Long Term Health Insurance

[TCB]

My MIL took a fall a few weeks back and fractured a vertebrae in her back. She's doing well overall but moving into an assisted living facility next week. The majority of the cost will be covered by her LTC insurance but the facility is already warning us that we'll have to constantly have to stay on top of them to get paid.

Just curious if anyone has any tips/tricks, best practices they'd be willing to pass along on handling the insurance company in this type of situation.

Thanks!!!

[Huntingfool]

I sell LTC. Who is the company?

That does not sound right. Once they qualify for benefits the insurance company has to pay.

[TCB]

It’s John Hancock insurance. The facility we’re going to told us to be ready to file 2-3 times each month.

[Mudslinger]

You can get long term policies just for the assisted living and retirement places. Those places are not cheap by any means. We had my FIL and his wife put into one. We cashed in our life insurance policies and bought long term care that was cheaper than the life insurance premiums, plus we did not really need the life insurance as we have no kids, just the wife and I and if either of us dies, we are still in good shape unless the economy tanks along with everything else and then everyone will be in the same spot!

[BarBBar]

Following since I have one of those policies, but have never used it.

[camoclad]

Parents have that company. In for how it goes as they haven't need it yet.

Seems like with all things you have to stay on people to get them to do what they are supposed to, especially these days. Hoping for a smooth experience for you OP.

[TCB]

One thing I learned tonight is the “100 day elimination”. Basically the policy won’t kick in until she’s been in the facility for 100 days. So we’ll have to pay the first 2 months out of pocket plus some.

[Huntingfool]

One thing I learned tonight is the “100 day elimination”. Basically the policy won’t kick in until she’s been in the facility for 100 days. So we’ll have to pay the first 2 months out of pocket plus some.

An elimination period is standard. Insured elects when applying the length and the shorter the waiting time the higher the premium. 100 days is pretty common and some even choose 6 to 12 month wait to lower premiums.

Once the company begins payments it should be a seamless process. The nursing home should send Hancock the paperwork each month. My Mom had Handcock before she died the they paid claims just fine.

PS: you may want to make sure you know what the daily amount they will pay (found in the policy) along with how long will it pay? Could be anywhere from 3 years to unlimited. Having coverage is huge as opposed to no coverage. Good luck

[Huntsman27]

My parents both had LTC insurance through John Hancock. They paid well and things went smooth.

Prior to moving into an assisted living facility my mother's Alzheimer's had gotten pretty bad and Dad, who had been her primary care giver started having some hip back issue. we made a claim for in home care and they paid it each month without issue.

When there situation worsened they moved into an assisted living facility and changed mom's claim from in home to in facility and it was paid no problem. We didn't make a claim on Dad as they didn't need the money at the time and the policy only paid for 5 years of in facility care and not knowing how long they would live we waited to make a claim on him.

After Mom passed away we made a claim on Dad and they paid it no problem.

We were able to get the home healthcare provider to file our billing each month and then the assisted living facility to file the billing each month. the only time we had an issue was one month the facility forgot to send the billing to the LTC carrier.

We were very happy with John Hancock and the claims payment.

Hope all goes well for you.

[TCB]

I'm thrilled to hear the good news with John Hancock!!!

[Daniel32]

The main thing is getting them (John Hancock) the paperwork that's needed in a timely manner.

Basically you pay the first few 100 days out of pocket until the policy kicks in

Once it kicks in you'll still continue to pay, but you (or the Assisted Living) can submit the paper work to John Hancock. Most of the time it's the monthly bill, and a short checklist that the facility has to fill out.

Most LTC policies pay "per day" meaning if she were to leave the facility for a few days to spend time with family during the holidays, or gets admitted to the hospital the LTC policy wont pay those days. The checklist filled out asks these questions, and a few others. Unfortunately the Assisted Living will still charge you for the full month as they don't bill "per day".

The LTC will then reimburse you, and not the facility. Personally I would send in the paperwork yourself if possible, and stay on the Assisted Living to fill out what they need to fill out and send in. If not it'll delay your reimbursement.

If you have any questions feel free to PM me as I use to work in the Senior Living industry and worked with several LTC policies

[BrianL]

Really really good reason to have you assets in a trust instead of your name........

[Huntsman27]

Be sure to use John Hancock's website. I was able to see when the Assisted Living Facility submitted the monthly billing and when the check was mailed. This made it easier to monitor and follow up with the carrier or facility if things were not done timely.

[JBJTX81]

Another issue to be mindful of this the daily rate paid by the insurance vs the daily rate charged by the facility. Its possible you all might have to supplement what the insurance pays from her social security check or other personal funds.

[TCB]

Another issue to be mindful of this the daily rate paid by the insurance vs the daily rate charged by the facility. Its possible you all might have to supplement what the insurance pays from her social security check or other personal funds.

Yeah, we'll have to pay about $1k/month out of pocket once insurance kicks in. Fortunately her and her sister just sold some property, so she has enough to cover for a while. If this turns into her "forever" home, we'll have to look at selling her house. Definitely not boxed into a corner thank goodness.