Persevering through long-term care insurance denials

On Behalf of | Sep 8, 2020 | Firm News

Long-term care for your loved ones should not have to be a burden to you or them. Insurance companies these days reconcile with the fact that cheap policies sold years ago demand pay from them today. In order to preserve their bottom line profits, they can work toward making the process of securing medical needs a nearly life-threatening hassle.

As a Forbes story details, paying into a 20 year policy may not equal appropriate care depending on the circumstances.

Reasons for denial

Insurance policies for long-term care may carry several stipulations regarding their coverage. As the story goes, a daughter appealed to her mother’s long-term insurance provider over their coverage denial. The aide she chose for her mother’s long-term care did not fall into the niche set of licensed caregivers the insurance dictated.

After researching, the daughter discovered that the home health aides that the insurers preferred received about 75 hours of training versus her choice’s training of over 1200 hours.

Their denial did not concern the training, only the accreditation.

Furthermore, the preferred home health aides could not administer medication — a vital necessity for her mother’s care. She eventually secured a “one-time” allowance from the insurance company after months of back-and-forth hassle. Her aunt was not so lucky and died — denied by her insurance.

Resources for appeal

Taking care of your loved ones may demand sacrifice and time, but when your loved ones have prepared plans of care and insurance, the smoother the process the better. When facing reasons of long-term care denial, it is important to know that there is hope in persevering. When the coverage of your loved ones is on the line, it takes knowledge, patience and, when necessary, litigation to try and make sure they get what they need.