Demystifying Long Term Care Insurance

Part 3: How Do I Open a Policy?

Written by:

James Jennings

Published:

November 16, 2018


When the time comes, either you – or one of your adult children – will need to open your policy to receive reimbursement. Make sure you have kept track of your paperwork, policy numbers, and managed your POA accordingly. The first step is to reach out to the provider and initiate a claim – at this point, if your benefit is approved, your elimination period starts. This is important, because it takes 2+ weeks to open a policy. Doing this ahead of time can help you realize savings.

Your provider will send out an RN to do an evaluation, where they’ll assess your parent’s needs. This is typically oriented around the activities of daily living: bathing, toileting, dressing, transfers, eating, and fall risk prevention. Most policies require help with 2 or 3 of the activities. If your loved one has a cognitive impairment, make sure to have a physician’s note, as this can be harder to identify during a nursing assessment. Often, older adults tend to under communicate their needs. It can be helpful to be present during the assessment to ensure you’re communicating your parent’s needs and giving the RN the best understanding possible.

After the RN completes his or her visit, the company will review the assessment and measure it against your policy terms. This typically takes 5 to 10 days. Make sure you’re taking the initiative to follow up with the insurance company. Don’t wait for them to come to you.

“Re-Inheriting” a Life

A five month journey starting with a hospital stay, then a stopover in rehab, culminated in a heartwarming return home for one Commonwise client.

Written by:

Amber Best Roberts, RN

Published:

November 11, 2018


As the Commonwise Home Care (Charlottesville) Director of Nursing, I recently had the opportunity to help a client return to his home after he had spent almost half the year in facilities. I quickly realized what an honor this was and that watching him become reacquainted with his home will now and forever be a highlight in my nursing career.

The first time I met this gentleman, he was in a facility lying in his bed alone. I knew very little about him, so I looked around his room for clues. It was empty, void of any character or personality. He was mostly non-verbal throughout my visit, so I wasn’t able to learn much about him though his own words. His friend had given me some of his history – – a highly cultured “Renaissance Man,” but today I was staring at a shell of who he once was. I asked staff in the facility how they would describe him, but they weren’t able to give me any details beyond saying he was “cooperative.” I wondered how it could be that in all of his months of residing there, no one knew anything about him.

A few days later, I would have the privilege of helping him return to his home. I arrived at the facility to help prepare him for his transfer. I re-introduced myself and told him I was a nurse with Commonwise Home Care and I would be helping him to go back to his home to live. The smile that beamed across his face is something I could never accurately pen. He practically leaped to his feet to walk towards the front door!

Upon entering his home, walker in tow, he completed a victory lap around his familiar space. Then, he sat down with his friend, his new Commonwise caregiver and myself. He confessed that even though he was happy to be home, he was feeling a bit overwhelmed. Suffering from, but living with dementia, it was obvious to me that his memories were rushing back to him with some haze. He shared that he had wondered what had become of his home while he had been away for so long. I felt deep sadness for him or anyone else in a similar situation. I could only imagine how he was trying to reconcile his past with his present state.

Hoping to assist in his assimilation, I pointed out a work of art on the wall and said how much I appreciated it. He proceeding to share the history behind it. Then he pointed out another piece and told everyone how he had brought it home from Germany. Then he pointed out another piece, then yet another. His eyes began to sparkle again, his haze was now turning into utter joy. Memories were now refining as he recalled the history of his belongings, recalling his past, speaking of his parents and his childhood. Then he paused and his countenance changed to absolute triumph and contentment. He looked at each of us in the room and said, “this is an important day, a day for which it’s important that each of you were here to share this moment with me, it’s the day I have ‘re-inherited’ my home, my belongings.”

Re-inherited – what more could be said? I’m careful not to add to or subtract from such a wonderful sentiment of gratitude. I desire for moments such as these to deepen my own personal and professional inheritance, causing a greater appreciation. As days have moved forward with this client, I have been overjoyed to watch Commonwise caregivers and Care Managers help him to burst from his shell and take possession of his life again.

Demystifying Long Term Care Insurance

Part 2: What do I need to know about my policy?

Written by:

James Jennings

Published:

November 9, 2018


Like any insurance, the quality of your coverage depends on the type of policy you purchased. However, there are a few constants that are important to know as you begin the process of opening your policy and setting up care. Here are three items common to every policy that you should familiarize yourself with:

Daily / Weekly / Monthly Reimbursement: your policy will have a maximum payment they reimburse, and typically they measure this by the day, but occasionally they measure by the month. I’ve seent his range from $50 per day to $8,000 per month. Obviously, the higher your reimbursement limit, the more care it will cover on any given day, and the more expensive your premium.

Elimination Period: think of this like you do your deductible for auto or health insurance. Most policies have a timeline that you’ll be responsible to pay out of pocket before they reimburse. This can range anywhere from 0 days (on more expensive policies) to 100+ (these are more common than you’d think). As you work through your budget, it’s important to remember that these will be out of pocket for your family. With care costs often upwards of $100/day, this can mean $10,000 upwards in out of pocket expenses. However, if receiving home health through medicare, your policy should count these towards elimination days, which can lead to savings!

Lifetime Benefit: Like your auto policy has a max coverage, your LTCI will have a max lifetime benefit, too. Occasionally, old policies didn’t have these underwritten, but all policies do now. I’ve seen unlimited lifetime benefits to $100,000, on the low end. Policies are written to index towards you not hitting these number.

Policies have many other perks, if you purchase them. Some have inflation protections, some have different access to reimbursement depending on care type (home care, assisted living, skilled nursing), clauses to bypass elimination periods under circumstances. These will all be policy-specific, and it’s important to understand them from your parents or the representatives at their companies.

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