Navigating insurance coverage for in-home caregiving services can be very hard and confusing for a lot of families which is completely reasonable. To make it somewhat easier, we want to share a breakdown of the most common insurance types and their positions regarding in-home care.
Quick Answers:
- Health Insurance: No coverage.
- Medicare: We are being told Yes . . . but WE have yet to see it.
- Medicaid: Yes, but income limitations apply (single applicants are permitted a max monthly income of $967. Married applicants, with both spouses applying, can have a max monthly income of up to $1,391- based on the Medicaid Idaho website).
- Life Insurance, Car Insurance, Homeowners Insurance: Nope, nope, and nope.
- Long-Term Care Insurance (LTCi): Yes, this is a potential avenue.
Delving Deeper:
We are focusing on Medicaid and LTCi for insurance coverage. To qualify for each:
- Medicaid - Getting Medicaid coverage involves understanding intricate financial eligibility. We suggest contacting an elder law attorney to discuss your asset and financial situation, or you could call Medicaid at 877-456-1233.
- LTCi - For LTCi, we suggest you read your policy closely. If it's a head-scratcher, don’t worry! Our CEO, Eric Wallentine, can help you. You can email a copy to him at ewallentine@hwcg.com, and he will be happy to give you a synopsis of what he read. He has read hundreds of these policies and helped folks apply for coverage. He has submitted thousands of insurance claims and can explain most of them, as well as the hurdles many people face getting qualified for coverage.
Key LTCi Terms:
- Elimination Period - The duration of time during which you cover care costs before insurance kicks in.
- Elimination Accelerator - Some policies offer accelerated progress towards meeting the elimination period. For example, some allow you to count a certain number of hours of care per week as 7 days towards your Elimination Period.
- Inflation Rider (IR) - Increases benefit value over time. This adder increases your benefit by a certain percentage each year. For example, if your long-term care insurance plan has an IR of 5% per year, your benefit is worth over 63% more after 10 years (if compounded).
- Qualifying for LTCi – In order to qualify for long-term care insurance coverage, it is typically required that you need assistance with two or more activities of daily living (ADLs), or have a cognitive impairment.
- Activities of Daily Living (ADLs) - Basic tasks of daily living. If you need help with these tasks, you may qualify for long-term care insurance coverage. Examples of these daily activities include bathing or showering, dressing, getting in and out of bed or a chair, walking, using the toilet, and eating.
- Max Benefit - Maximum insurance payouts during a set period of time. Insurance policies have different structures for maximum benefits, with some having daily, weekly, or monthly limits. Checking this detail is crucial, as it indicates the amount LTCi is willing to cover within a specified period.
Understanding these terms is pivotal in making the most of your LTCi coverage.
Insurance intricacies can be intimidating, but with the right knowledge, you can navigate them effectively and ensure your loved ones receive the best possible care without breaking the bank.
If you’re confused and need help deciphering your LTCi policy, Eric would be more than happy to assist. You can send a copy of your policy his way, and he will provide guidance, regardless of whether you are affiliated with our agency or not.
Reach out via email at ewallentine@hwcg.com or call 208-350-7269.
