LTC 101:  Can My Parents Get Long-term Care Coverage?

LTC 101: Can My Parents Get Long-term Care Coverage?

That is one of our most frequently asked questions. The short answer is - possibly.

Before the question can be answered we need to drill into your parent’s specific situation. We will ask some questions to determine some factors that influence the final answer. Eventually, your parents will need to be directly involved in answering these questions.

  1. Do you understand what services are paid for under long-term care coverage?
  2. Does one or both of your parents currently require substantial assistance with two or more of the six Activities of Daily Living (called ADLs which are eating, bathing, dressing, continence, transferring, and toileting)?
  3. Does one or both of your parents need assistance to protect him-or-herself and/or others because of a mental deterioration (such as Alzheimer’s Disease)?
  4. What medical conditions are present and what medications are currently being administered?
  5. What surgeries or hospital stays have occurred in the past 5 years (brief details and diagnosis for each)?
  6. What are the ages of the parents?

The answers to these six questions will determine if coverage is possible. If your parents are not approvable for coverage we will let you know. In some cases the insurance company may have further questions.

Assuming that we get a green light, next come the design of the coverage and the preparation of a quotation.

There are lots of options in this stage, which means more questions. Among them are:

  1. Where do the parents want to receive long-term care (at home, in a facility, day care, etc.)? It is common that this care starts at home and eventually moves to a facility when a high level of services is needed.
  2. What are the financial constraints? Consumer protection regulations require the collection of financial information so that we can insure that this coverage is “suitable.” Financial information is submitted as part of the coverage application.
  3. Are their special requests or requirements that need to be considered? This may include considerations such as insuring that a specific facility or luxury level is planned for.

At this point we have enough information to provide an initial quotation. This quotation may change with the details of the plan that change as a result further discussion and clarification.

Once the coverage is settled and the quotation is approved, the detailed application is prepared and submitted to the insurance company for underwriting. The length of the approval process depends on the details of the medical history. It can take as much as thirty days to get the final approval. The time required depends on the completeness of the application and how fast medical service providers respond to the underwriter’s requests.

While somewhat lengthy, working through the details will insure that you and your parents get the coverage you need at a cost that is appropriate.

The last question: How about your long-term care coverage? Buying it earlier in life is less expensive and, chances are, disqualifying medical issues are less likely. There are policies available that guarantee your premium will not increase.
Call us for more details. There is never a charge for consultation.

C. Lawrence “Larry” Thomas

C. Lawrence “Larry” Thomas began working with long-term care and Medicare programs in the mid- 1980s. He is currently associated with Insurance 101 Services to provide long- term care solutions to seniors and those approaching. Larry can be reached at (949) 374-3316 or ltinsurance@me.com.
CA Insurance License # 0C79256.

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