Long Term Care Insurance

Americans routinely buy all sorts of insurance — for cars, homes, health and even pets and boats. But when it comes to long-term-care insurance (LTC or LTCI), relatively few buyers exist. According to the American Association for Long-Term Care Insurance, only about 2% of all Americans have any such protection. The low participation rate is partially a function of the perceived lack of need for such coverage and it also reflects the high cost of long-term-care insurance.

While many Americans share the financial goal of not becoming a burden to their loved ones, the reality is that each year, an estimated 11 million U.S. adults need some type of long-term care. People who require long term care are not “sick” in the traditional sense. Instead, these folks are generally not able to perform the basic activities of daily living (ADLs) such as dressing, bathing, taking medications regularly, eating, going to the toilet, getting in and out of bed and walking. Such care can be overwhelmingly expensive. For example, merely one hour of home-health-aide care costs roughly $20, while the average private nursing home room costs $87,000 a year. However, neither routine employer-based medical insurance nor Medicare/Medicaid will pay for extended periods of custodial care.

What is long-term-care insurance?

While health care insurance or Medicare helps pay for immediate medical expenses such as a surgeon's bill, long-term-care insurance helps people cope with the cost of chronic illnesses, such as Alzheimer's disease, or various disabilities. The policies pay for assistance with everything from ADLs to skilled care from therapists and nurses for months or even years.

Long-term-care insurance typically covers out-of-pocket expenses that come with home care, assisted living and nursing homes. Most policies have a waiting period that works like a deductible. So if you need the help of a home-nursing aide, you may have to wait 90 or 120 days before your benefits start to cover those costs. Long Term Care insurance generally covers home care, assisted living, adult daycare, respite care, hospice care, nursing home and Alzheimer’s facilities.

Don’t Be Denied the LTC Coverage Your Insurance Company Promised

Because of the very limitations for which LTC insureds require long term care, these consumers are particularly vulnerable to abuse by insurance companies. Insurance companies know that oftentimes the people who need long term care insurance benefits do not have the physical or mental strength or ability to fight insurance companies. So, what can and often does happen is that once long-term-care benefits are denied, LTC insureds simply give up and the insurance companies end up with all the premiums without having to pay benefits.

The Law Office of Eduardo A. Brito aggressively represents the rights of consumers whose insurance companies refuse to abide by the terms of the long-term-care insurance they issue. As a former insurance defense lawyer, Mr. Brito knows that insurance companies often seek to take advantage of the fact that many who need long-term care benefits are elderly, disabled, vulnerable and dependent on relatives for responsible decisions on medical care. For example, some insurance companies engage in wrongful rescission of long-term care coverage. Other insurance companies contest the high level of care some insureds require; while others use similar methods to deny or limit the long-term-care benefits promised in the policy.

If you or an elderly relative have been the victim of an unreasonable claim denial or rescission of long-term care coverage, contact the Law Office of Eduardo A. Brito so your rights or the rights of your senior loved one are protected and you are provided the long-term care you paid-for and which was promised to you by your insurance company.