Horrible Story Illustrating Why Medical Insurance and Medicare Supplements Don’t Pay For LTC

I just came across an all-too-common, tragic story titled “Insurance abruptly stops covering Spokane man’s long-term care.”

This article came through my Google alerts, which are set for “long-term care insurance.” The title instantly caught my attention because I thought this might be bad press about long-term care insurance (LTCi). It wasn’t.

It turns out that this is a horrible story about what can happen without long-term care insurance.

In the over 23 years I’ve been selling LTCi I have never seen a LTCi policy not pay a legitimate claim. LTCi would certainly pay for the care described in this situation.

What this story illustrates so well is that Medicare and medical insurance cannot, will not, do not pay for long-term care. The story is about an innocent man named Doug who had a horrible motorcycle accident and suffered brain damage. His condition will not improve (that’s part of what’s causing the crisis). He needs constant skilled care. Medical insurance and Medicare do no not cover long-term care when there is no possibility of improvement. The best medical insurance and Medicare supplements only cover the type of care Doug needs for limited lengths of time.

In this horrible situation, the nursing home wants to kick him out. “The nursing home called me at 6:30 in the morning on the 11th, saying I had until the 15th to get him moved,” claimed Mrs. Barr (Doug’s wife).

Premera Blue Cross told her Doug’s condition “…wasn’t showing significant progress.”

She said that if she cannot find another solution, her only remaining option is putting Doug on Medicaid. Yet, her lawyer told her that once Doug is on Medicaid then she loses all of his social security, retirement, and life insurance.

In desperation, Mrs. Barr said, Doug even asked the people at the dialysis clinic to help him die.