Representing People With Denied Insurance Claims

Long-term care insurance and Alzheimer’s

On Behalf of | Nov 28, 2017 | Denied Insurance Claims

Caring for a family member with Alzheimer’s is a unique and difficult challenge. You become an advocate for a parent who can no longer advocate for themselves while trying to respect their wishes for their care before they were afflicted by the disease.

If your parent has long-term care insurance, you are likely relying on that insurance during this vulnerable time in their life. Here are a few things to know about long-term care insurance and Alzheimer’s:

1. Know their policy

Regardless of your parent’s health, the insurance company may try to claim services are not covered under the policy. This is common: long-term care policies were written differently in the 1990s compared to how they are written today. If your parent purchased long-term care insurance a long time ago, there may be gaps in coverage. For instance, assisted living facilities were often not written into older plans because they weren’t as ubiquitous as they are today.

If you are searching for a living facility for your loved one, look into the policy details regarding what is or isn’t covered before you move them into a new place. Moving often stresses Alzheimer’s patients, so check your insurance policy so you won’t have to do it again.

2. Make sure Alzheimer’s is covered and when they can collect

Most long-term care insurance companies cover Alzheimer’s, but be sure to confirm that care is included in the policy. Read carefully to determine when your parent can start collecting benefits, as many policies will require evidence of physical or cognitive impairment before they will pay out benefits. This is typically defined by demonstrating an inability to perform two or more activities of daily living (ADL) without “hands on” or “stand by” assistance.

Unfortunately, once you loved one is diagnosed with Alzheimer’s, if they don’t have an existing long-term care insurance policy they will no longer be able to apply for one.

3. Insurers can’t deny coverage because of Alzheimer’s

If the policy covers Alzheimer’s, the insurance company cannot deny your claim. If they try to suggest your parent’s care is not covered, consider discussing the plan with an experienced insurance professional who can review the policy details and help get the coverage your parent needs.

Alzheimer’s is a unique disease that requires specific care. Know your parent’s policy and what you can do to make sure they are cared for and comfortable.