You met the qualifications. You made the phone call to the long-term care insurance company and you were armed and ready. You knew what the Activities of Daily Living were and you painted a beautifully clear picture of how you are getting along. The claims department asked you several questions and you never said you were independent. You told the story of how your day goes and you explained in detail how you function and how you have made adaptations. Good Job. You passed the first hurdle.

Now, you need to figure out who you are going to hire and how often they need to come in. You most likely have a 90-day elimination period. This is where you can talk to the claims department about a few more items. First, you need to know who you can hire. (This is where knowing what your policy says is really helpful). Can you hire your neighbor or a family member? Or, are you required to hire a licensed agency?

Second, you need to know what paperwork the insurance company requires. They will want some sort of documentation of the help your person is giving you. They will most likely have a form that they want completed. It will be like a timesheet for your hired person to complete. Your person will need to make sure they complete the type of help you need. For instance, if you qualified for help because of dressing and bathing assistance, your helper needs to document they helped with your dressing or bathing. Remember the help can be stand-by assistance. (Go back and read previous issues or go to https://kydncountry.com/answers-in-aging/ and listen to previous shows where I go into detail explaining stand-by assistance and hands-on assistance)

Third, you need to decide how often you are going to want to send in your paperwork for reimbursement. Is it going to be weekly or monthly or maybe twice a month? You decide. But, keep it consistent and mark what you send to the insurance company and have proof you faxed it or emailed it. Then a day or two later call the insurance company and ask if they received your paperwork. And, confirm that they received everything they need to process the claim. Trust me. They will give you a run around stating they didn’t receive something or they’ll say that it was not completed correctly. Chase them down. Especially chase them down on your very first billing.

You may have decided to go to a nursing home or an assisted living to receive care. In that case, what you’ll want to do is get the business office to help you submit the claim paperwork. They probably will take care of everything for you. If they do, be sure to keep checking with them that the paperwork was received and the insurance company confirms that they have all they need to process the claim. I cannot tell you how many times I fax and re-fax to the insurance companies until they tell me they have everything they need.

You did well. You have kept at it. You haven’t given up. You have taken one step at a time. You have taken one day at a time. You haven’t gotten overwhelmed. You have hung in there. Pat yourself on the back and tell yourself “Good Job!” I’m so proud of you. You are playing offense and are winning!

God Bless you for all that you do every day. Your family needs your prayers. It’s astounding the difference a praying mom and dad will do for a family. And, please, pray for the rest of the people in your community! We need your prayers desperately. Pray for your town, your state and your country. Declare Victory! No matter what the situation looks like, declare victory! Your prayers are powerful. God Bless You and God Bless the United States of America!