Getting the Most from Senior Care Insurance

Table of contents

• What is senior care insurance?
• Senior insurance benefits
• When does long-term care insurance pay?
• How Parentis Health can help

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Taking care of your senior parent can be rewarding, but there’s no doubt it also has its challenges. One concern that frequently comes up is covering the costs of senior care. 

Many seniors think that health or disability insurance will pay for their long-term care needs, but this isn’t usually the case. Medical expenses and other care needs can quickly eat up a significant part of their monthly income, leaving them and their families with financial concerns.

Fortunately, there is an option that can help seniors and their families cover the cost of long-term care: senior care insurance.

Let’s take a look at how senior care insurance works, what it covers, and how Parentis Health can help your senior parent maximize their coverage to get the most out of their benefits. 

What is senior care insurance?

Senior care insurance, also known as long-term care insurance, is designed to cover your parent’s ongoing care and support needs when they become impacted by age or acquired disability. 

Many people invest in a senior care insurance policy when they are younger and then use the funds for the policy to cover the care they need when they are older. Although there are still some policies that your parent can purchase even if they are older. 

Senior care policies cover custodial or personal care at home, in a nursing facility, or in the community. This could look like:

• Care in a nursing home
• Care in an assisted living facility
• Visits to an adult daycare center
• Home health and home care visits
• Living in a memory care facility
• Modifications to your parent’s home
• Temporary respite care

Since insurance policies can vary, it’s important to talk to a trusted insurance provider about coverage before choosing a policy. That way, your parent will know ahead of time what types of services and facilities are covered.

Senior insurance benefits

The benefits of a long-term care insurance policy aren’t just monetary (although that’s a big plus). Senior care insurance can also bring the relief of knowing that your loved one will be able to afford the care they need when the time comes.

Cost savings

The main benefit to using senior care insurance to cover your parent’s long-term care needs is, of course, the cost savings. Most seniors will pay far less in premiums than they would pay for care without insurance. This will allow your parent to preserve their savings and assets and maintain financial independence as they grow older. 

Care options

By relying solely on Medicare or Medicaid, seniors might limit their care options. Medicare only covers care in a hospital or in a facility or at home while recovering from an acute illness. Medicaid may help pay for custodial care, but it’s likely only in a nursing home. With senior care insurance, your parent can decide where they want to receive care, such as at home or an assisted living facility.

Range of services

Paying for senior services with the benefits from a long-term care insurance policy may expand the range of services that your parent has access to. This could mean visits from home care aides, time in an adult day care center, meal or chore services, or help with essential home modifications.

Relief for family

Caregiving services that aren’t covered by health insurance are often performed by the elderly person’s friends or family. While friends and family are often happy to help, it can become more difficult when care needs increase. With senior care insurance to pay for long-term care, your parent won’t have to rely solely on relatives for assistance. 

When does long-term care insurance pay?

Most long-term care insurance policies allow your parent to start making claims against the policy when they become unable to perform at least two out of six basic activities of daily living (ADLs) on their own. 

ADLs are the essential and routine tasks that most healthy individuals can do on their own each day. They are also used as a marker for functional status. The six basic activities of daily living are:

1. Ambulating: walking independently or being able to move from one position to another
2. Feeding: being able to feed oneself a prepared meal
3. Dressing: selecting appropriate clothes and putting them on
4. Personal hygiene: being able to bathe and groom oneself
5. Continence: controlling bowel and bladder functions
6. Toileting: getting to and from the toilet and using it appropriately 

Your parent should contact the company they bought their policy from and tell them they wish to make a claim. The company will likely ask for medical documentation and may send a nurse to perform an evaluation. The insurance company will review and approve your parent’s plan of care in order to process the benefits. 

Once the plan of care is accepted, some senior care policies still have what is known as an “elimination period”. This is a short period of time that your parent will still have to pay out of pocket for their care. How long this period lasts depends on the specifics of your parent’s policy.

After the elimination period, your parent’s insurance company will begin paying their long-term care expenses. 

Senior care plans cover a specific daily amount up to a maximum lifetime payout. The coverage amounts will be specific to the type of plan that your parent purchased.

How Parentis Health can help

Parentis Health is here to help your senior parent get the care they need in the most affordable and accessible way. We can sit down with your parent and call their insurance company to:

• Verify your parent’s daily, weekly, monthly, and total coverage limits
• Note any changes in the policy from the time of purchase to the present
• Confirm whether the policy has an elimination period and if it’s been met
• Help you understand if there will be any services the plan doesn’t cover
• Help your parent get the most out of their benefits with less out-of-pocket costs

Our CEO, Tarek El Nabli, is licensed and certified as a Long-Term Care Specialist, providing our clients with an expert review of their policy.

Need help getting the most out of your parent’s senior care insurance benefits? Call us today and we’ll help your senior parent access the care that they need.