Often adult children find themselves navigating complex long-term care policies purchased by their aging parents in hopes of maximizing the benefits for much needed care. Keep in mind these four tips as you review the policy:
It is common knowledge that if you do not pay your insurance premiums then the benefits will be denied. However, if the elder missed the premium payments due to a cognitive impairment, a physician’s statement demonstrating this impairment can help with reinstating the policy. An elder law attorney can help you negotiate with the insurance company in this situation.
Policies written decades ago used much different terminology than those available today. If your parent’s policy is older, there may be issues that arise concerning the language used.
Each policy will outline its activities of daily living (ADLs) requirements. If the elder is not able to perform a certain number of ADLs such as eating on his or her own, bathing, or using the restroom independently then the insurance company may refuse to pay benefits that fall under ‘personal care’ which may include assistance with hygiene, running errands or light housekeeping.
Long-term care insurance can be an individual plan, an employer-sponsored plan, or another type of group plan. First determine the type of plan and then determine whether the policy covers only one parent or if it’s a joint policy also covering a spouse. These plans typically have a maximum benefit for everyone insured.
For assistance in understanding long-term care insurance, please contact Stouffer Legal at 443-470-3599 in the Greater Baltimore area.