Receiving a claim denial on your long-term care coverage is the beginning not the end. In fact, a substantial number of insurance policyholders will have their claims denied, at least initially.
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 five obstacles that frequently arise and a few tips to help you overcome each and get your claim paid
Shielding 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 children and themselves. However, it’s a conversation that needs to be had. If you don’t want to have the conversation, and you have another trusted person who will help you through the claim process, have the talk with that person. That person could be your financial advisor, your insurance producer, your lawyer, or a good friend.
To overcome, review your policy with your adult children before you proceed. This will help 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.
Communicating with Your Insurer
Your insurer should absolutely be a part of the conversation as you seek long-term care facilities. To overcome, get your preferences and capabilities onto the table. Make your needs known to the insurance company. Many older long-term care insurance policies have an alternative care provision that provides for flexibility regarding covered or reimbursed services. Try working with the insurance company to get that customized care that you deserved paid for under the insurance policy…
Understanding Qualifications and Administrative Requirements
To qualify for long-term care insurance and meet its guidelines, you must first know what those guidelines are. To overcome, don’t go it alone. Don’t get discouraged. Get help in understanding the legalese on the contracts and with the paperwork involved in filing. State statutes, regulations and administrative bulletins sometimes fill-in the gaps in the insurance policy and better explain policy terms.
Getting Your Insurer to Do Their Part
Getting your insurance claims paid isn’t entirely on you. The provider must do their part as well. To overcome, always follow up and keep careful notes so that everyone is on point. Assuming providers will live up to their responsibilities in the claims process can be a mistake. Create templates. Make charts. Make it easy for your providers to document the care provided to you.
Financial Planning Ahead of Time
Understand the waiting periods. Long-term care payments do not begin immediately. Policies have waiting periods before they start. In some cases, it can take 90 days or more before the payments are issued. To overcome, financially plan for the periods of time before the policy kicks in. 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.
To Overcome a Long-Term Care Claim Denial
Do you 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.
