Long Term Care Insurance Alternate Plan Of Care Addressed

Los Angeles; June 13, 2013 – Confusion regarding many protections and beneficial options provided to those who purchase long term care insurance arise following major news stories.

“A recent article in The New York Times has generated an increase in the number of calls from consumers who already purchased or may be interested in purchasing long term care insurance,” explains Jesse Slome, director of the American Association for Long-Term Care Insurance.

The executive addressed a concern regarding the “alternate plan of care” benefit.   The benefit provides insurers with a degree of optional flexibility that can benefit both the insurer as well as the policyholder.  The Times story noted that an insurer was no longer honoring those provisions.

Slome pointed to comments shared by Phyllis Shelton, author of Protecting Your Family With Long-Term Care Insurance.  Shelton noted that the alternate plan of care is a wonderful and important addition to any policy.  But like many good things in life, it has been abused and sometimes misrepresented by well-meaning people who didn’t understand it.

“Alternate plan of care is intended to make a way contractually for a long-term care insurance carrier to pay outside the contract when it is cost-effective and makes sense medically for the patient,” Shelton notes.   ”The lawyer quoted in this article is incorrect in his statement when he says this provision wasn’t sold in a way that said the insurance company has the right to approve how this provision is used.   The policy language is very clear that the insurance company, the doctor and the family must agree on how this provision is used. It was never intended to provide extensive home care benefits to someone who just purchased a facility-only policy. ”

The provision has been used  to pay for new services that come along, for example care in an assisted living facility from a policy that was sold to pay only for care provided in a skilled nursing home.   Shelton noted her experience with a long-term care insurance carrier that utilized the alternate plan of care provision to buy a blind woman a seeing eye dog for $3,000 that allowed her to stay home while her daughter was working.

“We commend The Times for its continued efforts to cover important issues and the article did report the Association’s information regarding the $6.6 billion in claims paid last year,” Slome acknowledged.  “You won’t see articles about the 264,000 people who were paid benefits last year and how that helped their lives and their families, so we hope that’s a story the long-term care insurance industry will tell.”

For long term care insurance costs or to connect with a designated specialist, a member of the American Association for Long-Term Care Insurance, visit the organization’s website or call 818-597-3227.

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