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Subject:  Stretching your LTC claim dollars Date:  9/26/2009  1:15 PM
Author:  GertrudeCNA Number:  15 of 17

I sometimes work for clients who have Long Term Care insurance policies. Often, these policies have dollar limits to payouts, rather than specific time limits.

One of my clients, a couple, did some research into this, and found that their policy covered care by state-licensed individuals - meaning CNA's like myself.

Many other LTC policies, including those offered through the AARP, also have that same provision that covers the direct use of licensed CNA's.

For reimbursement, the client simply submitted a claim form indicating my license number. The insurance company paid the couple directly, and from that payment they then paid me our negotiated rate. That rate was lower than they would have paid through an agency or other corporate provider.

They would not be able to do this with unlicensed caregivers, but since CNA pay rates are usually the same as those paid to unlicensed providers, and considerably less than rates paid to corporate providers of these services, there was an opportunity for them to greatly stretch coverage.

I would add some points:

1. Clients should use legitimately licensed, self-employed caregivers to prevent 'employer liability' issues.

2. Clients should check that the CNA they use has her own malpractice insurance policy.

3. Follow the normal safe-guards that would apply to any home care agency or individual, including reference checks.

4. Whether considering licensed caregivers, agencies, nursing homes, or assisted living facilities, clients should educate themselves as to signs of quality care.

By checking into their actual LTC policies, clients may find simple ways to stretch their benefit dollars.

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