About 8 million Americans own long-term-care insurance, which helps cover the cost of in-home care or nursing home and assisted-living facilities. So why are so many claims being denied?
The reasons may vary, however some fear the recent turmoil in the industry may lead to even more claim rejections.
I think the key might be to read the fine print of your policy before hiring a caregiver or entering a facility...insurance companies each have their own requirements. Some claims are rejected simply because a health-care professional fails to document a disability adequately; if you are not sure ask a lot of questions and if you’re still not sure get it in writing. In some cases, it also may make sense for beneficiaries or their adult children to enlist help in preparing claims from an agent or geriatric-care manager.
What do you think would help the process of getting health claims paid?
Yes people should be fully aware of their rights as regards long term care insurance. As well if people are denied they should file for an appeal. Yes obtaining appropriate documentation to substantiate a claim is crucial at any level. At the same time for the future efforts to redirect long term insurance care into living in the community would beneficial both to the person and also has been shown to reduce overall expenditures.
There are many policy changes in the works on capital hill, however we must remember that health care is not going to disapear, especially Medicare. Federal, state, and community social program eligibility is complex, and enrollment processes are fluid. Governing bodies use a wide range of options to make continual improvements to their programs. Altegra Health has assembled a team of Government Relations Directors and staff who are experienced, proficient, and well equipped to navigate this challenging environment. Their ability to interpret rules, research policy, advocate for members, and develop relationships at all levels of government provides Altegra Health with expertise not commonly found in the private sector.
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