Have you ever come across a significant aspect of your parent’s or a loved one’s life and didn’t know where to turn to get information to help solve the problem? Perhaps, it might be a look at legal and financial documents to be sure they are in order. Further, it could be about planning for what could be needed ahead. This would include a chronic condition like Alzheimer’s, a sudden illness or the issues of aging. In the case of Alzheimer’s or dementia are you planning long into the future? It could be how to get a long term care policy to pay.
Sometimes referred to as an advocate or a concierge service; these people work directly for you and your situation on a fee basis. Let’s look at a couple of examples:
Will my LTC policy pay? An 82 year old brother has had three skilled nursing home stays in the past five years. He reached a total of 35 nursing home days. He also lived in assisted living for 45 days. The last two years he has not had any health events but has received home care two times weekly. This gentleman has a long term care policy (LTC) since 1992. A family member spent about a year trying to make a claim and gave up when he understood the company would not pay. What he did not completely understand was that the qualified days would be applied to the policy’s 100 day elimination period. Although no benefits were paid, the insured used about 80 of his elimination period days; only leaving 20 days left. If the claim is submitted properly and the proofs indicate that the brother met claim qualification, this would be equivalent to up to $21,600 for the nursing home stays (270 x 80 days= $21,600
Since he continues to receive 2 day a week homecare, with the payable claim he should receive up to the charge for homecare or $270 per day. Therefore, also payable should be 20 days (the last of the elimination period) of up to $270 a day for homecare. During the elimination period (20 days x $270 per day=$5,400). Plus the balance of the homecare for the past two years (84days x $270 per day=$22,680). Total benefits that could be pay payable are: $49680.
This will do exactly what he bought the policy for. So the value is paying for a concierge claim service to pull together all information for this calm and a consultant’s fee to do so. Is it worth it? No worries about what papers are needed and how to present the claim and no headache of trying to figure this out.
What about someone working past age 65 and then retires at age 66 or 67; how do they enroll in Medicare. How and when do they enroll in Medicare? Sometimes it’s not as easy as one might think. A concierge service can help.
Other ways a concierge service or advocate can also help you or a family member
- Discuss Social Security options.
- Discuss how senior communities work and which ones may be a good fit for your loved one.
- Provide information to you about skilled rehab centers and what might work for your loved one.
- Create a plan for the future for: seeing that your legal papers are in order, your financial papers are in order, and planning for living into the future.
Preparing yourself will put your mind at ease. In addition, your family won’t be given this burden at a tough time. The next time you have coffee with a friend at wits end about mom or dad, why not ask if a concierge service may be able to help ease the stress. We like to call this “Educated Choice = Peace of Mind”.