Long-term care is a variety of services that includes medical and non-medical care to people who have a chronic illness or disability. Long-term care helps meet health or custodial needs.
Medical insurance pays only for medically necessary hospital, skilled nursing facility and home health care. However, you must meet certain conditions for insurance to pay for these types of care. YBA helps clients secure these benefits under their medical plans. See Success Stories.
Long Term Care Insurance for Custodial and Skilled Care Not Covered by Medical Insurance
Most long-term care involves custodial care (non-skilled care) and skilled care not covered by medical insurance. Custodial care helps people with their activities of daily living such as dressing, bathing feeding and using the bathroom. It can be provided in a nursing home, assisted living facility, adult day care or at home. Since the cost of such care is not covered by medical insurance, individuals must pay-out-of-pocket for these services. The cost of such care is expensive, which is why some people purchase long-term care insurance (see note and disclaimer below).
Individuals with long-term care insurance often encounter roadblocks when trying to access benefits under their policy. Insurance carriers reject or deny the payment of benefits for a variety of reasons ranging from an inadequate claim submission (application process is very paperwork intensive) to a determination that the insured does not meet the plan requirements for benefits.
- Review your plan and counsel you before you make any costly mistakes (such as picking a non-covered caregiver).
- Guide and manage the application process under your long-term care plan.
- Advocate on your behalf when the insurance company rejects or cuts offs benefits; and if necessary.
- Prepare and file a formal appeal on your behalf.
See Success Stories.
Note and Disclaimer: Planning for long-term care is different for everyone. Depending on your assets, you should consult a certified financial planner or your accountant to determine whether you should consider purchasing a long-term care insurance policy as part of your overall retirement and estate planning. YBA does not sell or broker long-term care policies and does not do financial planning, but can connect you to a professional who provides these services.