Long-Term Care Insurance and Home Health Care: The Cheap Way Out Could Cost You

By David Kohnhome health care

OK, you’ve been feeling kind of rickety and your doctor’s told you you’re going to need some help with everyday tasks. Maybe it’s cooking and cleaning. Maybe you’re having trouble getting in and out of chairs. Maybe you have a medical condition that needs to be checked regularly.

Whatever the problem, you’ve now got to make a life-altering choice: continue living at home and have helpers and medical professionals come to your place – or move into a facility. Of course like most of us, you want to stay at home, with all your familiar things and memories. It’s a place where you’ve lived for years. It’s comfortable and usually less expensive than living in a facility. Still, someone’s got to pay the cost.

No problem, you say. You’ve got long-term care insurance. But long-term care insurance can lull you into a trap. Because you have the insurance, you may be tempted to hire the cheapest help possible so your long-term care insurance-allotted coverage stretches over a longer period of time. The result: less money out of your pocket. For example, suppose you have $100,000 in long-term care home health coverage. You might be tempted to hire aides at $15 an hour instead of the $35/hour that’s the going rate in order to make your insurance last longer.

Here’s the tricky part: The cheaper choice may not be the better choice. In fact, it may be a decision which ends up costing you far more than you ever expected.

Your insurance may or may not let you make the low-cost choice. That’s because long-term care insurance can cover home health care in several ways:

  • Some policies will pay only if it’s administered by licensed professionals sent by a licensed home health company.
  • Some policies also will pay for licensed professionals not sent by a licensed agency.
  • Some policies will pay for home health care aides who aren’t licensed or who come from unlicensed agencies or both.

The unlicensed staff and agencies probably will be the less expensive choice: Your coverage will last longer if it’s paying your helpers a lower rate.  But here’s the dilemma: Helpers and professionals who are licensed and bonded have had to prove they actually have whatever licenses are required. They must also undergo a background check. In addition, if they’re bonded, if they do something wrong, the bonding company must pay you for whatever damages have been caused.

Helpers who are unlicensed or who come from unlicensed agencies, and even unlicensed agencies themselves, are generally a crap shoot. Maybe all is right with the world and the unlicensed agencies and professionals wear halos and are exactly who and what they tell you they are. Then again, maybe they’re not.

In Florida, where I live, reading about a long-term care helper who has stolen a patient’s money or valuables happens with some regularity. So is reading about helpers physically or emotionally abusing patients – even going so far as to terrifying their patients to the point of keeping them isolated from friends and family.

There’s no guarantee that none of these terrible things will happen to you no matter how many precautions you take. But dealing with licensed and bonded professionals and agencies provides a thick layer of protection against your being abused, robbed or worse.

Remember, finding out that helpers and professionals are not who they told you they were, or can’t help you stay in your home as skillfully as they told you they could – or who even have a history of beating patients – after you’ve let them in the door, is a very, very bad time to discover you’ve been lied to.

For your own sake and safety, don’t let the fact that your long-term care insurance will let you cut expenses by using professionals and agencies that aren’t licensed or bonded tempt you into actually taking the road which is low-cost. Your health, well-being, and even your life, may depend on the choice you make.

Remember, you’re lucky enough to have a long-term care insurance policy. Go ahead and do this right. You – and your insurance company – can afford it.

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David Kohn is a veteran journalist and investigative reporter recognized as Your Straight-From-the-Shoulder Consumer Advocate.  He specializes in helping people make decisions about high-ticket items and services. For more in-depth information about purchasing Long Term Care Insurance, visit: www.buyinglongtermcareinsurancewisely.com.

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