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FAQ: Understanding Long-Term Care Insurance and Claims

Many people, as they age or due to an injury or illness, will need assistance with activities of daily living (“ADL”), requiring the assistance of another person. This is where long-term care insurance comes into play.

Activities of daily living include:

  • Bathing
  • Toileting
  • Transferring
  • Eating
  • Dressing
  • Continence

Typically, the policies require a person to prove they are unable to perform at least two ADLs on their own or suffer from a severe cognitive impairment such that they require supervision to protect themself.

What do I need to prove to have my long-term care claim approved?

If you suffer from a disability due to sickness or illness or are of an advanced age such that you require the assistance of another person to complete at least two activities of daily living, you may qualify for long-term care benefits under your long-term care policy. Alternatively, if you have a cognitive impairment that makes it unsafe for you to be alone, you may qualify for long-term care benefits.

It is important to review the policy in detail and understand the definition of each activity of daily living and cognitive impairment as they do vary from policy to policy. Next, it is important to have a conversation with your treating provider about supporting your claim. Your doctors will need to complete forms confirming which ADLs you are unable to complete and why you need assistance with them.

What is long-term care insurance, and why is it important to consider it when making financial decisions for the future?

Long-term care insurance is a type of insurance that is designed to help people with disabilities live independently. It pays a monthly benefit to help cover the cost of assistance that a person requires to complete the activities of daily living. This includes assistance with activities such as bathing, dressing, eating, and managing medications, among others.

Long-term care benefits will allow a person to pay for the costs of necessary services and support that they need in day-to-day life so they can remain at home or in another supportive environment.

Furthermore, without proper planning for long-term care needs, individuals with disabilities may run out of money if they are unable to work or do not have family members able to provide the necessary support.

How can I go about finding a good facility or program that can provide the type of care I need?

Doing your research is essential to finding a program or facility with the type of care you need. Start by looking for reviews online from current and previous patients, as well as programs that specialize in your requirements. Check with organizations like Healthgrades to see if your desired facility has met national standards and accreditation requirements.

You can also contact social services, health departments, and mental health service providers for referrals and additional resources. Consider reaching out to healthcare providers familiar with your needs to help you find a facility or program tailored to them.

Lastly, ask the person providing care or services about their experience and qualifications – this can often be an invaluable source of information. By taking all of these steps, you can find a proper facility or program that works best for you.

What are the cost implications of long-term care, and how can I ensure I'm making an informed decision when it comes to financing my care?

Long-term care is expensive, and it’s important to be aware of the cost implications before committing to any plan. Long-term care insurance pays a monthly benefit to help with the cost of long-term care assistance, either through a person who comes to your house or at a facility. Depending on your specific needs, long-term care can be covered in part by government programs like Medicare and Medicaid, private insurance policies, or out-of-pocket payments.

What kind of additional resources are available to help me understand all my options when it comes to receiving long-term care?

When it comes to researching your long-term care options, the internet can be an invaluable source of information. Numerous online resources provide detailed and up-to-date information about various types of long-term care, such as home health care, adult day care, assisted living facilities, and nursing homes.

Insurance companies will often provide educational materials on the different plan options available that are tailored to meet your individual needs. Additionally, there are independent healthcare advocates and counselors who can help guide you through the process of choosing the best long-term care option.

Connecting with peers in similar situations can also be a great source for understanding all of your options; support groups or message boards dedicated to specific care topics can often provide helpful insight on quality services or cost-saving measures. Ultimately, taking the time to research various resources will ensure you make an informed choice when it comes to selecting a long-term care plan.

Help from a Lawyer with Experience in Long Term Care Insurance

  1. Our law firm focuses on long-term care insurance claims. That means we have experience with every major long-term care insurance company.
  2. Have successfully obtained long-term care benefits for our clients.
  3. We have represented clients across the nation.

Our lawyers can help you with the following:

  • Submitting a long-term care insurance claim;
  • Appealing a long-term care insurance claim denial;
  • Negotiating a lump-sum settlement; or
  • Filing a lawsuit against your long-term care insurance company.

Hiring an experienced long-term care insurance attorney is important. Because federal law applies to group long-term care insurance claims, our lawyers do not have to be located in your state.

Call for a free consultation with an experienced long-term care attorney. Pay no fees or costs unless you get paid.

Contact Dabdoub Law Firm today at (800) 969-0488 or fill out the online contact form to speak with an experienced attorney about your case.