Remember when you first purchased your long-term care insurance policy? Everything seemed in order. You knew what the insurance company was supposed to pay each day and for how long. Then you probably filed the policy away, hoping that you would never be ill enough to need it. Nevertheless, the time came when you did need home health care services. That’s when the insurance company and their team of case managers stepped in and screwed up the works. Here are some true-life comments from clients, experiencing problems getting their insurance companies to pay for their care. “Why can’t I have more than two hours each day? My policy is supposed to pay $100 per day!” “I’ve been paying the premiums for years. This is the first time that I’ve ever tried to use my insurance. Why is the insurance company giving me such a hard time?”

Are you, or one of your family members, in this type of predicament? Are you not getting what you paid for? Champion Home Health Care has successfully maximized benefits for its clients for many, many years. Here is some of our expert advice on this matter.

1. Choose a licensed home health agency or nurse registry. Do not use a companion or non-medical service. Most long-term care policies require you to use an agency that provides or refers home health aides and nurses.

2. Focus on your need for hands-on care from a home health aide or nurse. Most policies require you to be in need of two or more “activities of daily living.” Here is the short list: bathing, dressing, grooming, walking, transferring up/down from sitting to standing position and vice versa, toileting, feeding, and medications. Do you need someone to hold onto you while you do these things or assist you?

3. If you answered “no” to any of the “ADL’s” listed above, then reconsider. Do you need stand-by assistance for safety or supervision in any of these activities? You want to do as much for yourself as you physically can. It is healthy for you to try and stand up by yourself and walk by yourself. Nevertheless, it is foolish and dangerous not to have the home health aide standing close by, just in case you can’t make it. Preventing a fall and further injury to your health is very important.

4. Any amount of cognitive impairment and/or memory loss needs to be analyzed from a safety perspective. Many Alzheimer’s patients in the early stages of their disease can still walk, dress, and bathe by themselves. They are also fully capable of burning down the house because they left the stove on. One man drove his car through his garage into his kitchen, because he put the car into “drive” instead of “reverse.” Do not discount the need for supervision from a home health aide in all activities of daily living!

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