Tag Archives: Insurance

Looking at Long Term Care Insurance in a new way

Long Term Care Insurance (LTCI) is not new and over the past few years, has not had the best reputation. It has been understood that while LTCI is great for helping people afford caregiving in their homes, the use of this insurance has been declining for the last 10 years.

Recently, there has been a lot of changes in the Long Term Care Insurance industry as they have seen the escalating costs of private duty care eat into their ability to offer a substantial benefit to their clients. One of the biggest changed to help with making LTCI more affordable and increase the benefits for elder Americans was allowing individuals to use companies like Well Beyond Care to hire their own caregivers instead of having to use the more costly private duty agencies in order to get reimbursement.  Lauren Tarrant, Well Beyond Care’s COO and Chief Nursing Officer was able to talk recently with, Randal Parker, who works in the LTCI industry and he was able to shed more light on some of these changes and how LTCI should be used by more people.

Mr. Parked stated that the driving force for him to offer these (LTCI) policies to families and seniors is, “I get to see firsthand what a difference I can make in someone’s life. To get a hug from a daughter after signing a policy  which allows her parents to afford care in-the-home or God-forbid a nursing facility.” He added, “I’ve delivered death claim checks and benefit checks and the hardest thing for me would be if I wasn’t able to help them in their time of need. To be appreciated by my clients is important to me. I used to be in the business of selling John Deere Tractors in Vermont. Now I’m here and this feels so different. Maybe because I’m aging or maybe just because I can help people in a totally different and more personal way.”

Mr. Parker outlined two LTCI policies that not only offer great benefits, but allow individuals to get reimbursed when hiring their own caregivers. One is from New York Life and one is from Kemper Reserve National. Disclaimer: Mr. Parker offers policies from both New York Life and Kemper.  He explains that there are many moving parts and LTCI used to be very pricey and limited, but much of that has changed recently.

First, New York Life (NYL) offers a policy through AARP.

New York Life: Benefits included in the policy.

Day 1 – Care Family Friends can be your caregivers and get paid.
Day 1- adult day care can start on day one and get reimbursed.
Day 20 – Home Care – Health caregivers can start coming to your home and can get reimbursed.
Assisted Living and Nursing Home care – you can choose from 30 to 365 days of waiting-
Extra Hospice Care is covered even with Medicare.
Dividends – You begin receiving dividend payments starting on year 10. These will reduce your premiums until your policy is paid in full.
Care Coordination support – You are assigned a person who creates a plan of care with your doctor, and then monitors your care for the whole time you are on claim.
Restoration of benefits– If you go on claim and then recover, all those used funds go back in your benefit pool.
NYL Financial Strength – New York Life has paid dividends for 172 years, and has $1.47 for every $1.00 in liabilities.
Plus, NYL  has another 29 billion in excess reserves, a 100 Comdex score, and only ever had 1 Increase in premiums (2014).

To learn more about this NYL LTCI offering – Click the link below to register: https://nylltc2020cc.eventbrite.com for an upcoming Online Long-Term Care Insurance Sales Presentation dates.

Here is the information about the Home Health Care plan being offered by National Reserve as part of the Kemper Insurance Company. This plan pays for both Home Care and Adult Day Care but not for assisted Living or a Nursing home. That is why the cost is so reasonable.  Concerning this plan, Mr. Parker stated, “So far, I’ve been able to help people with Parkinson’s, Autism, MS, pre- dementia, heart issues, cancer less than 1 year out from treatment, as well as individuals using walkers, canes etc. These plans are a gift for these people.”

Kemper offers two plans.  Each plan lasts for 365 days of care and pays up to $150 per day (or $4,5000 per month)  The reason to purchase the 2nd plan is to create uninterrupted care for as long as you pay the premiums. You can even overlap these plans for twice the benefit.

So what are the costs?

Kemper cost example: for a 65-year-old Male or Female.  The base plan is $27.25 per month. The inflation rider [5% compound] is $27.95 per month. That totals $52.20 per plan per month. Purchasing both plans  costs $110.40 per month, with the inflation rider included. This inflation rider guarantees that your benefit will increase to $232.00 a day or $6,960.00 a month in 10 years time.  The math is simple. You pay $110.40 per month for a $4,500 a month benefit initially, which  increases to $6,960 over time.

While the New York Life plan is nationwide, Kemper is only offered in 39 states. People 55 and older think that they might or will never need it. Kemper is different, as it offers lifetime benefits with just a 6 month waiting period. As long as you are making the premium payment, clients will have coverage of $150 per day today, and $232 per day after 10 years. With the inflation rider, benefit goes up every year.

So why are we at Well Beyond Care telling you about Long Term Care Insurance? Well, it is about letting you have more benefit without spending more money. Of course you can use a private duty agency and pay between $25 and $30 per hour, or you can use Well Beyond Care and do it yourself and pay between $15 and $18 per hour, or 35% to 50% less. That means you benefits go further.

As an example, if  you are receiving an $150 per day LTCI benefit and you care paying $25 per hour for care, you will receive reimbursement for 6 hours of care per day. Will Well Beyond Care, that turns out to 10 hours of care at $15 per hour. That is a 67% increase in the amount of care received. And this is huge.

Out company’s interest in LTCI started when we found that our client, Lois, had spent years and a fortune on LTCI but did not know how to get reimbursed and didn’t want to “bother” her daughter who lived out of town. She said to Lauren Tarrant, “She (my daughter) has better things to do than to hunt down signatures and forms, ahhh, just forget it.”

We could not just forget about it.

From our view at Well Beyond Care, people do not ask for reimbursement even when they have paid for years of coverage. If you have paid for the coverage for years, there should be an easy way to get reimbursement. Because of Lois, and many others since, we have simplifies Reimbursement Process for anyone who uses are system to hire and manage a caregiver. All you have to do is to complete the LTCI page with your LTCI information and your forms will be processed and waiting for you in the Finance Section. Payroll is performed weekly and the forms will only need to be printed and sent either by email, fax or mail by you for weekly reimbursement. Your choice.

We hope this has been informative, and thank you.

About Well Beyond Care
Well Beyond Care is the only company that teaches families and individuals how to find and manage affordable non-medical in-home care, while solving the chronic problems of caregiver truancy and turnover through the web application, WellBeyondCare.com. The Company’s platform combines the power of the internet with the personal touch of nurses to offer families a pathway to transitional care, allowing our elderly parents to safely age-in-place. Their solution lowers stress in hiring a caregiver and saves families tens of thousands of dollars per year in care costs.

 

CMS Adds Non-Skilled In-Home Care to Medicare Advantage Benefit

Beginning in 2019, non-skilled in-home care services will be allowed as a supplemental benefit for Medicare Advantage (MA) plans the Centers for Medicare & Medicaid Services (CMS) announced in a final rule issued Monday, April 8th. This ruling, originally proposed in February, was met with enthusiasm from both the home health and private duty home care industries.

This marks the first time CMS has allowed supplemental benefits that include daily maintenance in Medicare Advantage. “CMS is expanding the definition of ‘primarily health related,’”the agency stated in its announcement. “Under the new definition, the agency will allow supplemental benefits if they compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization.”

In 2015, 35% of Medicare beneficiaries were participants in MA, according to CMS data. And that figure is expected to grow quickly over the next several years. Home care providers are not the only ones welcoming this change, as many also believe MA payors are ready and willing to pay for non-skilled in-home care services but as of yet did not have a mechanism to do so.

“The Medicare Advantage plans have a very different payment environment [than fee-for-service],” Tracy Moorehead, CEO of industry group ElevatingHome, told Home Health Care News at the association’s National Leadership Conference in March. “They have greater flexibility than the fee-for-service providers do. They do not have a home bound requirement in many cases. So they are tasked with full capitation, where they have an amount they are provided [with] to care for a patient and they will do whatever they need to make sure that patient doesn’t cost them more money than necessary. And if that [includes] private duty services, then I’m sure a plan is more than ready to pay for that.”

In fact, insurers and payors have been positioning themselves to better align with post-acute care services for years. As the focus also shifts toward the high-cost, high-needs dual-eligible patient populations of people who qualify for both Medicare and Medicaid, that has provided additional incentive to cover personal care services as well.

“What Humana, UnitedHealthcare, and Aetna have been saying for several years is that we’ve have a great relationship for skilled home health and hospice for quite a while,” Keith Myers, CEO of LHC Group (Nasdaq: LHCG), told HHCN. “In the last few years, they’re starting to focus more on dual-eligible population and have needed us to have a bigger commitment in personal services.”