Mansell, Engel & Cole

Managing your parent's long-term care claim

As your mom or dad ages, you may be noticing signs of a decline in health. You may have expected this if conditions such as Alzheimer's run in your family or if your loved one has already received a diagnosis of a degenerative or debilitating disease. If you and your parent investigated the benefits of long-term care insurance, you may feel relieved to have that policy in place as your loved one's needs change.

Most people in Oklahoma who have dealt with LTC coverage may attest to the complexity of the claims process and the excessive wait for obtaining the funds needed for adequate care. To avoid such complications, elder-care advisors recommend beginning the process as early as possible to ensure proper coverage for the services your loved one requires.

Know the policy's limitations

You may already feel overwhelmed. Certainly, watching your parent suffer is never easy, and your role in his or her life has likely changed frequently in recent years. Now you have the responsibility of navigating the process for claiming benefits that will provide assistance for your loved one. For now, this may be only simple chores such as cooking meals or doing laundry. Once your parent is unable to complete two of these daily tasks without assistance, you may consider this a trigger to begin the claims process.

Understanding exactly what your loved one's LTC policy covers will be essential. You don't want to hire a nurse or assistant only to find that your parent's policy has specific restrictions on the level of care the insurance will cover. Some of the questions to investigate long before you need to file a claim include:

  • What is the daily amount of the policy's benefits?
  • Are there exclusions in the policy?
  • What is the lifetime maximum your loved one can expect?
  • How long will the benefits last?
  • What are the stipulations for eligible facilities or in-home caregivers?
  • Does the policy cover modifications of the home?
  • Will the court waive the policy premiums once you file a claim?

You may also want to understand the elimination period. This is the time your loved one will pay for care before the insurance company picks up the cost. The elimination period varies with each policy.

There are many other aspects in the complicated world of LTC coverage. If you feel the time is close when your loved one will need to file a claim, you may wish to seek advice to avoid having that claim denied. An attorney who will review your parent's LTC policy and help you understand its implications may bring you some peace of mind as you enter the very difficult time ahead.

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