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Overview Long Term Care

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Overview about Long Term Care

Overview about Long Term Care

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  • 1. OVERVIEW INSURANCE LONG – TERM CARE The long-term care includes many different services that help people with chronic conditions to overcome the limitations that prevent them from being independent. The long-term care helps people maintain their level of functioning, rather than improve or correct medical conditions. If a person has physical illnesses or disabilities often need practical help with daily living (ADL, by its initials in English). These ADLs include bathing, continence, dressing, eating, grooming and travel. If a person is mentally retarded, generally need supervision, protection or verbal reminders to perform everyday activities. Specialist services and custodial care is the term generally used to describe the long-term care and the type or level of care you may need.
  • 2. CARE INSURANCE LONG TERM Insurance Long Term Care is designed to help pay for health care long term of a person. Depending on the plan you choose, insurance may pay part or all care. The insurance policies long term care are not standardized like Medicare Supplement Plans. Instead, companies sell policies that combine a variety of benefits and coverage in different ways. The policies also can be complicated. Each insurance company must define its terms, benefits and exclusions in the policy. Companies should give potential buyers an "Outline of Coverage" that helps explain these terms. The bottom line: Be careful when buying coverage for long-term care. You should understand what services are covered by the insurance policy long term care and various types of long-term care you may need. Some policies cover only nursing home stay. Others only cover home care. Other cover both medical care in nursing homes and home.
  • 3. CARE INSURANCE LONG TERM Many policies also include coverage for day care centers adult, assisted living facilities and other community facilities. Coverage of home health care also varies. Some policies pay benefits only for skilled nursing care performed at home by registered nurses, licensed practical nurses, occupational therapists, speech and / or physical therapists. If you apply a policy of long-term care, you can choose your policy. You decide on: • the daily benefit amount, • the maximum benefit period and • the qualifying period that best suits your needs. The benefit may be a fixed dollar amount or may be established as the number of years, months or days to receive benefits. However, before benefits begin, you must meet a qualifying period, which is the time to wait after entering a nursing home or use home health care before your policy benefits begin. The grace period varies from zero to 180 days.
  • 4. WHAT IS AN INSURANCE POLICY DEDUCTIBLE LONG TERM CARE? Insurance contracts long-term care eligible for federal tax deduction offer certain tax advantages on federal revenues. If you are paying a premium for a contract of long-term care deductible, you can deduct part of the premium or the full premium. WHAT IF I CAN NOT AFFORD A POLICY OF LONG – TERM CARE? Older adults who lack the financial resources to pay expenses of long-term care may be eligible for Medicaid. To be eligible for Medicaid, your monthly income must be below the federal poverty level and assets can not exceed certain limits. Medicaid will cover only nursing homes that offer Medicaid-approved level of care you need. In certain circumstances, Medicaid will pay for nursing home care. The Medicaid rules are complex. For more information about Medicaid, contact the Department of Children and Family Services of Florida at 1- 866-762-2237.
  • 5. WHAT IS A PARTNERSHIP PROGRAM POLICY FOR LONG – TERM CARE? The Partnership Program for Long Term Care (LTCPP, by its initials in English) is designed to help protect the assets of the holders of insurance policies long term care later seeking the benefits from Medicaid. The Federal Deficit Reduction of 2005 allowed states to establish programs Insurance Company Long Term Care Skilled State. But having a policy's deductible LTCPP not guarantee that the insured will be eligible for Medicaid. The Department of Children and Family Services determines eligibility for Medicaid in Florida. As part of LTCPP Florida, not all states do. If a consumer plans to move to another state, check with your Medicaid eligibility agency to find out if they participate in the program. In addition, while not all states recognize acquired policies in other states, Florida respects LTCPP insurance policies purchased in other reciprocal states.
  • 6. WHAT IS THE ADVANTAGE OF A PARTNERSHIP PROGRAM POLICY FOR LONG – TERM CARE? When you have exhausted all the benefits of a policy of long-term care is eligible for the Partnership Program for Long-Term Care, the advantage of that policy is non-cash consideration. In exchange for the purchase of company policies or certificates, a part of the assets of policyholders will not be considered when determining eligibility for services of long-term care Medicaid, provided that such services are requested. Traditionally, to be eligible for Medicaid, the assets of applicants can not exceed financial eligibility limits. By requesting services from long-term care Medicaid, the program allows people who bought these policies retain one dollar in assets for every dollar of insurance benefits long-term care paid by the policy. For example, the typical asset limit for a person who applies for nursing homes is $ 2,000. If an applicant received $ 100,000 in benefits by insurance policy or certificate of partnership program, may retain up to $ 102,000 in assets.
  • 7. POLICIES THAT PROVIDE LIMITED BENEFITS Although there are others, better known policies that provide limited benefits are: • Basic Hospital Expense • Basic Surgical Expense • Specific diseases such as cancer • Hospital Indemnity Plans
  • 8. HEALTH INSURANCE TIPS Verify before you buy Contact Florida Department of Financial Services to verify the license of the agent and the insurance company before signing an application for a policy. Guides to Helth Insurance The guides are excellent tools if you are looking for a specific type of insurance and want to get a better understanding of all aspects of the product before purchase. List of Small Group Insurance A list of companies offering health insurance to Small Business Owners of Florida. List of Insurance for Private Persons A list of companies marketing health insurance policies with guaranteed issue for eligible individuals as defined in Section 627.6487 (3) of the Florida Statutes. Cover Florida provides access to affordable health service and quality. Plans are available for all applicants from 19 to 64 years, who have not had health insurance for at least six months and who are not eligible for a program of public health insurance. Read your policy carefully Know your deductible and coinsurance provisions understands. Know your liability in case you need a referral to see a specialist. Also, learn about their rights to file an appeal or grievance if a complaint which you believe should be paid, is rejected.
  • 9. INSURANCE ADVICE LONG – TERM CARE Verify before you buy Contact us to verify the license of the agent and the insurance company before signing an application for a policy. Insurance Guide Long-Term Care The guide is an excellent tool if you are looking for an insurance policy. It will help you understand the coverage and your rights and obligations. Read your policy carefully Understand your coverage, where they provide assistance, when it begins and how long. People have a provision of free 30-day review. You have the right to take 30 days to review your policy and decide whether to keep or return it and get a full refund. An individual policy should include provision of grace period. The grace period for premium payments is 30 days for insurance policies Long-Term Care.

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