When most people purchased their long-term care (LTC) insurance policy, they felt confident that their policy would ensure they received the care that they would someday need. But the truth is that more and more policyholders are learning that loopholes, imprecise language, and differing regulations across stateliness can make getting that care covered by their insurer feel like an impossibility.
A recent article published by MarketWatch describes a man who paid the premiums for his wife’s LTC policy for twenty years. After he passed away, their son hired a caregiver hired for his mom as she battled Alzheimer’s disease. But he was shocked when the insurance claim for that caregiver was denied on the grounds that she wasn’t qualified to perform those care services. He says it took “months of dogged efforts” to convince the insurer to pay out the benefits as expected.
This story isn’t an outlier. Thousands of policyholders (and their families) are learning that LTC insurers are not prepared to or not interested in paying out claims for the types of home health and long-term care services that are critical to maintaining quality of life.
And there’s plenty more to come, with the Bipartisan Policy Center estimating that three in four Americans over 40 “are not confident they will have the financial resources to pay for needed care as they age.” These adults are facing the depletion of their retirement accounts, creating financial burdens for families, and risking their health when they can’t afford care.
As the population continues to age and more people submit claims for their LTC benefits, the system is likely to become only more difficult to navigate—especially if policyholders are trying to make sense of it on their own.
“I have talked to other people and many just give up out of frustration,” the daughter of one of our claimants told us. “WE ARE NOT GOING TO DO THAT! Thanks for hanging in there with us and offering your expertise. It is a minefield.”
If you’re in the midst of submitting or appealing an LTC claim—or if you expect to be filing one soon—Family Solutions for Care can help you get the benefits your family deserves. Read about our services or call us today at 844-858-4500!