Long Term Care insurance is a relatively new coverage in the U.S., meant to cover the increased costs of medical care after retirement. However, long term care coverage is so complicated and difficult to claim that it is a wonder that a disabled senior can ever make a successful claim at all – much less ensure that the proper amount of benefits are being received.
Unlike a disability policy, which provides coverage when the policyholder is suffering from disabling disease(s) or injury, a long term care policy provides benefits when the policyholder has a qualifying level of difficulties with basic daily activities, called “Activities of Daily Living” or ADLs.
ADLs are usually classified into five categories:
- Personal Hygiene
Long Term Care policies typically provide insurance benefits when the insured is incapable of performing at least two of the ADLs without assistance for a designated period of time, in many cases 90 days. If the insured also experiences cognitive impairment, the eligibility for benefits varies.
Long Term Care benefits are calculated based on the provided figures in the policy, which can seem straightforward when reading the policy language, but when you receive the actual checks and the dollar amount inevitably does not match what you expected, insurers don’t provide much reassurance or clarification.
If you or a loved one was denied your Long Term Care benefits, if your Long Term Care policy was revoked or the premiums became too expensive to manage, or if you suspect you or a loved one is not receiving the full amount of benefits due, contact the attorneys at Defever Law for advice.