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Archives for August 2012

Do Long-Term Care Insurance Carriers Pay Their Claims? You Bet!

August 24, 2012 by Honey Leave a Comment

A US Department of Health and Human Services, Office of Disability, Aging and Long-Term Care Policy (April 2010) study sought answers to the following:

Is the denial of benefits to policyholders making claims on their policy appropriate?

Is the approval of benefits to policyholders making claims on their policy appropriate?

Their findings are based on the analysis of 1,200 claims from companies accounting for 70% of industry claims.

“An estimated 200,000 policyholders are currently claiming benefits.”

“The review indicated that everyone who was eligible to receive a payment for benefits under their policy, in fact received it, and those who the insurance company determined did not meet their policy triggers did not rceive payments.”

“There are many reasons that a payment might be denied or delayed after an insurer is approved for benefits based on the clinical criteria of their policy. These reasons include provider ineligibility, elimination period not met, coordination of benefits (other payment source), and lack of documentation about service costs or bills.”

“Insurance companies tend to err slightly on the side of approving claims that may not meet policy eligibility criteria.”

“The clinical audit team found that 19% of the sample had not met their elimination period within six months of notification of clinical benefit eligibility, while another 14% had not submitted bills within the same timeframe.”

“Upon a blind review of cases, clinical auditors would have approved 65% of the cases for benefits, denied 30% and would have required additional or clarifying information in 5% of the cases. Put another way, the clinical auditors would have approved 5% fewer cases than the insurance company adjudicators…”

Re-published from the 2012-2013 Sourcebook for Long-Term Care Insurance Information (Thousand Oaks, CA: American Association for Long-Term Care Insurance,  2012).

 

 

 

Filed Under: Helpful Information About LTC, I'll Just Self-Insure Tagged With: AALTCI.org, Honey Leveen, the American Association for Long-Term Care Insurance, www.honeyleveen.com

Long-Term Care Insurance Pays!

August 22, 2012 by Honey Leave a Comment

According to page 22 of the 2012-2013 Sourcebook for Long-Term Care Insurance Information (Thousand Oaks, CA: American Association for Long-Term Care Insurance,  2012), the nation’s 10 leading long-term care insurance (LTCi) companies paid over $10.8 million a day in claim benefits in 2010!

Benefits paid by just these insurers totaled nearly $4 billion for the year!

During a typical 30-day timeframe, these insurers paid benefits to 134,430 individuals.

Imagine the improvement in dignity, options and choices LTCi ownership gave these policyholders and their families!

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: AALTCI, AALTCI.org, Honey Leveen, the American Association for Long-Term Care Insurance, www.honeyleveen.com

Education creates longer lives and greater need for long-term care

August 18, 2012 by Honey Leave a Comment

A newly published study in the journal Health Affairs proves that the correlation between education and health and longevity are striking.

 “Education exerts its direct beneficial effects on health through the adoption of healthier lifestyles, better ability to cope with stress, and more effective management of chronic diseases. However, the indirect effects of education through access to more privileged social position, better-paying jobs, and higher income are also profound.”

According to the American Association for Long-Term Care Insurance, 2012 LTCi Sourcebook, page 3, in 2011, over 65% of all long-term care insurance new claims were for people over the age of 80!

The more affluent you are, the longer you’ll live. The longer you live, the higher the odds are that you’ll eventually need long-term care.

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: AALTCI.org, Health Affairs, Honey Leveen, the American Association for Long-Term Care Insurance, www.honeyleveen.com

Aging Boomers Face Home Health Care Shortage

August 8, 2012 by Honey Leave a Comment

We are entering a crisis involving a soaring demand for home health care workers, according to this article in the August 5, 2012 edition of Bloomberg/Businessweek News.

According to the article, the US Labor Department projects that there will be a need for 1.3 million more of these workers during the next decade.

Yet the article reports the average wage for these workers is $9.70/hour, which is 4 cents an hour less than the average fast food server makes. Medical insurance is typically not included.

Nearly half of today’s home health care workers live at or below poverty level. Many receive government benefits such as food stamps.

If this soaring demand for home health care cannot be met, OR if people cannot afford such care because they have avoiding long-term care planning and have not purchased reasonably-priced long-term care insurance, people will probably be forced to move in with relatives or enter nursing homes, which will cost taxpayers even more.

Filed Under: Helpful Information About LTC, I'll Just Self-Insure, Information About LTC Tagged With: Bloomberg News, Bloomberg/Businessweek News, Honey Leveen, John Seewer, US Labor Department, www.honeyleveen.com

Report on an Exciting Joint Pilot Program Launched in Texas

August 6, 2012 by Honey Leave a Comment

On July 20th and 21st I had the chance to participate in a very exciting pilot program supported by the 3in4 Association, the Texas Long-Term Care Partnership and the Texas Department of Health and Human Services.

I was one of ten Texas based LTCi specialists carefully vetted and trained to participate in this program by the 3in4 Association. Our mission was to educate Texans on the how and why of responsible long-term care planning. The seminars took place in Austin, San Antonio, Houston, and Dallas/Fort Worth. Our training involved not only learning how to teach the seminar, but also all aspects of our conduct.

The outreach consisted of 50,000 direct mail pieces to surrounding zip codes.  The invitations were great looking. Recipients could register for a seminar by simply scanning a QR code or going to a special site, http://www.3in4needmore.com/texas-ltc-seminars, to register.

Our team was ready and prepared to do what we excel at, which is teaching the public about the risks of needing long-term care, and how to prepare responsibly for such an event.

The goals of the 3in4 Association and the Texas LTC Partnership coincide. Both organizations seek to increase awareness about the need to plan for long-term care. The 3in4 Association has “feet on the ground” to carry this mission to the public, through education. The Texas LTC Partnership does not, yet they share our strong conviction about the need to convey this information to the public. The groups are perfect partners.

The first seminars took place in Austin, on July 18 and 19th. Although I only attended the Houston seminars, I am told that the Austin seminars were well attended, especially the kickoff seminar, given by Dr. Marion, the 3in4 Association’s spokesperson. Many of the senior staff of HHS attended and were able to see how organized, professional and effective we were.

The seminars were arranged to coincide with Dr. Marion’s 12 week, cross-country bus tour. While she was in Houston, Dr. Marion’s bus pulled up to the Oak Branch Public Library, the location for Houston’s seminars. It was very exciting for me to finally see the bus in person.

The bus was built in 1967 by Greyhound and is very large and impressive, a sight that you can’t miss. I’m told it averages 5-6 mpg, weighs 25,000 pounds and is converted inside to support the film crew and their editing needs. The bus serves as home base for Dr. Marion and her crew during their 12 week cross-country tour to promote the in4 Need More campaign, the public service message of the 3in4 Association.

I had time to visit with Dr. Marion while she was in Texas and I am convinced the 3in4 Association could never find a better spokesperson. She is warm, engaging, eloquent, and a true believer in our cause.

Here’s an example of some of the great press coverage Dr. Marion and the tour received while inTexas: http://www.youtube.com/watch?v=QJOrlSVxm5M&feature=plcp

We are not quite sure why we had paltry attendance at theHoustonpresentations. We have many theories. The location was convenient. The seminar itself is about 20 minutes long, with plenty of time afterwards for Q & A. It’s a fun seminar. The slides are concise; offer good content, and even contain humor.

Speaking on behalf of myself and my Houston teammates on this project, Grace Harrington, Mary Dillon, and Kevin Cain, we feel this project was a success, despite lackluster seminar attendance. Perhaps this is because we feel deep conviction about the need for reaching out to the public with this very important information.

Here are some comments from Jonas Roeser, President and Founder of the 3in4 Association, “None of the success we have had thus far would have happened without your support. The hard part is over! As a group we have earned the trust of Health and Human Services of Texas (HHST) through transparency and selfless acts.  We have built a unique program, marketed the program to the public and received national coverage for the effort.  The only thing that seems to be missing is the willingness for large numbers of the public to step inside for our education process. I have been informed by a number of you that daytime seminars are a bad idea, night is better.  Summer is tough compared to fall, do it when children are back in school, etc. Thank you for the feedback and for your willingness to continue to serve.

“Build it and They Will Come,” is a famous quote from the “Field of Dreams” movie.  In time, this program will scale and be worth the time of LTC specialists who support them and the consumers who attended them.”

I am hoping that this collaboration will be replicated over and over, not only in Texas, but in other states.

 

Filed Under: 3 in 4 Need More, Helpful Information About LTC, Information About LTC Tagged With: 3in4 Association, Honey Leveen, TX Department of Health and Human Services, TX Long-Term Care Partnership, www.3in4needmore.com, www.honeyleveen.com

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Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

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Honey Leveen, LUTCF, CLTC, LTCP
“The Queen, by Self-Proclamation, of Long-Term Care Insurance (LTCi)”
404 Royal Bonnet
Ft. Myers, FL 33908

Phone: 713-988-4671
Fax: 281-829-7177

Email: honey@honeyleveen.com

Email: honey@honeyleveen.com

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