A Guide Through the Long-Term Care Insurance Maze

Last summer, Sandy’s mother was placed in an assisted living facility’s Memory Care Unit. After years of paying for a long-term care insurance policy, the time had come for her to begin collecting benefits.

Yet Sandy found that the process of accessing the long-term care benefits that had been paid for was extremely complex. And while she had been handling details of her mother’s care for some time, she knew she would need outside help dealing with the assisted living facility and the insurance company.

“I needed someone who had the expertise to be able to present herself on behalf of the family and to be on equal ground, to be able to use the same language as the doctor, the assisted living facility and the insurance company,” Sandy said. Fortunately, she found Nicole Christensen of Care Answered to help navigate the maze of paperwork.

“The LTC insurance company that my mom had spent so much money on for the past few years was giving us push back regarding the terms of coverage,” Sandy explained. “Nicole spent countless hours on the phone with me as well as with the assisted living facility and the insurance company making sure all the paperwork was correct.”

But Nicole’s help didn’t end there. “Nicole has also been the liaison with my mother’s doctors’ offices, who also have to file certain paperwork within certain time limits as per insurance company,” Sandy said. “Nicole has been on top of this process from day one. She continues to monitor all paperwork with all parties in this process.”

The impact on Sandy’s life has been immeasurable.

“Having had Nicole as our liaison now for more than a year has enabled me to be able to actually be a little calmer in regard to sharing the responsibility for paperwork and payments” Sandy said. “Nobody can fully appreciate the service that she provides until they have the need for her help, but nobody should ever even consider navigating through the system without someone like her.”

Today, Sandy wholeheartedly recommends Nicole and Care Answered to anyone dealing with a similar situation.

“I would encourage any family in any long-term care or life-changing situation to immediately contact Nicole to have her mediate for your loved one and be the advocate that you will need,” Sandy stated. “She is a wonderful listener and can put a plan into action to achieve the outcome that the family needs. Nicole is an invaluable asset every family should avail themselves of.

To learn more, give Care Answered a call at 516-584-2007.

Don’t let a chronic illness prevent you from enjoying the holidays

beansLiving with a chronic illness or as a caregiver to a loved one with a serious health issue can be stressful on a day-to-day basis. When additional activities associated with the holidays – shopping, cooking, entertaining, visiting and more – are added, it is easy to feel overwhelmed. However, careful planning and simple strategies can help you avoid exhaustion, flare-ups and stress. Here are a few tips:

  1. Plan ahead. Try to avoid last-minute parties, visits and obligations. Having a clear idea of holiday events well ahead of time can help you plan in advance. Schedule preparation time as well as rest time in order to conserve your energy so that you can be fully present.
  2. Don’t be afraid to say no. Self-awareness and self-care are essential during the busy holiday season. You know what you will be able to accomplish and how much you can handle. Give yourself permission to turn down invitations and avoid situations that will drain your energy.
  3. Remember to prioritize your health. Important routines – medication, therapy, diet, and doctors’ appointments – must be maintained, regardless of your holiday plans. Try as much as possible to maintain those schedules. In addition, be sure that caregivers are taking care of their own health. Only by remaining well can a caregiver continue to be there for their loved ones.
  4. Scale back your expectations. It’s OK to host a smaller holiday gathering, to contribute a store-bought dessert rather than a home-baked treat, or to give gift cards instead of personal gifts this holiday season. Remember that the true meaning of the holidays lies in being with friends and loved ones. Trying to live up to holidays past or your own image of the perfect celebration may not be realistic or even necessary.
  5. Do a little at a time. Whether you are addressing cards, wrapping gifts, or cooking a meal, break the task down into smaller chunks. Start early, and schedule time to rest and unwind between chores.
  6. Ask for help. How often have you heard the words, “Is there anything I can do to help?” People truly do want to lend a hand, but often they don’t know exactly what you need. Don’t hesitate to ask those around you to pitch in. If you are financially able, hire someone to help with chores such as shopping, cooking and cleaning.
  7. Take time for you. Schedule time to do things that provide you with a sense of peace and pleasure. Read a book, watch your favorite TV show, talk to a friend, meditate or just breathe. These mini-breaks will help you to recharge your batteries so that you can keep going!

Forget Politics…Talk About Healthcare Decisions this Holiday Season

Thanksgiving is right around the corner. As you get ready to roast the turkey, bake the pies and gather with loved ones, think about adding one new tradition to your family gatherings. Take politics off the table and instead use the time together to talk about healthcare. Share any important family medical history and discuss the decisions you would like made on your behalf should you become unable to make care decisions for yourself.

A good place to start is to give your loved ones peace of mind by selecting your health care proxy.

What is a Healthcare Proxy?

The New York Health Care Proxy Law allows you to appoint someone you trust — for example, a family member or close friend – to make health care decisions for you if you lose the ability to make decisions yourself. By appointing a health care agent, you can make sure that health care providers follow your wishes. Learn more here.

How do you talk about healthcare decisions?

Once you have selected your proxy, be sure to inform that person about his or her role and let him or her know about your wishes should an illness or injury leave you unable to make your own healthcare decisions.

Sometimes these topics make people uncomfortable. Try to ease the discomfort with these suggested opening lines:

“My faith is important to me and I don’t want to have….”

“I’m allergic to …. Please make sure that I don’t receive that medicine”

Talk about what you value as specifically as you can. You might say:

“I don’t want to ever be sustained by machines,” or “I have to be able to live independently,” or “There are new health findings every day. I would like to be kept alive until they find a cure.”

Points to remember about healthcare decisions

The discussion with your healthcare proxy can and should be ongoing. You cannot imagine every possible scenario but if the person you select as your healthcare proxy understands your values and knows the types of life-sustaining treatments that you would want, as well as those interventions that you would not want, your proxy will feel confident that they are following your wishes rather than having to decide your fate on their own.

This is not a contest of who loves you the most; rather, it’s about who will be able to carry out your wishes.

It is a tremendous burden to expect your loved ones to make these decisions for you if you have not expressly told them your wishes. Help them be your proxy by freely sharing your feelings.

Take time this holiday season to begin your discussion. And fill out your healthcare proxy form. Think of it as a compassionate gift to your loved ones should they ever have to make an important healthcare decision for you.

 

Do I Have to Pay This Bill?

“…in this world nothing can be said to be certain, except death and taxes.” To this list of life’s certainties attributed to Benjamin Franklin, we might also add bills. While the season of gift catalogs and holiday greetings is nearly upon us, our mailboxes are perennially filled with notices of balances due from utility companies, credit card providers, and medical offices, among many others.

When it comes to medical bills, there is often confusion about what we are responsible to pay, what should be covered by insurance, Medicare or supplemental Medicare plans, and whether other arrangements can be made.

Care Answered works with our clients before they have a medical encounter to ensure that planned services and providers will be covered by their insurance.  If you receive an unexpected bill after services are rendered by a healthcare provider, our best advice is to not automatically pay it before asking a few questions.

If you believe you received a bill for a medical encounter that should have been covered by insurance, contact your insurance provider and ask them specifically why they did not pay it. If the services provided are unclear, call the provider and ask for a detailed, itemized bill. If something listed on your bill is unclear to you, ask what it is.

Long-term skilled nursing facilities (A.K.A. nursing homes) should not bill patients who are covered by Medicaid. If your loved one has been approved for nursing home Medicaid and you receive a bill for their care, you may not be responsible to pay it.

Bills are generated by people working in billing departments; they are human and sometimes make mistakes so it always pays to check your bills carefully. If you feel you need an advocate because the billing seems wrong or if you want to make sure you don’t get charged before you go, contact Care Answered or call us at (516) 584-2007.

Untangling healthcare bills can be daunting, especially when you should be focusing on getting better.  We can help.