Receiving a claim denial on your long-term care coverage is the beginning not the end. In fact, anywhere from one-quarter to one-third of patients will have their claims denied from the ages of 60 to 69.
That’s deeply concerning when you need your long term care benefits. In this article, we hope to help you shed those worries by teaching you what you’re up against. These are the five obstacles that you’ll most need to watch out for if you hope to avoid such situations.
Trying to Shield Your Loved Ones
One obstacle that gets in the way of long-term care plans is failing to involve the family. It’s a touchy subject.
Many older people with adult children hesitate to have the talk for fear of upsetting their kids and themselves. However, it’s a conversation that needs to be had.
Review your policy with your adult children before you proceed. This will ensure that you both make the right decisions as time moves on and more responsibilities transfer to them. This can go a long way in helping you avoid a claim denial letter.
Failing to Communicate with Your Insurer
Your insurer should absolutely be a part of the conversation as you seek long-term care facilities. Getting your preferences and capabilities onto the table early in the process can ensure that your policy has the bandwidth to meet all of your needs.
It will also actively involve the insurer in standing up for your wishes throughout the long-term care claim process. Last but not least, you can understand everything about the process from how to file a claim to how to appeal an insurance claim denial.
Glossing Over the Qualifications and Administrative Requirements
To qualify for long-term care insurance and meet its guidelines, you must first know what those guidelines are. Too often, patients try to go it alone.
They see the legalese on the contracts, the paperwork involved, and they get too discouraged to pay adequate care to what they’re doing. This can create problems when paying for long-term care.
Assuming Your Provider Will Take Care of Their Part
Getting your insurance claims paid isn’t entirely on you. The provider must do their part as well. Unfortunately, it’s not always at the top of their to-do list when they have other patients to manage.
Assuming providers will live up their responsibilities in the claims process can be a mistake. It can lead to something not getting submitted that needs to be before the claim can be paid. Always follow up!
Poor Financial Planning Until the Policy Kicks In
Another obstacle to your insurance claim is a failure to understand the waiting periods. Insurance is not automatic.
In some cases, it can take 90 days or more before the payments are issued. Long-term care payments, on the other hand, begin immediately. Therefore, you have to financially plan for the periods of time before the policy kicks in or else you could face some early denials.
Sit down with the long-term care provider and your insurer. Make sure your adult children, your likely power-of-attorney, and your long-term care attorney are part of those meetings.
Receiving a Claim Denial Is Avoidable
Need someone in your corner who understands the ins and outs of long-term care insurance laws and will fight for your rights? Contact Jonathan M. Feigenbaum, Esquire, today to get the benefits you’re entitled to.
