Use Your Long Term Care Plan

How to Use Your Long Term Care Insurance

You were wise enough to acquire an insurance policy to protect your family’s future home care needs. Let SARA’s experts help you use your Long Term Care Plan.

Now you need home care services, so how do you put that Long Term Care insurance policy to work?

What is a Long Term Care Insurance Policy (LTC)?

• It is a type of insurance designed to cover the costs of long term services, like home care, that regular insurance, Medicare, or Medicaid might not cover.
• Regular insurance, Medicare, or Medicaid focuses mainly on medical care.
• LTCs provide coverage for personal care, i.e. ADLs or Assistance with Daily Living Activities such as bathing, grooming, and mobility.
• In addition, a home health aide can perform chores such as light housekeeping, laundry services, and preparation of meals for the care recipient.
• Also, home care services are an excellent way to provide companionship and ensure safe living at home.

Long Term Care Insurance Sounds Great, so How Do I Use it?

When you acquired your LTC policy, you might have read it over in depth or glanced over it briefly and then forgotten what it said exactly.  That’s natural. If we don’t need the insurance right away, we are glad it’s in place, but pretty much forget about it except for paying the premium each month.

Long Term Care can be difficult to navigate so consulting with an expert can help.

Experienced Long Term Care Expertise Will be Helpful

We met with Sherine Shah at Sara Companion HomeCare Services and asked her to provide insights on how people can implement their policies for home care. Sherine has been helping people for 8 years at this New York Department of Health licensed home care agency. She oversees the agency’s Long Term Care team of experts.

What Surprises People Most About Long Term Care Insurance?

According to Sherine, the biggest surprise for many LTC policy holders is that there is an elimination period which can be days, weeks or even 6 months long.

An elimination period is how long one waits for LTC payments to start. It’s a waiting time where you pay out-of-pocket before the insurance company pays for services, similar to a deductible for health insurance.

What Should I Do First to Secure My LTC Benefits?

Sherine advises reading your policy carefully to understand the coverage details of your Long Term Care Insurance.

• What types of care are covered (home care, assisted living, nursing home care, etc.)?
• Are there key provisions that affect that coverage, such as daily or monthly benefit limits, inflation protection, or exclusions?
• Learn under what conditions your benefits are triggered.
• Find out if you need a doctor to certify that you need long term care.
• Understand your elimination period.
• Check to see if there is a time or cost limit for long term care services.
• At what point does your coverage start?

I Read My Long Term Care Insurance Policy, What’s the Next Step?

Great, you are on your way to getting the Long Term Care services you need.

• Contact your Insurance Company and let them know you need long term care services. They will direct you to the department who will help you make a claim.
• Confirm all the details of your policy.
• Submit any required documents to the agency, such as medical records or physician’s health assessment.
• Confirm your elimination period information with the insurance company, in case anything has changed since you signed up for your policy.
• Begin your home care or assisted living services but be prepared to pay out of pocket at first.

I’m Finally Receiving My Benefits, How Do I Manage Them?

You may be asked by your insurance about assigning benefits.

• Benefits could be paid directly to the care provider (who will provide documentation to insurance firm).
• Benefits could be reimbursed to you, but you usually must provide proof of services to the insurance company. You will pay for the services first.
• If you are not the care recipient, you may have to provide a POA or Power-of-Attorney document to collect payment from the insurance company.

Sherine and SARA’s team of Long Term Care Insurance Experts, help clients with all the paperwork needed for the insurance company. They can provide invoices for services to the client or to the insurance company. In the meantime, SARA’s Client Care Specialists focus on coordinating the custom home care services needed for the care recipient.

You’re All Set to Begin Using Your Long Term Care Benefits.

Long Term Care Insurance is an excellent investment. However, policies vary greatly between insurance companies. Some insurers pay 100% of the long term care costs, while others only pay much less. Even when two people are insured by the same company, their policies can be very different. Claims, elimination periods, and what’s covered can be confusing and cause frustration when a family is already stressed out.

That’s why it is good to have experts like Sherine Shah and her team at Sara Companion HomeCare Services (a New York State licensed home care agency) to help you navigate all the complexities of Long Term Care Insurance.

For more information, you can contact SARA at 516-837-3388 or visit https://www.saracompanions.com/long-term-care