The founder of a top-rated home care agency explains why trying to execute a policy by yourself might be a big mistake
When I first started CT Help at Home about 6 years ago, it became clear that many families requesting our services did not have long-term care policies and could not afford to self-pay. Except for the very wealthy, only families with an airtight, long-term care insurance policy could take advantage of high-level, homecare services like ours.
Why home care policies are so expensive
About 40 years ago, a few insurance companies began offering a new kind of policy that would allow people to be professionally cared for as they age. Families jumped in to purchase these long-term care policies for themselves and their loved ones. The policies were not cheap and the insurance carriers made lots of money until about 20 years ago when health care costs began skyrocketing. As boomers with these early policies began aging and living longer, these insurance companies found themselves on the hook to pay out the many claims that were pouring in. Before they could utter the word “premium”, there was very little profit left in the policies they had sold years earlier. Many companies reneged on their promise to pay claims because they did not have the money, ignoring the phone calls and letters begging them to make good. It was not pretty.
Today, because of exploding health care costs, there are far fewer insurance companies offering these policies. The ones that do decide to participate in the long-term home care insurance business must charge hefty fees in order to keep up. People are encouraged to buy premiums at a young age and this helps support claims from families with aging loved ones. Still, some bad-actor insurance companies collect premiums but stall when it comes to paying claims. This, in turn, hurts home care providers who are often not paid in a timely fashion.
Why am I telling you all this?
Clients often give out my phone number to family and friends because I am a home care professional who also knows a lot about long-term home care insurance. I am extremely grateful for their trust and happy to help. I receive calls every day from people whose loved ones are showing signs of dementia, battling Parkinson’s, or are simply unable to handle a daily routine by themselves. These calls are often difficult and heart-wrenching.
I always ask, right up front, if there is a long-term care insurance policy available to be executed. Many people just don’t know because they have just taken over the responsibility of an elderly family member. Others want to know if they can still buy a policy, what an elimination period means, or if they need a note from a doctor. They need someone to explain what an inflation rider is or how to get authorization of benefits based on the five activities of daily living, known in our field as ADLs. These condition levels help determine eligibility for care — unless, of course, there is a diagnosis of dementia, memory, or cognitive impairment which typically supersede any ADLs when attempting to execute a policy.
My experience can help expedite a very difficult process
As a home care provider, a nurse, and someone who takes care of two elder parents myself, I understand how to navigate the bureaucracy that stands in the way of much-needed home care. I know the loopholes, the pitfalls, and how to circumvent those mind-numbing phone calls. I know what language to use when describing the symptoms and conditions required for authorization of benefits. This kind of inside knowledge allows me to champion for my clients who desperately need quality home care for a loved one.
Think of me as your go-to person.
When I decided to share all this information on a consultative basis, many of my clients happily took advantage of my for-fee service to avoid the hassle of navigating this complicated and emotionally-charged industry. One of my $300 per hour consultations can easily eliminate 40+ hours of stressful phone calls, mind-numbing research, and a lot of very expensive mistakes!
I want to help you navigate your long-term care insurance policy
When you book a consultation with me, I will tell you what is covered and what is not, how to initiate your policy, and which forms need to be filled out. As we get into it, I will help you understand what the insurance companies need, what your benefits include, and how much help is available each day. Together, we will determine if there is an inflation rider and when increases may become available. I can also assist families and POAs with complex claims. In other words, I can help anyone who has a long-term home care policy in place and is interested in getting that policy up, running, and paying claims!
I hope all this information has been helpful. If you are ready for an honest and objective conversation about an existing, long-term home care insurance policy, I look forward to speaking with you. Please feel free to contact me with any questions about my consultation process or to schedule a consultation!