Memory care at a locked facility because you cannot stay awake 24/7. Let go and let the professionals offer her safety and appropriate activities. Start looking now and talk to an Elder Law Attorney to guide you through the Long Term Care BS.
Would they more likely cover her in a Memory care unit. Just my opinion, she should not be on her own. Even in early stages, someone should be with her 24/7. ALZ and any Dementia is too unpredictable.
Prudential basically got 100% out of LTC underwriting abt decade ago. They stopped issuing individual stand alone policy back in 2012 & stopped group LTC couple years after that (shut down group LTC website overnight, can we say FUN!). The policies are still serviced @ 800-732-0416 & seems to be on a totally different system from anything else Pru. If I had to hazard a guess, they are having it done by an outside contractor…. technically moves like this are allowed under policy terms & the approval of State Insurance Commissioners, so if this has happened, you really don’t ever deal with Pru per se but their contractor. It’s all been a fine print type of change. So if you are thinking that a Prudential insurance agent can help you, that is so not going to happen…. their agents are all about selling life insurance policies, annuities, yada yada. As they no longer “sell” LTC, they cannot help you.
Huge exodus 2010/2015 of insurance co. from LTC underwriting as not profitable. Sold off LTC units to smallish companies & outsourced contractors. Technically still whatever insurance Co name it was initially but the LTC unit was spun off and now it’s own separate lil entity.
My suggestion is for you to get in writing what the step are in the Appeal process and get a copy of the assessment / needs determination for your Sister that was done by the LTC insurer ASAP. Also you want details on the individual(s) who did the evaluation, eg. education, certification. There probably is a narrow window for an appeal to be filed. Make sure HIPPA releases and POA are on file so that there is no delay due to that not being in Sissy file for you to have access to her health records.
fwiw Genworth has their service center in Canada & they have a very good system. Gen is the market leader for LTC policies imo. But even they tried to sell their LTC unit & couldn’t find a suitable buyer.
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Do you have a question? We can help Our customer service associates can answer your questions and assist with any policy-related transactions. Please visit our Contact Us page to find the right business group to handle your inquiry.
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Get a copy of the assessment & then file an Appeal. You will likely need to get an independent assessment done on her ASAP to document that she does not have the cognitive ability to “process” what is needed to do her ADLs and this is what you will use to counter their determination. Yeah physically she can do stuff but cannot know to do stuff…. that’s what’s happening isn’t it???
also for more fun in all this there will be a waiting period b4 any payment made. Could be 60-90-120 days. Read the contract carefully and in detail as to how the waiting period is determined. If you’re doing in home care by family for free setting a start date can be squishy as no invoice with a date of service start date. Sometimes you end up having to hire in home health for a bit to get start date established.
if you don’t mind me asking, is this Genworth? Or an old MetLife?
Huge exodus 2010/2015 of insurance co. from LTC underwriting as not profitable. Sold off LTC units to smallish companies & outsourced contractors. Technically still whatever insurance Co name it was initially but the LTC unit was spun off and now it’s own separate lil entity.
My suggestion is for you to get in writing what the step are in the Appeal process and get a copy of the assessment / needs determination for your Sister that was done by the LTC insurer ASAP. Also you want details on the individual(s) who did the evaluation, eg. education, certification. There probably is a narrow window for an appeal to be filed. Make sure HIPPA releases and POA are on file so that there is no delay due to that not being in Sissy file for you to have access to her health records.
fwiw Genworth has their service center in Canada & they have a very good system. Gen is the market leader for LTC policies imo. But even they tried to sell their LTC unit & couldn’t find a suitable buyer.
This is what popped up:
File a Complaint with Prudential
At Prudential, we are committed to providing you with the best possible service.
Do you have a question? We can help
Our customer service associates can answer your questions and assist with any policy-related transactions. Please visit our Contact Us page to find the right business group to handle your inquiry.
To submit a complaint
Do you have a specific grievance or dissatisfaction with a Prudential product, service, or associate? If so, please tell us about it using this form: https://www.prudential.com/links/about/complaint-form
also for more fun in all this there will be a waiting period b4 any payment made. Could be 60-90-120 days. Read the contract carefully and in detail as to how the waiting period is determined. If you’re doing in home care by family for free setting a start date can be squishy as no invoice with a date of service start date. Sometimes you end up having to hire in home health for a bit to get start date established.
if you don’t mind me asking, is this Genworth? Or an old MetLife?
DI'd they send someone out to assess your sister's ability to live alone?
Who has POA?