Both of my parents have LTC policies which cover home health care for $245/ day. A company contacted them and said they could help them with their claim and help them qualify. The upfront fee would be $7,600. My parents have been very resistant to getting home care but now that they may be able to use this policy they are interested. I would be very relieved for them to get some help. My Dad recently had knee replacement surgery, has trouble with walking and is in a wheelchair part of the day, incontinence, recent falls and dizzyness, some dementia and doesn’t drive (my mom still does). Anyway here are my questions.
Has anyone used a service to help facilitate the claim with LTC in which the company charges a sizable upfront fee ($7,600).
Is it worth it? I have zero experience dealing with LTC insurance but I suspect they will not want to pay and I am wondering how difficult it will be to get Dad approved.
If we are able to get Dad approved will that likely continue long term? As he is 83 I don’t think he will improve a lot. Hopefully just maintain for awhile.
Thanks for any info.
There's no way they need a middle man to scam them out of $7k to do paperwork.
Also, the policy should include information on the requirements for how to qualify for benefits. Generally, one must require assistance with 2 out of 6 activities of daily living - bathing, dressing, eating, transferring, toiletting, or assistance with incontinence. This will need to be verified by their doctor. The length of the waiting period (0, 30, 60, 90, 180 days or longer) during which Mom and Dad would pay for care will need to be met. Ask Mom and Dad to let you read the policy, and look at the benefits page - it will tell you the length of the time period (1, 2, 3, 4, 5, 6, 10, or longer) used to calculate the total lifetime benefit available. Example: $245/day for 3 years = $268,275 lifetime benefit. If they purchased inflation protection the initial daily benefit will have increased each year they have held the policy, so the lifetime benefit would also have increased. The insurance agent or the insurance company's representative can explain all of this to them, or to you (with Mom and Dad's permission).
I might also research any class action suits against this company or the filing of any complaints with the insurance commissioner in your area. This sounds not right to me.
I have seen some dreadful things with LTC. The worst was a policy that denied care compensation in facility unless there was 24/7 RN present; in all truth that just doesn't happen.
I sure do wish you luck.
Unfortunately mother is again throwing up roadblocks about having anyone in her house. So I think we may be stuck again with disaster plan.
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