If you are unable to perform daily living tasks, you will want to engage your long-term care insurance. Eating, bathing, dressing, walking, and other activities can become impossible with age or certain disabilities. With this kind of coverage, your expenses for home health care, companion services, and other costs would be covered.
According to the Administration for Community Living (ACL), people over the age of 65 have a 70% of needing this type of long-term care. Claiming your long term care benefits may pose a challenge, which is why you may want to hire an attorney to ensure your approval.
What Determines Eligibility for Long-Term Care Benefits?
Since every policy for long-term care is different, you’ll need to go over your contract to determine if you’re eligible for long-term care benefits. In an older policy, it may say something like ‘medical necessity,’ but in newer policies, they provide more robust details to make things clear.
Generally, this will mean an inability to perform two or more of the activities required for daily living, such as preparing food, bathing, dressing, or cleaning your home. Cognitive impairment is another thing that will be covered, though a physician must sign off on your impairments and recommend a provider who can meet your needs.
Reviewing Long-Term Care Insurance Policies
Choosing an insurance policy for long-term care is a massive challenge as you age. The outline of coverage must detail the principal benefits, state the principal exclusions, and inform you of renewals and limitations in the policy. It’s up to you or a loved one to review the policy and check if it restricts you from receiving those benefits in a nursing home.
Since the language can be confusing and tedious to read, you will want to hire an attorney to be sure you’re choosing the right policy. It should not contain a clause for preexisting conditions, nor should it charge excess premiums based on age.
Claiming Long Term Care Insurance
Because legalese can be difficult to understand for most people, it will be to your advantage to hire an experienced long-term care attorney to help you claim your long-term care insurance claim. Even making a minor mistake can set things back, but an attorney that specializes in this part of the law will be sure not to miss a thing and help you make your claim to start using those benefits.
After you’ve submitted your claim, the insurer will likely conduct an assessment. This assessment will be conducted by a licensed healthcare provider. You must adhere to the specifications of this step, and with an attorney, you will be sure that everything will fall into place.
Why an Insurer May Deny Your Long-Term Care Insurance Claim
If there is any ambiguity in your situation or your claim is mostly constructed of anecdotes provided by loved ones, your insurance company may deny your claim. The reasons for denial may involve a misunderstanding of the language in your policy, which often happens without an attorney’s assistance.
Insurers sometimes don’t receive important documents, while other times, the wrong ones are sent by mistake. In fact, much of the time, a denial on a long-term care insurance claim is usually because of some small error. Again, this is why you should hire an attorney for this task.
How a Long-Term Care Insurance Attorney Can Help with Your Claim
Most people aren’t experts in understanding the jargon of long-term care insurance policies. However, a long-term care insurance attorney knows the regulations of these policies inside and out. They can help you find a proper contract and assist you with activating your long-term care claim.
While it is certainly possible to do it yourself, you may face unnecessary delays in activating your long-term care claim. With an attorney, you’ll avoid those common pitfalls and have one less thing to stress about. Activate your long-term care insurance claim with greater ease by hiring an attorney to help you.