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May 21, 2022 8:30 am
Hans and Robby are back again this week with a brand new episode! This week's show is all about making sure you cross the T's and dot the I's on your long term insurance claim application.
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This is Sam from the masking journey podcast of our goal with the podcast is help you to try to find your way in this difficult world. Your chosen Truth Network podcast is starting in just seconds to enjoy it, share it, but most of all, thank you for listening and choosing The Truth Podcast Network. This is the Truth Network welcome to finishing well brought to you by Cardinal guy.com certified financial planner belonged to child best-selling author and financial planner helping families finish well for over 40 years of finishing well will examine both biblical and practical knowledge to assist families in finishing well, including discussions on managing Medicare IRA long-term care life insurance and investments and taxes. Now let's get started with finishing well, finishing well is a general discussion and education issues facing retirees guide.com partner advisors on trial CFP some insurance this show does not offer investment products or investment advice welcome to finishing well, a certified financial planner Hans Shiloh and today show the different but I love it how to fill out an application for a long term insurance claim.
And so, as you may know, when you're filling out insurance claims. Now the insurance companies even though there are fairly complicated and you want to make sure you get this stuff right and is no place to find a loophole well you the thing that immediately occurred to me when it comes to long-term care is that were all looking for this the ultimate long-term care program obviously is that we want and that you know what Jesus in heaven and say this is no place did not know what's on the application stuff. But you know I got it. Talk about that, briefly, that you know the question that that you often ask someone if they did it in a do you know if you die today that you have the ultimate long-term healthcare program that you end up in heaven, and the Jesus wants and never knew you and you know a lot of times a symbol. I'm a good person you know I did get it out. You know well flunk that that will get you across the border because you know what's what's happening here is that Jesus paid them across the application fee. EEE did it all and dislike.
If you're struggling with your long-term care.
You know, you might want to call Hansel in the case of struggling with the application of getting into heaven.
You gotta know a guy and the guy you gotta know is Jesus right and you gotta know that that he is God and he did dynamic cross for you and it is by his blood that he purchased your righteousness, and to know that in your heart and ask him to come in your heart and to be born again and to get that new life in him and be willing to surrender our life to him and a walk with him in enjoy that's that's what's on the application.
I thought they would cover that quickly that's you know of all the applications that we don't want you to miss out on. I mean this is the one that obviously is very very critical that at that point in time when you're there like you gotta know a guy in the guy you gotta know is Jesus hung what is the root like why were doing a lot of talking about long-term care claims in writing that you people are not to be too happy with me talking about long-term care claim problem that it is now it has and what that is, the insurance companies don't want to let loose their money when the person is laying in a nursing home or assisted living or other you know I mean they just don't insurance companies that who they are and there is a there's a subjective element.
These claims which is really around the word substantial. So let me just read what an actual policy says that the person filing the claim of the policyowner is unable to perform, without substantial assistance from another individual, to activities of daily living and unable to do this for a period of 90 day and then he goes on in list the six activities of daily living with her bathing continence dressing, eating, toileting, transfer, must've thought about that and get in the situation where they can't do two or more of those things despite nature people don't want to go over the subject at all and talk about it they don't necessarily like me, and them so then what really made us do this show years. We just had a couple of clients lately more than a couple that specifically they have lots of resources like a lot of money and wealth for their retirement age is not binding. Long-term care insurance if they do not even talking about any further with an agent due to inexperience.
One lady had with trying to file claims on her mother is now deceased, and she and her eyes got the runaround and it was a runaround just back and forth from the insurance company trying to get the doctor to say this social worker about how much she needs care when she needs care and she's sitting there with these insensitive people that she's dealing with the insurance company and she's the daughter of going through a really bad situation with her mother in the end of her life and along.
And she just had a perception that these people were just playing catch 22 and she got so upset about it. She said she nonviolently might just no way no way and so I just can't put it aside and really just didn't have much more to say other than I did. Circle back in the end of our meeting and I said that they ultimately pay on your mother's insurance company after she wasn't upset about.
And the answer was. He played it yet.
In most situations where people tell these horror stories of the insurance company. The insured finally got pay coming they think they can so it's hard for me to review anything she saying in an activity with her. I am going to go up and meet with her up in the mountains and maybe play a little golf and can get to know each other a little bit better with machine her husband and then I'm impressed upon them is that the big losers in the steel where she got under them because they live and be left without long-term care insurance and I know they are taking comfort in the fact that they have the money to pay for it with these people, then having children and when they started the interaction with us with a put down on the form is they want to develop a trustee or a third-party trustee to take care of them when they can't take care of themselves or to at least take care of their financial matters. And since even describe the situation that they might be in. They don't have anybody look accurate. And then at the same time they think this person is going to be able to spend their money appropriately to care for them, so I'll let you talk for a minute because you know what we learn or what I know is you know in my father's own case he knows my father was reaching that age that he had the money for the long-term care or for the home healthcare that he needed when he heard what the prices were now just absolutely no part of that and so you know it's the family and in most cases a course in this case they don't have any kids but know your left there trying to figure out how to take care of you know your your family member and I'm actually met situation right this very minute is my mother-in-law fell the other day.
She's in her 80s and I'm watching my wife and I just she can't do anything. I mean she can go to the bathroom.
She can't do this you can't do that and Tammy is with her 24 seven and there is no relief and and it it's it's hard on the rest of the family is not just part of the patient.
It's hard on everybody is that is the case may be. So yes them by one of the cool things about this video that I saw that Hans and Tom did their cargo advisors.com as they went through this process was. They said hey if if you're what you bought the policy from us or not. If you're struggling with an insurance company with a claim.
Call us and time again in the in the stories that I heard the people got paid. The claimant is just a matter of understanding the process in getting the the eyes and the tease darted in the right place rounds will and you know I have a lot of experience. I went through this with my own mother okay with the insurance company pretty much saying no to the home healthcare benefit on my mother's long-term care policy that I folder and paid for in the first year to you and I talked about that book of the policy and the insurance company they work for.
It is the no and what they were really saying is your mother does not qualify for the home healthcare that she doesn't meet with that standard of care that I just read earlier and then of course I got them to look at it differently and then they ended up in claims against help, the clients with companies I didn't used to work for getting out the policy reading the qualification appear and then going to the professionals and just getting them to certify with the dealer and get the people claim so that it is actually once we can get through it we get through. Somebody that knows what they're doing on insurance companies and and on Iran. This is actually pretty easy to fix. I love the way Tom walked us through it and you have this board in the video that shows the two different ways to walk through that application of you know folks that are not not cognizant. Obviously Horgan went on like Alzheimer's and that kind of thing where they require somebody look at him all the time or the other where they needed the other six areas of life in a bathing and dressing in incontinence and those kind of things and it's helpful to know that what what Tom said was that it doesn't necessarily have to be filled out by a doctor when it isn't. It's gonna be a whole lot easier to get it done right right but it started with on the board and on the video you want to go to YouTube and look at it is the definition of care in the standardized policy they think of and standardize the late-night. So in other words, your policy or your parents policy long-term care policy and disperses sometime in the late 90s, or more currently, you're the last 25 years, then this is their definition. But if the policyholder than that. It's not too far from this, but what I wrote on the board. I just pulled out of one policy. But it is exactly the same in all insurance departments really put the clamps on insurance companies. This definition of care.
This qualification appear needs to be written exactly the same in all policy and 25 years old or newer.
This is exactly what it and I really want to talk about this, even if it doesn't apply to you right now this is beneficial to just get a few things planted in your mind, either for your own policy to tell your kid or for you may have parents that have insurance or answer uncles or somebody to come in your church. The sole owner that has them actually need your help or you to get to me to help him when they're in the situation I break so we want to remind you this is brought to my cardinal guide I cardinal guide.com or you can get contact information for Hans if you got a situation like this all there at the website.
Cardinal guide.com will be right back with a lot more on these applications, which by the way, is helpful. From my perspective, all sorts of insurance claims. Realizing that it is, it helps to know where the advisors must be done.
Hans and I would love to take our show on the road to your church and Sunday school Christian or civic room. Here's a chance for you to advance the kingdom through financial resources and leveraging Hans expertise and qualified charitable contributions veterans aid and attendance and IRA so security care and long-term care.
Just go to Cardinal guide.com and contact time to schedule a live recording of finishing well, your church, Sunday school, civic group contact time that Cardinal guide.that's Cardinal guide.com welcome back to finishing well, a certified financial planner Honshu Island today show is getting their eyes darted in the tease crossed on that application for home healthcare insurance claim or a long-term healthcare claim on your board you you separated this out so that people could easily see you know what they were to run up against the that they be able to get it done right will definition of care. Key word here is financial keyword is substantial, meaning that you know like if you took the six ADL bathing continence, dressing, eating, toileting, and transferring unique substantial assistance with two new have to required for you. Just make it through the day so you were being substantial like for that meeting is not good enough to simply prepare your meal for me. You could make a case that I need financial assistance somebody preparing a meal for me. You know I need any help, and substantial assistance with eating really means that somebody pleaded there and sit there at least help you get it on the floor tenant or no substantial assistance being substantial assistance and so for starters what I recommend. People do when they come to me and I say to get me to and the easiest to qualify for that.
Everybody needs to do regularly will will just say is bathing and dressing so those are the two that I always focus in on and then if we can't meet the standard on most of them will start looking at some of these other, but you know when you think about it. A person with bathing, they either need assistance with okay minute taking going to the bathroom and turn on the water in the shower get into the shower, set the tile towel out the side they themselves turn the water off. Tell themselves go out and get something wrapped around him and they don't need assistance if they but if they need somebody to turn the water on help them get in there watching mother and their assignment on going all the latest, it's pretty easy for somebody is filing a long-term care claim to make the case that they need substantial assistance with say things to address meaning just dressing is something we all have to do one today, sometimes more than once a day and you need any help with Saturday down and most people that meet this care qualification in the getting home healthcare they need substantial assistance with those two things I gonna see the others but those are the two that I zero in on and is for starters okay and when it when you're trying to qualify somebody for a benefit payment minute. Checking into an assisted living is pretty easy because then I can like in isolation help with two or more of these things so it's usually at home healthcare claims were, like claim start that the question gets brought up and nobody ever reaches before they before they got a sharp eye on client and the other thing that was really helpful that Tom brought out was you know you can actually help the certified healthcare system which again knowing what needs to be on your claim.
Whether it's a doctor or a certified healthcare assistant you can actually walk them through what they need to write down so that it doesn't get confused right, absolutely because there's a big or or means one of the other because the war is that they require substantial supervision caused by a severe cognitive impairment. So in other words, you have a cognitive impairment or your loved one does and you like Alzheimer's like dementia. Unlike a lot of other things they call it, but if they require again substantial supervision. That doesn't mean calling them up every hour. I mean, that means that somebody's there watching him in there there that doesn't mean you're staring at him every hour and it doesn't mean you couldn't do it for for five or six people but if they require substantial supervision caused by severe cognitive impairment, and they meet that criteria then we don't have to mess with the first step that I was talking or one or the other so in most people filing long-term care claim have some level of dementia mean they they they just do and or memory loss or whatever you want to call it.
So you really need to before you start piling on these claims as you need to decide this a memory based thing. Or is this a physical thing and they need care with the activities of daily living and then is it just complicated with dementia because if you start trying approving going down both Road gets a little confusing and so my recommendation is you make a decision whether regular going to do the physical thing with the ADL surrender the cognitive thing, but when I can be stuck in the middle for St. doctor stated that sometimes I may want to make some, comment on every paragraph and that just messes up the claim and a lot of times we get brought entities after the claims already gotten into the home office and the insurance company is already blocking or asking for more. They been asking for more live in writing to the doctor and the reality is with mostly faulty.
You don't even have to get the doctor involved a licensed healthcare practitioner is all you need.
The social worker usually not a nurse but sometimes the social workers are nurses is just that person if they have their licensed healthcare practitioner.
They can fill out and certify the claim and all the recertifying are not given your whole health history.
This person needs help substantial assistance with bathing and dressing mean literally if you put all that down in but nothing more. Can't you engage claim K so so so you're right to me.
We can use the doctor and a lot of people do with the doctors generally in a put down too much, or he can cover a whole lot of areas with three or four words, and Dan just invite there and check every last little thing he puts down out and people are reasonable to get mad about this, but when I'm just telling it.
It can be not as frightening as were talking about. Not as bad as what were talking about and you know I'm more than happy to help in going so you if you're one of those people is going through this problem. Let me know and I'll give you some counseling, get to sleep. If you're a person who's just using a bad experience are just some people, it's good enough for them if they just heard about the bad experience. You know from somebody secondhand or thirdhand. That's enough of them.
Sam never messing with that stuff and long-term care insurance and talk about and that's really why we did this thing is we just want to come and get that ugliness of the claim. Time out on the table and Reese want to talk about it. There are ways to deal with it and the people and ultimately get the kind and so will you and I'd hate to see you do without long-term care insurance because you're making that decision based on here's scientists and my my mother-in-law sell two weeks ago and I'm just sitting there knowing what I know best. She unfortunately has nothing to help her accept her daughter who is completely overwhelmed with all that's going on and oh my goodness, I do not want to put my kids through or or anybody right where that you know they can't get some kind of break they can get some, help and elicit. And it did.
It gets heavy duty when they're in their 80s because just like you send Hans that usually there is some dementia going on with that too, and they're not really aware of all that's going on, which just makes for bigger messes and oh my goodness this is such a wonderful, in my opinion opportunity for you to assess the situation realize that these claims in other gonna take some effort to get done everything in life that so that man is so worth it because you see this kind of thing all the time we do every day. Not all clients are like that in the people to deal with buying long-term care insurance retaken part of their asset or their IRA money and buying a hybrid are people that have had this in their family which is a lot of people have a husband and the wife. They each have two parents, you know, so that's four people and these people that are coming into us are in their 60s or 70s or 50s and there one of those poor people or two of those four people is probably spent some time needing care and the kids had to deal with it. This is usually a pretty easy conversation with those people about the hardest people to deal with the people that are just kind of in the bloom where they were to just have experiences so they don't totally know what were talking about. They think it will apply to them or their well-to-do people that have Artie made up her mind with Adventist Simpson Selzer, the easy solution is pay for myself on my money and so we just got about a minute left, Hans. I think we can make that time that call once again that if you know somebody is struggling with that get up with Hans or me.
That's why we Cardinal guy.com we talk about that every week or you know what Cardinal advisors on the YouTube channel. The links are there to get up with Tom or his his company and you know that's what you guys are, therefore, is did you know how God placed you for such a time as this for people that are struggling with this stuff. You need to plan for you and we can certainly help you fluctuate, we have smaller policies like the one you bought give you a year in a nursing home or an assisted-living may give you separate benefit year at home you have substantial indemnity benefits and sure you could you could use that often run out of benefits, but you know if your mother-in-law had had this policy coming, you would've had people in since the day she fell and it would make your life a lot easier. So my Christmas yes again, Hans Silas. It Cardinal advisors is though is the YouTube channel is got a group wonderful video on this whole subject of the shows a lot more on this claim process as well as a course Cardinal guy.com as we always talk about reading get Hans's book the complete Cardinal guide to planning for living in retirement.
Thanks again Hans, you finishing well is a general discussion and education of the issues facing retirees Cardinal guy.com Cardinal advisors upon child CFP some insurance this show does not offer investment products or investment advice. We hope you enjoyed finishing well brought you by Cardinal guy.com visit Cardinal guy.com for free downloads of the show previous shows on topics such as Social Security, Medicare and IRAs, long-term care and life insurance, investments and taxes as well as cons best-selling book, the complete Cardinal guide to planning for and living in retirement and the workbook once again for dozens of free resources past shows what you get. Hans book of Cardinal guy.com if you have a question, comment or suggestion for future shows. Click on the finishing well radio show on the website and send us a word. Once again that's Cardinal guy.com Cardinal guy.com. This is the Truth Network