do you need to do?
• How do you start the process?
• Will your coverage meet your needs?
• How does Long Term Care Insurance work?

This process begins with a phone call to the insurance company claims center. Each company processes claims differently. However, they all begin by determining if your condition will qualify you to receive your benefits.

A crucial first question is: Will your doctor certify that you have a severe cognitive disorder or are unable to perform at least two activities of daily living without assistance and expects this disability to last at least 90 days?

Activities of daily living include:

• Eating – Getting food from plate to mouth
• Toileting – Help with personal hygiene tasks
• Bathing – Washing yourself and/or getting in and out of the bathtub or shower
• Dressing – Putting on or taking off clothing and/or assistive devices
• Continence – Control of bowel and bladder functions
• Transferring – Getting in or out of bed, chair, wheelchair

Now once you have qualified fir the claim, the insurance company will assign a care coordinator to work with you. They will try to develop a plan of care for you, meaning they will control the hours and the days you will receive care.

Does your policy pay Daily or Monthly? The most common is daily, but do you know what your policy does?

Also, do you have an elimination period (Deductable) or first day coverage? If you do have one, those are the number of days you will pay out of pocket until those days are satisfied. Once that is satisfied, the Long Term Care Policy now starts to pay. But, remember that you must show (prove to) the insurance company that you have paid for the elimination period so benefits can begin to be paid.

Most policies are reimbursement, which means that you will pay these expenses then submit proof of services to the insurance company. You will then be reimbursed for some, or all of the actual charges you have incurred. However, if you have an advocate helping you, we get the Home Health Care Agencies to take an “assignment of benefits.”

This is why I suggested in an earlier article about having an advocate to make sure you get all the benefits you have been paying for.

Even the most experienced Long Term Care experts need to remember about the core concept of selling Long Term Care Policies. It is about helping the client when they need to use the policy. The agent who sold you the policy is most likely out of the insurance business, leaving you helpless when you need the assistance and guidance.

This is why you simply contact the Abe Glickman Insurance Group. We have been here since 1988 and will continue to be here to make sure at your greatest time of need your not alone.

Abe Glickman, LTCA, LTCP
Abe Glickman Insurance Group
Toll-Free Phone: 877-298-5824

“It is better to create a plan 10 years too soon than one day too late.”

Questions or Comments? Give me a call!