FAQs – Long Term Care Insurance and  COVID – 19 (Coronavirus)

 

How do I contact Gordon Associates Long Term Care Planning if I have a question?

If you are currently looking into LTCI for the first time, Gordon Associates can accommodate you and your needs.  Our team is currently working remote, and we are fully operational at this time.  Please go to this page for more information.

 

Can I apply for a long term care policy?

Yes. Insurance carriers are taking new applications. We are also performing along with the carriers to allow clients to apply easily. For more background, here’s an interview we did recently on the Price of Business online radio show about applying for coverage during COVID – 19.

 

Have any carriers made changes due to COVID-19?

Yes, changes already have or are being rolled out with a handful of our LTCI carriers.  We are seeing maximum issue ages lowered, tweaks in the underwriting process and some price increases, just to name a few.  It varies by carrier and type of policy and if you are interested in discussing this further please contact us for details.

 

Will COVID – 19 impact the premiums of new policies? 

Generally, lower interest rates mean the insurance carriers may price new policies higher. There are many factors insurance carriers take into consideration when pricing their product, such as cost of care and mortality rates, but interest rates will also impact the premium you’ll pay.

 

Will COVID – 19 increase the premium on my existing LTCI policy? 

COVID-19 cannot by itself increase premiums on existing policies. Carriers only raise premiums on a state and class wide basis. With the anticipation of COVID-19 lower interest rates can compel insurance carriers to refresh and update the pricing for the new applicants in the future.

For existing Stand-Alone LTCI policyholders, if an insurance carrier is seeking to increase premiums they would first need to file their request with the Department of Insurance for the entire state. Carriers cannot single out any specific policyholders. Rate increases must cover a particular group/class of policies that were written in that state.

 

I’ve already applied for a policy. Will my application keep moving forward or stall out?

Yes. Carriers will continue underwriting policies as before.  Most applicants can expect the process to move along customarily.  There may be some extended delays if you need a face to face interview or medical records have been ordered.  Your agent at Gordon Associates Long Term Care Planning will be able to give you a better understanding of a timeframe prior to submission.  We will also provide you with detailed updates throughout the underwriting process.

 

I’ve already filed a claim. Is my insurance carrier still processing it?

We understand there is a lot of concern from those who are currently on claim or in the process of filing a claim. If you have already begun the claim process, please continue.  All carriers are still processing claims as normal.

 

I’m getting ready to file a claim. Can I still do that?

If you are considering filing a new claim, we encourage you to not wait until the last minute to file.  The claim process from start to approval can take a while.

 

Can I modify the benefits in my policy?

Yes, you can modify your policy at any time. Benefits can never be increased, but most policyholders can reduce benefits, therefore modifying/lowering their premium. Keep in mind with most carriers the effective date of change will not happen until the policy anniversary date.

 

I want to stop my caregiver from coming into my home due to COVID-19. How will this influence my claim moving forward?  Most companies will allow you to not receive care for 45-60 days before they close a claim out.  For most policies, you will not receive reimbursement during this timeframe.  However, your claim will not close due to inactivity.  You can let the carrier know if you will have a break in your care.  The carriers are taking into consideration that many individuals will be pausing their care temporarily during this time.

 

If I’m on claim and choose to stop care during COVID-19, Will I have to meet the elimination period again once I re-start care?  Most carriers have a “one time” elimination period. Meaning you only must meet it once.   Even if you went off claim and back on again.  So, that should not be an issue.  With that, there are some older plans you may have to meet the elimination period again.  Such as, if you go without care for more than 180 days or if you stop and start a new claim.  With most of our clients receiving care at home, it would be unlikely that they could go more than 30 days without care based on their heath situation.

 

My parent needs some form of home health care and we cannot see or assist him/her because of COVID – 19.  What resources are available?

If your parent has a LTCI policy, first make sure they are benefit eligible.  This typically means they need assistance with 2 of the 6 Activities of Daily Living (ADL’s), which are bathing, dressing, continence, transferring, eating and toileting, and/or have a cognitive impairment, such as Alzheimer’s or dementia.  Once benefit eligible, the next step to consider is if they need care at their own home/apartment or if additional care is needed at the facility/retirement community where they reside.

Due to COVID-19, residents at facilities/retirement communities may not be able to bring in caregivers of their choosing if they are not already employed by the facility they reside in.  In this case, we suggest contacting a manager to inquire if outside help is permissible.  If your parent is living at their own home or apartment, there are many resources they can tap into.

Many home health care agencies are ready to help and have modified their procedures to be able to continue servicing their stay-at-home clients during this pandemic.  It’s important to do a Provider Review before you hire anyone to ensure the person or agency meets policy requirements.  You can call the insurance carrier directly to take care of this or we can walk you through the steps beforehand, but the policyholder or immediate family member will need to request the review (name, address and phone of the agency will be needed).

The Aging Life Care Association for Geriatric Care Managers is another great resource.  They can help determine what specific care a senior needs, where to get that care and what local resources can be utilized to assist the client.

Even if your parent is not LTCI benefit eligible and/or doesn’t have an LTCI policy, health care assistance can still be obtained using the same resources.  We also offer claims consultation services for a nominal fee for clients that did not take out their policy with us.  For existing Gordon Associates policyholders, claims consultation is automatically included for free.

Here at Gordon Associates we always suggest our clients contact us first.  You may need to start with a policy review, to better understand the benefits and triggers, and we will be happy to guide you through the claims process and provide resources whenever available.  We would be happy to offer a recommendation to the local agencies we work with regularly and have grown to know and trust or put you in touch with someone in your state.

 

If you are still have questions about your claim, please feel to reach out to Jolene Winter at Gordon Associates Long Term Care Planning and she will assist you or your family members in your claim process.

Your Long-Term Care benefits will provide you a guaranteed income for the period you have chosen.  Market downturns do not affect your policy benefits and they are something you and your family can always rely on.  It’s during times like these, it’s important to have something like long term care planning that can guarantee some benefits/income for you and your family’s future.

Resources: Long Term Care and COVID – 19

Medicare: Telehealth Benefits Expanded

Medicare: People Who Should Take Extra Precautions

Resources for Older Adults, Family Caregivers and Health Care Providers