The Podcast was originally posted on Jan 29th 2013.On the show Steven helps listeners understand their benefits, how to access them, and how to have benefits restored if the policy has lapsed.
Some people have lifetime polices, which essentially never “expire”-as long as the insured keeps the policy active by paying the premiums. The majority of people though, have limited-time policies. In order to maximize these limited-time policies, it is crucial to understand how to utilize and maximize their features in order to fully benefit the policyholder.
One of the most crucial yet overlooked policy features is called restoration of benefits. Perhaps the most important characteristic of this “restoration of benefits” feature is its ability to essentially transform a limited time policy into a perpetual policy, when used properly.
A serious issue that I have encountered in the long term care world is when an insurance company undercuts a plan of care for an insured person. Oftentimes, even though a plan of care has been approved by an insured’s physician, the insurance company will disagree with the amount of care hours assigned. This is probably one of the biggest problems in the industry because there is a lot at stake for everybody.
Allow me to explain.
Many of my registry clients are told that their policy benefits have been maxed out. Consequently, when registries or agencies are no longer getting paid by the insurers, they look to their clients to step in and pay. In many cases, these clients cannot afford to pay, and more often than not, the registry or agency will stop providing care, and essentially lose their client as a result.
This happens primarily for two reasons:
This summer Frank Anania from Mesa, Arizona reached out to A Place for Mom with what at first glance, seemed like a simple question. “My wife is in memory care. Our long term care insurance, which pays $200.00 dollars per day for nursing care, will only pay $100.00 per day for memory care. Memory care requires more daily care. What can I do?” he asked. (more…)