Many of our Senior Concierge clients have purchased a Long Term Care Insurance Policy. Long Term Care Insurance (LTC) provides a portion of the funds for the costs of long term care for a designated period of time like home care or care at an assisted living facility that is not covered by Medicare.
As a Senior Concierge I have identified the policies when filing paperwork or paying their bills for my clients. Sometimes, my clients will forget that they have paid for this policy or that their employer purchased one on their behalf earlier in their careers. It's important to help them to determine if they have a policy or not because it can be very helpful for them as they begin to pay for assistance.
Unfortunately, our senior concierge fees are not covered by any LTC policy because we are not home care providers and we don't have that specific licensing and certifications.
Once you have identified that the policy exists that's the first of many steps. Make sure that your clients family members are aware of the policy too (with permission of your client). It's important for them to know because if your client was unable to communicate this information now someone else knows beside yourself.
If you client's health begins to decline or declines suddenly and some of the Activities of Daily Living (ADL) are becoming difficult like (eating, bathing, dressing, toileting, transferring, memory, grooming, walking) it's probably time to start a claim. Most LTC Insurance companies require at least three ADL's to be problems before your claim will be accepted. Often memory issues are in their own category and don't require additional ADL.
Before you help your client begin a claim, the entire care team needs to be on the same page. Your clients, the financial adviser, your Geriatric Care Manager, the doctor, and pertinent family members need to know that you're helping your client begin this claim. It might not be a good time financially to start the claim o.
Most LTC policies require a 90 day deductible. This means that your clients must be living in an approved facility or be receiving care with an approved home care agency (normally a licensed organization). This 90 day period of time can be a huge expense for your clients.
During the claim period you will be required to fill out required forms, see the doctor to have him or her fill out a portion of the forms and often your are visited by an independent nurse to review your case. Sometimes it can be very difficult to get your claim reviewed. Just because you file a claim does not mean that you will pass the requirements.
I help my clients through this process because it's long and it can be very confusing. Keep track of what has happened, who you have spoken with, and keep copies of all records you're sending to doctors etc.
Hopefully your client will be approved and they can benefit from an added income to help pay for their care.