Problems With The Accessibility of Long-term Healthcare Benefits

There is a problem with the accessibility of benefits for people who purchase long-term health care insurance. Many family members of the policyholders are having difficulty ensuring that their loved one gets the benefits they spent years paying for. For people filing claims on a family members behalf should know the reasoning behind the denial of a claim.

A few specific areas giving filers problems include deductibles, eligibility, licensed care services, and documentation. Deductibles have waiting periods attached to them usually in 30-day increments that force the policyholder to pay for the number of days in the deductible before the policy will begin to payout. Most policies include a provision stating that the policyholder can only get benefits once he is in need of “ substantial assistance.” The definitions of those words vary in different policies. Most policies will also only cover licensed caregivers. In other words, children caring for their parents will not be covered. Documentation for long-term health care is a nightmare. Be prepared to keep receipts and have documents sent back. 

See Tara Siegel Bernard, Collecting Benefits Often Involves Collecting Headaches, Star Tribune Business, Jun. 15, 2013.

Special thanks to Brian Cohan (Attorney at Law, Law Offices of Brian J. Cohan, P.C.) for bringing this article to my attention.