Elder Care Home Health Blog » Long Term Care Insurance

Long Term Care Insurance – Elimination Periods

admin — Fri, 03 Feb 2012 12:00:53 +0000

We Urge You to Look at Your LTC Policy Before You Need It and Check about Elimination Periods and Your Daily Benefit.

Many of our clients at Boca Home Care Services, Inc. have Long Term Care Insurance. They use their policy when personal care and household assistance following a fall, accident, illness or surgery is needed. The client may be returning home from a hospitalization or Rehab stay, compounding a stressful and busy time of coordinating care while recuperating.

It’s not unusual for people to forget that the policy they purchased has an “Elimination Period” which likely lowered their premium payments. However it means home care coverage does not begin right away, but after the “Elimination Period” is met. Let’s face it, few people remember the terms of their insurance policies. As time goes by, details fade. It’s an expensive “surprise” through which time you must pay out of pocket for the care you need. Insult to injury, usually the most help is needed at the start of care.

“Elimination Periods” can be a few days, a few weeks or even a few months. If you require live-in or substantial care, the costs can be thousands of dollars – you didn’t expect to pay.

Boca Home Care Services, urges you to familiarize yourself with your Long Term Care Policy BEFORE you need to use it. Call your agent or the company and review the terms of your coverage. If your policy has an “Elimination Period”, plan accordingly. Suggestions include: setting funds aside to cover the period you would have to pay out of pocket expenses for your care, put together a plan with family, neighbors and friends of who can help with which tasks. If some people can do the shopping, bring in cooked dishes, and take you to appointments, then you may need a Home Health Aide just for personal care such as bathing, dressing, respite time and laundry. In this way, you may be able to manage with only the minimum hours from an Aide. Research which food stores, restaurants and pharmacies deliver in your neighborhood.

Lastly, some policies will count days in a Rehabilitation facility and Medicare home health visits (Boca Home Care) towards the “Elimination Period”. Explore these possibilities with your insurer. Ask what paperwork is required to have these Rehab and Medicare visits count

Private vs. Licensed Home Care

admin — Fri, 27 Jan 2012 15:45:47 +0000

Once the decision is reached to that a home health aide or caregiver is needed one has to decide whether to hire privately or go with a licensed company. There is a lot more to consider than price so you must know your responsibilities as an employer or as a client. Also, Long Term Care insurance may come into play.

A cautionary tale learned the hard way. Every now and then a client decides that they will hire someone privately who someone in their building used. It is cheaper after all-although as the employer of the privately hired aide, you are legally responsible to pay Social Security and other Federal taxes- remember “NannyGate”?

Last week, a client did just that, they decided they wanted to save their insurance, hired someone referred to them and discontinued service. Two days later Boca Home Care Services received a call from the hospital from this client. Her new aide whom she hired on her own didn’t stay with her or come when called so the client attempted getting to the bathroom on her own, fell, is severely bruised along her left side. Thankfully, nothing was broken, but her spirit.

Of course this scenario can happen with the best of care however, the client had no recourse. She couldn’t call the office and ask for a new caregiver. No one could speak to the aide and set a higher standard. The client learned the hard way, she was on her own. We were back on service in the hospital that day. Even though her LTC insurance doesn’t cover in the hospital, she wanted one on one help in the morning to start her day.

There are tangible, important advantages to hiring a caregiver through a licensed company. You have back up in case the caregiver cannot work or they change schedules. The aides are screened and credentialed. There is accountability and transparency. When you or a loved one is incapacitated these things are worth the cost.

Home-Care Services May Become More Costly

admin — Fri, 20 Jan 2012 12:00:29 +0000

An Obama proposal would make home care more costly by allowing for overtime pay to caregivers. This will effect hours of care, number of caregivers, Long Term Care insurance coverage and possibly evenallowing people to remain at home. Take Action and communicate to your representatives.

The Miami Herald > Opinion > Letters to the Editor

Letters to the Editor * Friday, 01.06.12

Home-Care Services May Become More Costly

Millions of seniors enjoyed the holidays, thanks in large part to the affordability of trusted licensed home healthcare givers who provide daily critical assistance, be it medication reminders, dressing or cooking.

But as early as March, barring a reversal of an executive order from President Obama, the quality of life enjoyed now by many seniors could be adversely affected both in their independence and checkbook.

Under the president’s Dec. 15 directive to the Department of Labor, home health aides, exempt from federal wage laws since 1974, will have to be paid an hourly wage and overtime for service over 40 hours a week.

Don’t expect insurance policies to extend for this added cost. If the consumer pays out of pocket for all home care now, the cost could be staggering. Imagine paying a licensed, trained and background-checked home health worker, now costing $17 an hour, $25.50 an hour for 30 hours of overtime. Weekly, that added expense would be $247.50 and yearly it could be almost $13,000.

The options are not pretty:

• Individuals may give up their independent lifestyle and shift to institutions that until now were more costly.

• Children paying for or monitoring a parent’s expenses might start hiring independent caregivers, skipping over companies that provide credentialed caregivers.

• To get around overtime, individuals may choose to create a revolving door of caregivers. This won’t make the client particularly happy either. “Don’t send me anybody else,” is a familiar directive to home healthcare providers such as myself.

A relationship between the caregiver and senior can determine if the senior is comfortable enough to go on an errand or an activity with an aide or choose to stay home, shrinking their world and opportunities for happiness.

Individuals who provide this important work for our growing senior population should be fairly compensated, but at what cost to the consumer? There must be balance.

The Department of Labor has opened a 60-day public comment period ending Feb. 27 before acting on the president’s initiative. Concerned South Floridians should call President Obama and their congressional representatives to express opposition to the anticipated negative impact.

Joseph Bensmihen, owner and CEO, Boca Home Care Services, Boca Raton

Your Aging Parents Have A Personal Emergency Response System – Do They Test It Monthly?

admin — Wed, 18 Jan 2012 12:00:30 +0000

For Every Senior Who Has an Emergency Response Button, You Must Test it Monthly to Make Sure it Works and Keeping You Protected.

It is so gratifying to see more and more clients who already have PERS button on their wrist or around their neck—especially when they live alone. We recommend to all clients and patinets to get such a system so that should they fall, help is immediately available by pressing a button.

The Pros of such a device are multiple:

*After a fall, limited waiting on floor, often in pain, for help to arrive.

*Your parent is known to the company and their vital info is stored, unlike with a 9-1-1 call.

*Emergency contacts (family members, sons, daughters) are notified of the incident and whether your parent is taken to the hospital.

*It can also be used as a security system for added peace of mind.

We at Boca Home Care Services believe it is a great gift that parents can give to their out of state children in particular. Often Adult children worry about their parent’s safety and the “what ifs”.

Yesterday I met a new client who has Congestive Heart Failure, just came out of the hospital, uses a walker and is feeling very weak. She showed me her PERS and said she hasn’t worn it in awhile even though she pays for it. However, this last hospital stay has scared her and now she won’t go without it.

I asked whether she tests it every month. She didn’t know what I meant. I asked does she press the button once a month to make sure it is working and that a representative from the call center responds to her signal? She said “no” she “hadn’t thought about that”. So we tested it, she pressed it 4 times and nothing happened, no phone call to check what the matter is.

She was stunned, got her personal phone book and called the company and left a message. She learned her lesson! It is a lesson I hope everyone with a Personal Emergency Response System will learn. The button is only good if it connects to help on the other end. Like smoke detectors and changing batteries, it is a good idea to press the button every month and test to make sure it is working in the event you do have an emergency. The companies expect such tests of their equipment.

Obama Proposes Overtime Initiative

admin — Sat, 07 Jan 2012 12:00:22 +0000

Read more: • www.usatoday.com – home health

The Proposed Overtime Initiative Could Actually Increase Home Care Costs and Possibly Nursing Home Placements.

On December 15, 2011, the White House announced that the U.S. Department of Labor’s Wage and Hour Division will publish a proposed rule that will effectively end the companionship services exemption for home care aides. The proposal will revise the companionship and live-in worker regulations under the Fair Labor Standards Act to more clearly define the tasks that may be performed by an exempt companion, and to limit the companionship exemption to companions employed only by the family or household using the services.

In addition, the Department of Labor proposes that third party employers, such as in-home care staffing agencies, could not claim the companionship exemption or the overtime exemption for live-in domestic workers, even if the employee is jointly employed by the third party and the family or household. Click here to review the proposed rule.

WHAT DOES THIS MEAN TO YOU OR YOUR PARENTS WHO NEED HOME CARE?

*Most LTC insurance policies do not pay overtime – leaving you with a co-payment.

*Your Out of Pocket expenses will INCREASE.

*Will a loved one go with less care than they need or have to move to a Nursing Home?

*WIll your parent have to get used to several caregivers instead of enjoying the rapport established with one steady aide?

Example: A live in (24 hour a day) caregiver at rate of $170.00 a day would cost at an hourly rate: $408.00- The differecne to you–$238.00 out of pocket– and that doesn’t even compute overtime at time and a half per hour.

Here is What YOU CAN DO!!

Let your representatives know you are against changes to the Fair Labor Standards Act which would require caregivers to be paid time and a half – overtime.

Pres. Obama – 202-456-1111

Se. Rubio – 202-224-3041

Sen. Nelson – 202-224-5274

Rep. Wasserman Schultz – 202-225-7931

Rep. Hastings – 202-225-1313

Rep. Rooney – 202-225-5792

Rep. West – 202-225-3026

Rep. Deutch – 202-225-3001