As a home care provider in Milwaukee we receive a lot of calls about Long-Term Care Insurance. The majority of calls are from policy holders or their children. The policy holder bought their long-term care insurance years ago with the idea that it would pay for long-term care when they got older. They are now older, and want to start using the insurance. They have no idea about the specifics of long-term care, the specifics of their policy, or how any of this works. If you are reading this article, it’s likely you may be one of those people! Smile, you are not alone!
The purpose of this article is to help give long-term care insurance policyholders an understanding of how their insurance policy works in regard to home care services.
First we need to understand what long-term care is. Long-term care is not like traditional medical care that’s purpose is to treat an injury, illness, or disease. Long-term care is care that is given in the home as home care, in a nursing home, or in an assisted living facility. Its purpose is to help clients that are unable to perform activities of daily living (ADLs) to maintain their independence and lifestyle. ADLs include eating, bathing, dressing, toileting, transferring (walking) and incontinence. At PHCS, we like to say that we can, “provide all the care you need to remain in your home and independent!” Our goal is to help our clients maintain their independence to allow them to remain active members of our Milwaukee community. Please see OUR COMMITMENT.
If you are unable to perform ADLs, have a Long-Term Care Insurance policy, and believe home care could help you, you need to call your long-term care insurance company and file a claim. After you file a claim, the insurance company will send a nurse to your house to do an assessment. You will then receive a report that explains to you how much services you are entitled to. The services that most long-term care insurance policies cover include personal care and homemaking services. (Please visit the SERVICES section of our site for more detail.) You will need to find a home care provider that is state licensed. If you are looking for a Milwaukee home care provider, please consider PHCS. Typically, there is an Elimination Period. This means that you will have to pay for a set number of home care visits out-of-pocket before the insurance starts to pay. A home care visit is not an hour, it is from the time the caregiver comes to your home that day until they leave.
Do not let the elimination period hold you back from getting home care services. Home care visits in the beginning can be less hours and will cost less. In time, as you need more help, the hours per visits will increase. Having an Elimination period consisting of visits with fewer hours is the most affordable route. More importantly, we get a lot of comments/compliments from our home care clients with long-term care insurance saying how much we have helped them to maintain their lifestyle. They insist that they should have used our home care services sooner. Family members have also commented on how we have made their lives a little easier also.
When your elimination period is exhausted, you will continue to receive invoices from your home care provider. You must continue to pay your home care provider, but you will receive a check from the insurance company that covers the cost of your home care services. So, going forward, you will still have to pay for our home care services, but the insurance will send you a check reimbursing you for the cost of the home care services.
If you have any additional questions, please leave a comment below and we will try our darndest to get you an answer quickly!
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