It often happens that the teacher becomes
the student when faced with real-life health insurance concerns. Dr. George
Freedman, a psychiatrist who recently celebrated 35 years as a practicing
physician, realized just that as he was weaving through the maze of red tape of
long term care insurance coverage with his father, Myron. Dr. Freedman’s father
made a conscientious decision when, in his sixties and living in Florida, he
purchased a long-term care policy “in case” he ever needed health care services
at home. He Then did what most people would do. He carefully filed the policy away in a
desk drawer. The “in case time” arrived twenty years later, and Dr. Freedman
needed to decipher the policy that had been purchased so long ago to access the
coverage for his father’s additional care at home. He soon discovered that the
policy his father had purchased contained many more variables and conditions
attached to it than one would assume. After much investigation and many phone
calls, the insurance coverage for his father, who had paid into his policy
diligently for 20 years, was granted. Throughout this process, Dr. Freedman
realized that there were a few things that people should know about long-term
care policies before they make a purchase. Catherine Brown, President of Coastal
Care Home Health Care Services, encouraged Dr. Freedman to share what he has
learned with others:
BEFORE YOU PURCHASE A LONG TERM CARE POLICY
•Shop around and ask questions. Find out the provisions of
each policy. Some policies have a payout time frame, where payment for care will
be provided for 1 or 2 years, then the policy ends.
•Find out if there is an inflationary clause in the policy. Fifteen years ago,
the average cost of a certified nursing aide in the home was $150 per day.
Today, this can cost up to $400 or more per day.
•Find out if there is an escalating premium. Many policies charge a lower yearly
premium for the first few years, and after a varying time period, can shoot up
by thousands of dollars.
IF YOU HAVE PURCHASED A LONG-TERM CARE POLICY:
•Make sure more than one other family member knows about
the policy and is familiar with where it is located.
•Make sure the premium is being paid each year, or else
the policy may become null and void.
•Become familiar with the policy and have
your designated family member become familiar with it and how the company
determines coverage for care.
•Every year, call the contact number on the policy and
make sure all the contact information on the policy is up to date. Many of these
policies are bought and sold to other brokers, and companies can change
locations.
•When you need to access coverage for care, make sure you
have all the criteria for coverage eligibility. Some policies require a medical
certificate from the attending physician. Some also require detailed clinical
documentation from the contracted home care company in order to reimburse for
services.
