Chipman Mazzucco Emerson LLC

Preparing to use your long-term care benefits

You may have thought you were doing a good thing when you took out your long-term care insurance policy. After all, you never know what the future may hold, and you certainly know many people who have ended up unable to care for themselves for one reason or another.

The problem is that trying to access the benefits from your LTC policy is not always easy. Additionally, not every policy covers every contingency, and it is not always easy to predict what type of care you may end up needing. Your first step may be thoroughly reviewing your policy and its limitations, then gaining more information about how to file for benefits.

What's in your policy?

The type of coverage you purchased will determine the type of care you may seek under your LTC insurance benefits. It will be important for you to know what your policy includes. You don't want to end up with an unmanageable bill because your policy doesn't cover the type of care you have been receiving. Here are some questions to consider:

  • Does the policy cover in-home care?
  • Does the policy limit you to certain care facilities in Connecticut?
  • Can you modify your home with your LTC benefits?
  • Will LTC cover care provided by family members?
  • Will you have to continue paying premiums after you file a claim?
  • How long is the elimination period, that is, the time when you will pay out-of-pocket before your benefits begin?
  • What are the exclusions in your policy?

Your policy probably covers only a limited amount of time, so you want to be sure you are ready to use it before applying. After determining the amount of your daily benefits and your lifetime maximum, you will be able to plan for the best time to file a claim.

Is it time?

You may already be experiencing benefit triggers, which are typically necessary before an insurance company will consider your claim. If you are having difficulty managing at least two normal, daily tasks, such as bathing yourself, eating, dressing, using the bathroom or just getting around your home, you may be ready to use your LTC policy.

For this, it may be helpful if you or a family member keep a journal of your health and declining abilities. In fact, having as much assistance as possible, including a legal advocate, may improve the chances of filing a successful LTC claim.

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