Mansell, Engel & Cole

Understanding your long-term care insurance policy

Purchasing long-term care insurance may have given you a certain amount of peace of mind. After all, about 70 percent of older Americans eventually need some form of extended care, whether it is following an injury, surgery or lengthy illness. Now that you are approaching retirement, you may want to review your coverage to avoid a claim denial at the worst possible time.

If you have already taken the time to explore Medicare and Medicaid and the difficult financial requirements you must meet before qualifying, you certainly want the best chances of receiving the benefits you deserve when you need them. Having a good understanding of those benefits is the first step to avoiding an unpleasant surprise.

What does LTC cover?

Long-term care insurance provides coverage if you need to spend time in an Oklahoma nursing home or require assistance in your home. While you may not need medical care, LTC can provide services that help you with personal and household tasks, known as Activities of Daily Living, which may become difficult if your health fails. Some of those ADLs may include:

  • Getting dressed
  • Taking a bath
  • Using the bathroom
  • Preparing meals and eating
  • Standing from a seated position
  • Getting out of bed

You may not need all of these services, or your condition may require even more intensive care. The overall length and quality of life is improving, and an illness or injury that once may have meant nursing care for many months may now require a much shorter time of in-home care.

Is your coverage adequate?

If you are concerned about your family's health history, your LTC coverage may provide assurance that your needs will be taken care of, especially if Alzheimer's or other degenerative diseases run in your family. You may not want your children to take on the responsibility of your care if you become unable to do so for yourself. However, you may be facing nursing home costs that approach $100,000 a year.

Knowing the scope of your policy coverage is essential, and an attorney with experience in LTC insurance policies can review your coverage and advise you on the best options for your circumstances. Understanding the limitations and exclusions on your policy may allow you to establish a more thorough plan for how to maximize the benefits of your coverage and avoid the danger of compromising your quality of life because of uncovered LTC expenses.

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