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I Have a Long Term Care Policy, Now How Do I Use It?

by Linda Jahnke

Linda began her career working in a continuing care facility in Arizona after graduating from the University of Iowa. She was especially drawn to this career path because of the love she had for her maternal grandfather. Linda’s family was deeply impacted by the cost and complexity of long term care needs her grandfather required as a result of a debilitating stroke. Because of this experience, it has been Linda’s desire to educate families on the need to plan for extended care. She is also passionate about guiding families into care choices that ensure a dignified experience.

No one can deny that if home or facility care is needed, a long term care policy can be a life saver. After specializing in LTCi coverage for the last 30 years, I can attest to the fact that most policy holders have little recollection of what they purchased, nor do they understand how to utilize their benefits. It is our purpose at Jahnke Consulting and Long Term Care Alliance to educate our clients and shepherd them through their claims process so that they receive all of the benefits they are entitled to.

“I thought I had to be bedridden before I could file a claim”, was what my client told me when I asked her why she did not file a claim after moving into an assistance living facility. This is a common misconception. Most policies will approve benefits once an insured needs either stand by, or hands on assistance with at least 2 of the following daily skills: Showering/Bathing, Dressing, Toileting, Incontinence Care, Transferring, Ambulating (not included in all contracts) and eating. In addition, if an insured has been diagnosed with a cognitive impairment such as Alzheimer’s or Vascular Dementia and requires continual supervision, they should file a claim.

None of my clients who started receiving long term care benefits were bedridden. In fact, the majority of our clients receiving benefits from their policies continue to lead purposeful, active, lives. Our clients and their family’s value assistance from care providers because the extra attention empowers them to keep going despite their physical challenges. Filing benefits for home care assistance can delay a facility placement.

“If I try really hard I can shower without falling.”

As the saying goes, if I had a dollar for every time I heard this, I would be rich! When our agency guides a client through their claims experience, I ask directed questions about how they manage their bathing, dressing and walking tasks. Falls that cause broken hips, ribs, and shoulders are a large percentage of our claims work. Despite this, most people do not observe that they are putting themselves in harm’s way by simply getting in the shower or taking a walk to get the mail. Our job is to guide our clients to the conclusion that trying harder is not the best option. Our role is to reframe their perspective so that they can respond to the claims adjuster with integrity while holding onto their dignity. By the time our claims process unfolds, our clients understand that they should not deny they need help, but rather communicate how difficult physical tasks have become, and support is vital to remaining independent.

“I have thought about having a caregiver, but I do not know what they would do for me” One of the reasons why I love working with this population is because of the generation their grit was birthed from. They are proud, courageous, frugal, private, and full of great wisdom. This group of folks really did pull themselves up by their boot straps. Convincing our clients that having a driver, fiduciary, personal assistant, or personal trainer is not an extravagant decision can be a challenge. LTCi is a great tool for accessing extra services that would otherwise be overlooked. For example, when Medicare stops paying for physical therapy, we recommend Reneu Health for continued strength training and improved balance and ambulation techniques. Knowing what a long term care benefit will pay for can open avenues for specialized care and equipment over and above what Medicare and secondary insurance pays for.

“When I am ready to file a claim, who can help navigate the process?”

Jahnke Consulting and LTC Alliance was created to provide a specialized service to families who took steps years ago to account for the potential need for long term care. We are careful to vet, or assess a client to make sure, based on their policy language the claim outcome will be successful. Part of our service also includes recommending vetted care providers and community resources. Aging in place does take a team and we know who the great team players are. Our evaluation of the LTCi contract will give a realistic perspective of what the insured can expect from their insurance contract and what kind of care services will be covered.

If you have a LTCi policy, but have not looked at it for years, I highly recommend getting the policy in an readily available file so that it can be accessed quickly. Give us a call at 858-513-8351 we will be happy to explain to you what benefits you have and how best to use your policy. Learn more about what Jahnke Consulting and LTC Alliance can do for you and Linda Follow Linda for updates and tips on Facebook and LinkedIn!

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