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Barbara’s Decision »
May 14, 2016 at 3:04 pm (UTC -5)
I could use some help. My Great-Aunt wants to return home to Minnesota (currently in Michigan) and she is 80 years old. Her only remaining family there is her own age and not capable of helping, so living on her own is not a choice. She has a Long Term Care policy but they said they will not cover assisted living home in town because she only has 1 ADL she is unable to perform.
How do I find her more flexible insurance? What are my options?
May 14, 2016 at 5:06 pm (UTC -5)
It is typical for LTC insurance policies to require help with at least two activities of daily living before paying benefits. Are you sure she isn’t failing two? They are bathing, dressing, transferring from bed to chair, toileting, continence and eating. Typically one would fail bathing and dressing first. If she only fails one, my guess is the second one is close behind. In the meantime, you might check to see if there are any bed and board homes, like foster homes, in the area that take care of 3 or 4 elderly people for a lower rate than an assisted living facility would charge. Does she have life insurance? If so, you could look into selling it for enough money to pay for assisted living privately until she qualifies for her long-term care insurance benefits. The website to check that out is http://www.lisa.org Another resource you might look into is http://www.aplaceformom.com This is a free service to help seniors find care solutions. Good luck – she is really lucky to have a niece like you who cares so much.
February 23, 2016 at 8:35 pm (UTC -5)
May 25, 2015 at 1:29 pm (UTC -5)
Dear Phyllis: Can you please help me. I live in Montana and am 70 years old. I am doing good now but would like to look into insurance assisted living or if ever need it nursing home insurance. My brother is currently in assisted living in CO and it is outrageous in cost. My father was in a nursing home for several years. Can you help me with what kind of insurance I should look in and perhaps suggestions for companies that are very good to look into? Thank you sincerely for any help suggestions you can offer me. Mary Zrubek
May 27, 2015 at 4:44 pm (UTC -5)
I will be happy to help you, Mary. Fortunately Montana is a little lower cost area than Colorado for LTC. I know my staff has already reached out to you to set a time for a consultation with me and I’m really looking forward to talking with you. Just email email@example.com if you haven’t already to work out a time.
June 8, 2013 at 5:23 am (UTC -5)
Assisted living as it exists today emerged in the 1990s as an eldercare alternative on the continuum of care for people, for whom independent living is not appropriate but who do not need the 24-hour medical care provided by a nursing home and are too young to live in a retirement home. Assisted living is a philosophy of care and services promoting independence and dignity.
June 8, 2013 at 10:43 am (UTC -5)
That’s right Brock. Many people bought older long-term care insurance policies before assisted living facilities were introduced. Insurance carriers have been good to use the alternate plan of care provision found in most policies to pay for assisted living even when it wasn’t mentioned as a specific covered service.
“Alternate plan of care” is intended to make a way contractually for a long-term care insurance carrier to pay outside the contract when it is cost-effective and makes sense medically for the patient. The policy language is very clear that the insurance company, the doctor and the family must agree on how this provision is used.
A great way this provision has been used is to pay for new services that come along. As I mentioned, a great example is that it has been used often to pay for care in an assisted living facility from a policy that was sold to pay inpatient care only in a nursing home. Assisted living facilities (ALFs) are less expensive than nursing homes and patients generally are much happier in them because they don’t look anything like a nursing home. Without alternate plan of care, however, an insurance carrier could deny assisted living facility claims because an ALF isn’t mentioned as a covered service in the policy.
So if assisted living coverage isn’t spelled out in the policy, look to see if there is an alternate plan of care provision and policyholders can ask the insurance company to pay for assisted living under that.
December 29, 2012 at 1:44 pm (UTC -5)
Does purchasing LTC insurance protect your assets, banking acct. etc. if you need to use assisted living or nursing home care?
December 30, 2012 at 1:36 pm (UTC -5)
The global answer Christine is yes but I have to qualify that with “it depends on the type of policy you buy”, and I will add two qualifiers for you to consider. First, you need to consider a long-term care Partnership policy which allows you to protect assets equal to the benefits paid out if you have to turn to Medicaid for help in the event the insurance isn’t enough. The premium is the same as for a non-Partnership policy so there is no downside to getting one. You do have to buy the appropriate inflation benefit for your age but you would want to do that anyway. You can learn more about Partnership policies by clicking here. That post will tell you the inflation requirements by age group and provide a link to a map that shows you the 40 states that are participating in the LTC Partnership. All of the states reciprocate on the asset protection except California. Second, you need to buy a meaningful benefit so you can make up the difference at claim time…otherwise a Partnership policy won’t help you. You can get some tips from “Your Customized Benefit Selection Process” but here is a quick formula: Look at the cost of care in your area, project it at 5% for 30 years, and choose a benefit that will pay the portion of that cost at that time. Do you want a plan that will pay half, 2/3, 80%? It’s most important to make sure your daily or monthly benefit pays the amount you want at claim time. How long it will pay is the secondary decision, especially if you buy a Partnership policy. If you need help going through this process and you don’t have a local professional who is knowledgeable in long-term care insurance, please complete the short questionnaire under the “Contact Us” tab. Oh yes, and a bonus answer to your question is that long-term care insurance also protects your assets if you need care at home, not just in a facility. Three-fourths of LTC happens at home and that’s really good news, isn’t it?
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