Have you ever reviewed your Long-Term Care (LTC) insurance policy?

At CareGivers of America we’re experts in Long-Term Care. We offer a complimentary benefit analysis to make sure you will get all the coverage you deserve.

Common questions about starting Long-Term Care coverage

Can I use my LTC policy at home?

Yes, absolutely! LTC insurance enables people to receive assistance in your own home environment. Private duty home care lets you stay at home and is more cost effective than moving into Assisted Living.

What does my policy cover?

Care in the home including a Home Health Aide or Certified Nursing Assistant (CNA). It will cover costs of hiring an Aide or CNA to assist you by providing care.

Does coverage start right away?

Sometimes yes and sometimes no. Your policy may have an “elimination period” – a deductible period. These waiting periods are policy specific and could be anywhere from a 7 to 100 days.

Do I need to qualify for coverage or is it automatic with having a policy?

You do need to “qualify”, but it’s simple! You qualify by needing some assistance with the Activities of Daily Living (ADLs) – personal care. It could be two or three of the following “Qualifiers”:

  • Bathing – Showering
  • Dressing
  • Transferring – moving from bed to chair or chair to shower or toilet.
  • Eating – feeding oneself
  • Toileting – Incontinence
  • Walking – Balance

Many policies have coverage for Cognitive Impairment (Dementia/Alzheimer’s disease) which overrides needs help with ADLs.

LTC polices do not usually cover assistance with cooking, driving, shopping, or housekeeping.

Once I’m qualified, how long does the coverage last?

Depending on your specific policy, it’ll be for a defined term either by dollar amount or years. Many have a lifetime benefit and it’s always great to get the care you need and deserve.

Do I have to have care for a certain period?

No, you choose your length of care. Because it is your policy, you are the decision maker for how many hours/day, and for how long you want care for.

How do I start a claim?

One of our representatives will get in touch with you via an introductory phone call to help you start your care. Or if it’s more convenient for you, we would visit your residence and explain the process personally.

The policy holder does need to call the insurer i.e., the company who the policy is with and start a claim. Once the claim is filed, you will receive a packet from the insurance company which typically asks about your medical history and other important information, along with your physician’s signature.

CareGivers of America will submit the home care forms directly to your insurance company on your behalf.

How do I get “approved”?

Almost always, you will be approved on the day care begins.

Am I free to choose my own Home Care company?

Yes, you are. Nearly all policies require you use a Licensed company like CareGivers of America

PRO Tips and Questions to Maximize your Policy’s Benefits

Is there an Elimination Period (EP) and how long is it?

We will assist you in finding this information out. A lengthy elimination period can sometimes be lessened or mitigated when you know the right questions to ask. A CareGivers of America representative will guide you on what to ask, for example is it a one-time elimination or does it restart for each claim/episode?

If your policy has an elimination policy, it pays to start care at a few hours a week to whittle down the elimination period days. It will save you a lot of money to pay for a few hours a day rather than the possibility of needing long shifts or round the clock care while in the elimination period.

Does “one day” equal one?

Some policies have one day (1) equaling 3 or 7 days of care. So, one day of service a week could be counted for more days off your elimination. It’s always a good practice to ask your insurance company whether any days of your elimination period have been used.

Do Medicare home care days, Hospital or Rehab Center stays count towards the EP?

Yes, many times other services count toward your elimination period. Contact your Medicare agency, hospital and/or rehab center’s medical records department to have proof of service sent to your insurance company and a copy to you.

Is my benefit a daily/weekly dollar amount or is there a “pool” of money? How much is in the pool of money?

Most policy benefits pay on a daily or weekly basis, while others use a “pool” of money. This pool of money is the sum of what the policy is worth.

If I don’t use the full daily amount, is the balance returned to me?

With some policies, if the daily amount isn’t used, it does remain in the “pool” of money.

If Medicare at home days count and you don’t need daily care, have your aide and any of the Medicare visits happen on different days. Having an RN and an aide on the same day still counts as one day, not two.

GOOD TO KNOW – Does My Policy…?

  • Cover 100% of the daily benefit or a lesser percentage. Some policies only cover 80%. CareGivers of America strives to keep you within your policy, so that you aren’t paying out-of-pocket.
  • Stop premium payments once care begins (this is called a Waiver of Premiums)? Many policies stop premium payments. We will verify this with you and your Long-Term Care insurance company
  • Have an inflation rider so that my policy’s daily worth will keep up with inflation?
  • Have other riders and what are they? I.e., Restoration of Benefits (does the policy “restore” after a period of time of non-use), Spouse Riders (does the spouse also receive benefits from the policy)
  • Cover any home safety equipment or medical supplies, how much? Is it a one-time benefit? Do I pay the money and get reimbursed or just send the receipts and policy pays the service company?
  • Cover Care Management or Care Coordination services and how much?

How CareGivers of America Makes It Easier For You

CareGivers of America Home Healthcare Services (CGA) has been assisting families in Southeast Florida for over thirty years. Caring for your loved ones is our specialty.

CGA is a licensed nurse registry in Miami-Dade, Broward and Palm Beach counties.

Private duty aides (Certified Nurse Assistants, Home Health Aides and Companions) help with all personal care and the day-to-day chores of running a household. Hiring a caregiver enriches one’s quality of life while giving peace of mind to loved ones. Care can be hourly, live-in on a short term or long-term basis. All CareGivers are credentialed, Level II background screened, carry their own liability insurance, and are experienced in senior care. The Magic is in the Match!

CGA accepts private pay, Veteran’s Aid & attendance, Medicaid Aide & attendance and all long-term care insurance. LTC insurance companies like: AF&L, Alliance, American Heritage, Continental General, Kanawah, NYLife LTC, Penn Treaty, Bankers, Bright House (formally MetLife), SHIP, John Hancock, CNA, Genworth, and Unium are some of the prominent names in the Long-Term Care Insurance industry to make sure that you get the right benefit out of your policies.

Research shows that 70% of the people who are turning 65 or older, expect to use some form of long term care in their household. Amongst them, more than 90% of the residents who receive Home Care, live in at home. We find the need for help often comes at a time of a medical crisis or with a disease progression causing loss of mobility and/or cognitive impairment. Added to this stress, is the understanding and filling out of insurance forms. Don’t, worry, we would manage the paperwork for you, as a courtesy.

CareGivers of America’s skilled and knowledgeable staff reviews your LTC policy with you. We help to get your paperwork completed, resulting in a quicker approval and help to make the most of your benefits, saving you money.

Call us Today – 954-206-1178 for a complimentary consultation!